Azoospermia (No sperm in semen): Causes, Symptoms, Diagnosis & Treatment @ Dr Shah Dupesh

Azoospermia affects an estimated 1% of all men. A man is said to suffer from Azoospermia, if his semen sample shows no sperm in the ejaculate. A minimum of 2 reports must confirm no sperm seen in the semen. If 100 men visit a male infertility clinic for azoospermia, then an estimated 10% of them will have 'no sperm seen'.

The symptoms of azoospermia include, low hair growth in the beard or mustache, poor male patter of body hair distribution along with small penis size, very small soft testis and history of infertility for more than 1 year. In some men, the testis will be 'peanut size' and very small. In these men a genetic condition called 'Klinefelter's syndrome' should be ruled out.

Azoospermia is of 3 types. They are namely
1. Obstructive Azoospermia, 2. Non-obstructive Azoospermia and largely 3. Borderline Azoospermia.

Obstructive Azoospermia is caused by an obstruction in the male reproductive tract, where in spermatozoa cannot come out due to blocks. However, the good thing is that there is a 100 percent chance of sperm retrieval in men with obstructive azoospermia.

Coming to non obstructive azoospermia, the reason sperm are not seen semen is because, the testis does not respond the sperm production hormones produced by the brain. The testis is usually dysfunctional by nature. Numerous gene related defects can lead to non obstructive azoospermia. Their is a 35% chance of sperm retrieval in patients with non-obstructive azoospermia. In some patients, FSH, LH and testosterone will be low a condition called as hypogonadotrophic hypogonadism. Here medical treatment with FSH and LH injections work to bring back sperm production into the ejaculate.

Lastly patients with borderline azoospermia, have either maturation arrest (where sperms are arrested at some previous stage of development) or patients have hypo-spermatogenesis. Either way, the patients have normal hormones. Yet, no sperms will come into the ejaculate. Once again sperm retrieval can be done, however in some instances treatments with medications can help increase sperm retrieval rate.

Azoospermia treatment however, depends on the cause of azoospermia. Medical treatment works depending on the patients individual disease state. The success of medical treatment for azoospermia is about 35 to 40 percent. However, a variety of sperm retrieval techniques do exist for the management of azoospermia.

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