Azoospermia is the condition of a man whose semen contains no sperm. It is associated with infertility.

There aren’t really any symptoms that you’d notice, but if you’ve been trying to get your partner pregnant without success, this condition could be the cause.

You might have a problem that keeps your testicles from making sperm or that stops sperm from getting out of your body.

THERE ARE THREE MAIN TYPES OF AZOOSPERMIA:

Pretesticular azoospermia: Your testicles are normal, but your body can’t get them to make sperm. It might happen because of low hormone levels or after you’ve had chemotherapy. This type is pretty rare.

Testicular azoospermia: Damage to your testicles keeps them from making sperm normally. It can happen because of:

• An infection in your reproductive tract, such as epididymitis and urethritis
• A childhood illness such as viral orchitis, which causes swelling of one or both testicles
• A groin injury
• Cancer or its treatments, like radiation
• Genetic conditions, such as Klinefelter’s syndrome

Post-testicular: Your testicles make normal sperm, but something keeps them from getting out, like:

• A blockage in the tubes that carry sperm from your testicles to your penis. This is called obstructive azoospermia.
• A vasectomy
• Retrograde ejaculation, when semen goes into your bladder instead of out of your penis during an orgasm

About 40% of men have the post-testicular type.

AZOOSPERMIA CAN BE DIVIDED INTO TWO BROAD CATEGORIES

Not all cases of male infertility are the same or should be treated in the same way.

Obstructive Azoospermia (OA): OA means that sperm are being produced normally inside the testicle, but there is a blockage or obstruction in the reproductive tubing that is preventing the sperm from flowing to the outside world.

Non-Obstructive Azoospermia (NOA): NOA means that the tubes are open, but there is a sperm production problem where either no sperm are produced at all or there is a very low level of sperm production.

CAUSES OF OBSTRUCTIVE AZOOSPERMIA CAN BE GENETIC, CONGENITAL, OR ACQUIRED.

Vasectomy: The most common cause of obstructive azoospermia, this surgical procedure interrupts the sperm ducts to stop the flow of sperm. 

 Infection: Obstructive azoospermia can also be caused by infections of the testicles, prostate, or reproductive tract such as epididymitis/orchitis, prostatitis, and venereal diseases such as Chlamydia. These can cause a blockage in the small tubules of the epididymis or the ejaculatory duct.

Congenital Conditions: Some men are born missing a portion of the vas deferens that is essentially a genetic situation similar to a vasectomy. Other men are born with a cyst in the prostate that blocks the ejaculatory ducts.

Surgical Complications: Surgical procedures performed on the urogenital organs or hernia repair can result in scarring that leads to a blockage. This is more common in pediatric patients because the reproductive tract is so small in children.

CAUSES OF NON-OBSTRUCTIVE AZOOSPERMIA

Varicocele: This reversible cause of NOA is characterized by varicose veins around the testicle. This condition is the most common cause of male infertility and is easily fixable. Most varicoceles only cause a minor lowering of sperm count but in some cases the varicocele results in azoospermia.

Hypospermatogenesis: This means that there is sperm production within the testicle but just at lower amounts than normal, and what would be required to see sperm on a routine semen analysis. This is the most common finding on biopsy.

Prescription Drugs: Among the biggest drug-related causes of NOA are testosterone and other anabolic steroids. These can cause sterilization and are a very common and usually reversible cause of azoospermia.

Testicular Cancer: Sometimes the first sign of testicular cancer or other tumors of the reproductive system is azoospermia or a very low sperm count. This is one of the most important reasons why a male reproductive specialist must examine someone with an abnormal sperm count. By detecting the tumor early, it could save a patient’s life.