Azoospermia

 is the medical condition of a man whose semen contains no sperm.  It is associated with infertility, but many forms are amenable to natural treatment. In humans, it affects about 1% of the male population and may be seen in up to 20% of male infertility situations.

It can be classified into three major types as listed. Many conditions listed may also cause various degrees of oligospermia rather than azoospermia.

PRE-TESTICULAR

Pre-testicular azoospermia is characterized by inadequate stimulation of otherwise normal testicles and genital tract. Typically, follicle-stimulating hormone (FSH) levels are low (hypogonadotropic) commensurate with inadequate stimulation of the testes to produce sperm. Examples include hypopituitarism (for various causes), hyperprolactinemia, and exogenous FSH suppression by testosterone.  Pre-testicular azoospermia is seen in about 2% of azoospermia. Pre-testicular azoospermia is a kind of non-obstructive one.

Causes of pre-testicular azoospermia

High fever – causing temporary lack of sperm
Undescended testicle
Testicle conditions
Obstructions of seminal passages
Testicle infection
Certain hormonal disorders
Sperm duct blockage

TESTICULAR

In this situation the testes are abnormal, atrophic, or absent, and sperm production severely disturbed to absent. FSH levels tend to be elevated (hypergonadotropic) as the feedback loop is interrupted (lack of feedback inhibition on FSH). The condition is seen in 49–93% of men with azoospermia.

Testicular failure includes absence of failure production as well as low production and maturation arrest during the process of spermatogenesis.

Causes for testicular failure include congenital issues such as in certain genetic conditions (e.g. Klinefelter syndrome), some cases of cryptorchidism or Sertoli cell-only syndrome as well as acquired conditions by infection (orchitis), surgery (trauma, cancer), radiation, or other causes. Mast cells releasing inflammatory mediators appear to directly suppress sperm motility in a potentially reversible manner, and may be a common pathophysiological mechanism for many causes leading to inflammation.Testicular azoospermia is a kind of non-obstructive one.

Causes of Testicular Failure:

• Genetic conditions
• Infection due to STD’s or surgery
• Surgery/trauma (vasectomy, cancer, radiation, chemotherapy)

POST-TESTICULAR

In post testicular azoospermia sperm are produced but not ejaculated, a condition that affects 7–51% of azoospermic men.The main cause is a physical obstruction (obstructive azoospermia) of the post testicular genital tracts. The most common reason is a vasectomy done to induce contraceptive sterility. Other obstructions can be congenital (example agenesis of the vas deferens as seen in certain cases of cystic fibrosis) or acquired, such as ejaculatory duct obstruction for instance by infection.

Ejaculatory disorders include retrograde ejaculation and an ejaculation; in these conditions sperm are produced but not expelled.

Causes of post-testicular azoospermia:

Acquired from infection due to vasectomy, or other injury to the male reproductive tract.

UNKNOWN

Idiopathic azoospermia is where there is no known cause of the condition. It may be a result of multiple risk factors, such as age and weight.