Azoospermia: what it is, types, causes and treatment

Azoospermia is the complete absence of sperm in the semen and is one of the leading causes of infertility in men. This condition can occur due to obstruction in the area through which sperm should pass, infections or as a result of a blow to the testicles, for example.

Although azoospermia is one of the leading causes of infertility in men, other problems can prevent a man from getting his partner pregnant, such as infections or hormonal changes. Learn about the leading causes of infertility in men and how to treat them.

Azoospermia treatment according to the cause, and surgery is usually indicated, especially when there is an obstruction in the vas deferens. By unblocking the passage, it is possible to restore the man’s reproductive capacity. However, it is essential to perform a sperm analysis to assess the characteristics of the sperm and ensure their viability.

Main causes of azoospermia

Azoospermia is caused by any condition that affects the production, storage or transport of sperm to the urethra. Therefore, the leading causes include:

• Injuries to the testicles or epididymis caused by blows;
• Infections in the male reproductive system;
• Presence of tumour in the testicle;
• Side effects of some chemotherapy medication;
• Cryptorchidism, which is a situation in which the testicles do not descend into the scrotum;
• Varicocele;
• Recent surgery in the pelvic region;

Infections in the genital region.

Furthermore, the presence of genetic alterations can also cause difficulty in sperm production, ultimately causing azoospermia from birth.

Make an appointment with your nearest urologist using the tool below to investigate the cause of your azoospermia:

Types of azoospermia

Azoospermia can be classified into two main types according to the probable cause, which are:

1. Obstructive azoospermia:  there is obstruction in the place where the sperm should pass, which may be due to changes in the vas deferens, in the epididymis or due to vasectomy surgery, for example,
2. Non-obstructive azoospermia:  characterized by a lack of sperm production, which may be a consequence of a congenital disease or due to blows to the testicles.
3. The urologist identifies the type of azoospermia through imaging tests, such as abdominal and testicular ultrasounds and laboratory tests.

Is there a treatment for azoospermia?

Curing azoospermia is a source of concern for many men who suffer from the disease. There are doubts, and many patients are unaware of the treatment options. Furthermore, the available treatment methods are often unknown, causing apprehension among patients. Fortunately, with the advancement of medicine, the possibility of reversing the disease is considerable. The main objective of treating azoospermia is to restore the patient’s ability to conceive.

Azoospermia is curable, but treatment success varies from patient to patient.

Azoospermia is divided into two types: obstructive and non-obstructive azoospermia. In the first type, the seminal ducts become obstructed, preventing the passage of sperm into the semen and, consequently, preventing the fertilization of the mature egg. In non-obstructive azoospermia, the patient does not have sperm in the ejaculate due to causes such as congenital disabilities in the testicles or trauma involving the male reproductive system.

Cure of non-obstructive azoospermia

Not long ago, azoospermia was known as an incurable disease with no viable treatments for the patient. The valid options for the couple to become pregnant would be to use donor sperm for IVF in Pakistan or adoption.

With the evolution of medicine, patients with non-obstructive azoospermia were observed to present sperm in testicular biopsies frequently. Thus, it was understood that patients with non-obstructive azoospermia also produced sperm (in smaller quantities), bringing a new understanding of the case to medicine.

One of the most appropriate procedures for patients with non-obstructive azoospermia is intracytoplasmic sperm injection (ICSI). It is an assisted human reproduction technique performed through in vitro fertilization.

Microsurgical testicular dissection for sperm collection – (Micro TESE) can offer better results to the patient than a standard biopsy performed without the aid of a microscope. It provides a greater chance of finding sperm, focusing on the sites with the most excellent chance of collection, ensuring a higher success rate.

In some cases of hypogonadotropic hypogonadism, clinical treatment may be a considerable option. Through careful evaluation, treatment can be successful.