Azoospermia (no sperm)

  • What are the signs and symptoms of azoospermia?

Azoospermia (no sperm) does not generally have any specific symptoms that would alert you to this issue. You may still ejaculate a whitish fluid but you would not know that there are no sperm present. It may be associated with small testicles, low sex drive and difficulty maintaining erections. However, commonly there are no warning signs and the first time this problem is noted is with difficulties trying to conceive. 

  • How is it diagnosed?

The only way to diagnose this condition is to produce an ejaculated fresh sample for formal analysis. If no sperm are found in the ejaculate then the next steps will be to meet with a fertility expert. A fertility consultant will need to examine the testicles to check their size and to see if the pipework (vas deferens) connecting the testicles to the penis are present.

The fertility expert will also want to check the male hormone profile to ensure the testicles are working properly. There are a number of genetic causes for azoospermia. In general the vast majority of men with no sperm in the ejaculate are not carrying a genetic condition. Blood tests can quickly exclude a genetic cause for azoospermia.

There are several explanations for finding no sperm in the ejaculate but there could be a blockage in the pipes connecting to the testicles. Some people are born without this important connecting pipe (vas deferens) between the testicle and the urethra and therefore are producing sperm in the testicles but don’t release it successfully in the ejaculate. This problem is known as obstructive azoospermia and is not easily correctable.

Alternatively no sperm in the ejaculate can be due to a failure of the testicular tissue itself to produce sperm. If this is the case then there are very few treatment options to boost sperm production and an expert opinion is essential.

  • How is it treated?

There may not be a treatment option available if the testicles have stopped producing sperm altogether (Testicular failure). However, if the hormone results confirm that the testicles are producing sperm then the next steps would be to undergo a surgical procedure to take sperm directly from the testicles and bypass the blockage. This is called a Surgical Sperm Recovery and involves placing a needle directly into the testicle while you are asleep to biopsy the sperm producing tubules in the testicle itself. It is normally performed under light sedation and can be done in most fertility clinics.