Azoospermia is the total absence of spermatozoa in the semen. The quality of the semen (morphology and motility) plays a determining role in fertilisation. Asthenozoospermia refers to the presence of sperm, but with reduced motility.
Both are male fertility problems, but azoospermia is more serious, because without sperm there is no possibility of natural fertilisation.
It is important not to confuse azoospermia with aspermia, which is the complete absence of ejaculation.
Azoospermia usually has no obvious symptoms beyond male infertility. Some men may experience other related symptoms, as erectile disfunction or low sexual drive, depending on the underlying cause.
Being diagnosed with azoospermia can be a setback to men, especially those who want to have children. The good news is that, in many cases, men with azoospermia can become fathers, depending on the type of azoospermia they have and the treatment they follow.
Azoospermia can have different causes that affect sperm production or sperm transport. These are some of them:
There are two main types of azoospermia, depending on their origin:
In obstructive azoospermia, the testicles produce sperm, but a blockage in the ducts prevents them from reaching the semen. It can be caused by infections, injuries or surgical procedures such as vasectomy.
Secretory azoospermia is due to a problem in the testicles that prevents the production of sperm. Causes may include genetic problems, hormonal imbalances or testicular damage.
This type of azoospermia is caused by this procedure in which the vas deferens is intentionally blocked to prevent the passage of sperm.
A diagnosis of azoospermia is usually made after trying unsuccessfully to conceive for a prolonged period of time. The first test performed is a seminogram, a semen analysis that evaluated both the quantity and the quality of the sperm present in the sample.
If the result shows a total absence of sperm, the next step will be to identity whether the azoospermia is obstructive or secretory, which may involve additional tests such as hormone analysis or testicular biopsies.
Depending on the type of azoospermia, there are several treatment options and assisted reproduction techniques that may allow having biological children.
In cases of obstructive azoospermia, direct sperm retrieval from the testicle may make in vitro fertilisation (IVF) possible. Surgery to remove the blockage may also be considered, but in a smaller number of cases. In cases of secretory azoospermia, the possibility of finding viable sperm in the testicles by biopsy is crucial in deciding the next step.
In obstructive azoospermia, the solution usually involves direct removal of sperm from the testicle, or in individual cases, surgical correction of the blockage.
In contrast, in secretory azoospermia, the treatment is more complex and may include hormonal therapy if the problem is due to an endocrine imbalance. If sperm cannot be retrieved naturally, sperm donation may be considered for treatment.
Testicular biopsy or TESA (testicular sperm aspiration) can be used to retrieve sperm directly from the testicles. If viable sperm are found, they can be used in an in vitro fertilisation (IVF) treatment to achieve pregnancy and maintain the male's genetic load.
Rather than preventing azoospermia, a number of precautions can be taken to minimise the impact of behaviours that can often lead to azoospermia. In this sense, avoiding the consumption of harmful substances such as drugs, alcohol or tobacco, or controlling exposure to toxins and high external temperatures can help prevent the onset of azoospermia.
It is also important to take care of hormonal health, avoiding testosterone deficiency or imbalances in other reproductive hormones and, of course, to have regular medical check-ups to detect health problems, such as variocele or reproductive tract infections.
While this does not guarantee that azoospermia will be prevented outright, it can help to control it and even prevent it from affecting men's reproductive health.
When sperm recovery has been attempted but has not been successful, there is the possibility of using sperm donation to carry out assisted reproduction treatment.
There are sperm banks that store genetic material donated altruistically and anonymously by other men, making it possible to achieve pregnancy. The selection of these donors is always carried out according to phenotypic criteria and offers great security for the pregnant woman, as it is subject to many quality controls.
Dr. José Manuel Gómez Santana, Medical Director of IVF-Life Alicante and expert in Reproductive Medicine.
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IVF-LIFE, hereby informs you of its privacy policy applied to personal data. The use of the website does not imply that the user must provide any information regarding their identity, and cannot be associated with a specific user by the company. In the event that personal data is provided, this data will be collected and used in accordance with the limitations and rights set out in the aforementioned regulation.
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DATA CONTROLLER: IVF SPAIN ALICANTE S.L.U (hereinafter IVF-Life)
CIF: B-54973227
Postal Address: Avenida de Ansaldo, no. 13, 03540, Alicante (Alicante)
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CIF: B95575874
Postal Address: Avenida de Tolosa, 71-73, 20018 Donostia / San Sebastián (Spain)
Contact with the Data Protection Officer: dpo@ivf-life-group.com
DATA CONTROLLER: IVF Spain Madrid (hereinafter IVF-Life)
CIF: B 85138113
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- Companies of the "IVF LIFE Group" on the legal basis of consent or legitimate interest: Instituto Vasco de Fertilidad S.L.U., with NIF B95575874 and address at Avda Tolosa, 71-73 Donostia (Gipuzkoa), and IVF Spain Madrid S.L., with NIF B85138113 and address at Calle Manuel de Falla, 6-8, 28036 Madrid.
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