Azoospermia is a medical condition where there is zero sperm in the male ejaculate. This condition can be obstructive or non-obstructive. While obstructive azoospermia refers to a blockage or disconnect that prevents sperm from entering the ejaculate, non-obstructive azoospermia refers to a condition that impairs sperm production in the testis.

What is azoospermia?

Azoospermia is a medical condition in which there is zero sperm in the male ejaculate. Two types of azoospermia exist: obstructive and nonobstructive. With obstructive azoospermia, there is a blockage along the reproductive tract which prevents the sperm from entering the ejaculate. Nonobstructive azoospermia, by contrast, may be caused by a hormone imbalance or other issue.

Azoospermia in male fertility

Azoospermia has a significant impact on male fertility;10% of infertile males experience this condition. (About 1% of all people with testes have azoospermia.) Azoospermia will lead to issues conceiving, as there is an absence of sperm in the ejaculate, and sperm is required to fertilize an egg. However, treatments do exist for this condition that can restore  fertility, including surgery to undo the blockage or medication.

Causes of azoospermia

The most common cause of azoospermia is an obstruction in the vas deferens, ejaculatory duct, or epididymis. Infections, inflammations, trauma to the area, or a development of a cyst can all cause obstructive azoospermia. Azoospermia can also be caused by congenital absence of the vas deferens (CAVD), the tubes that carry sperm from the testicles to the penis. Nonobstructive azoospermia, on the other hand, can be caused by genetic disorders, such as Kallmann syndrome,Klinefelter’s syndrome, or Y-chromosome deletion. In some cases, azoospermia can be caused by a lack of development of the testes as a fetus or environmental factors. 

Treatment of azoospermia

Treatment of azoospermia will depend on whether it is obstructive or nonobstructive. With obstructive azoospermia, treatment is typically a surgery to unblock or reconstruct the ejaculatory duct. As nonobstructive azoospermia can be caused by a myriad of factors, the first step is diagnosing the problem. Hormone medications can be given to patients with low sperm production, including follicle-stimulating hormone (FSH) and human chorionic gonadotropin (HCG).