Azoospermia: Types, Causes, Symptoms and More

The condition where there is zero sperm count during ejaculation of semen is known as Azoospermia. Male factor infertility accounts for a significant portion of Infertility in couples. Among those, 10-15% of Infertility in males is caused due to Azoospermia.

What is Azoospermia?

Azoospermia is a medical condition that causes the male infertile problem of having zero sperm count in the semen.

Usually, Sperm produced by testicles travels through the reproductive system to mix with semen. But if you are affected by Azoospermia, there will be semen released during ejaculation without any sperm. 

Types Of Azoospermia

Azoospermia is categorized into two different types

1. obstructive azoospermia 
2. non-obstructive azoospermia

1. Obstructive Azoospermia

Obstructive azoospermia is a condition where sperm production in the testicles is good but cannot travel through the reproductive parts of the body due to blockages that prevent sperm from mixing with semen. 

Causes that can lead to blockages include

• Absence of the vas deferens (A tube that carries sperm out of the testicles)
• previous surgeries in the reproductive area
• Injury or trauma in the testicles
• Vasectomy
• Inflammation
• Sexually transmitted infections (STIs)

2. Non-obstructive Azoospermia

In non-obstructive azoospermia, the testicles either don’t produce any sperm at all or make so little of it that it isn’t visible in the ejaculate. 

Causes of non-obstructive azoospermia

• genetic factors such as Klinefelter syndrome
• hormonal imbalances like low testosterone and androgen
• Spending time in heat often
• Regular alcohol or drug Consumption
• varicocele
• testicular damage due to trauma
• chemotherapy or radiation therapy

Symptoms of Azoospermia

There are no symptoms you could notice for Azoospermia until your effort to make your partner conceive fails. You may see some hormonal abnormalities such as decreased libido, breast enlargement (gynecomastia), or reduced face or body hair.

Diagnosis of azoospermia

A sexologist or urology doctor will diagnose azoospermia by discussing genetics, injuries to your pelvic region, Sexually transmitted disease(STD), Infections, and previous surgeries to the pelvic area. The below-mentioned tests are done. 

Semen Analysis

Semen analysis tests will help to identify doctors the presence of sperm in the semen. Analyses of several samples may be necessary to verify azoospermia.

Hormonal Testing

Hormone levels such as those of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone are measured to assess the function of the testicles. Primary testicular failure may be indicated by low testosterone and elevated FSH levels.

Genetic Testing

Genetic testing helps look for Klinefelter syndrome and Y-chromosome microdeletions, two genetic conditions that may affect sperm production.

Imaging Studies

MRI or ultrasound scan is used in imaging studies to evaluate the anatomy of the male reproductive system and identify congenital disabilities, obstructions, and anomalies of the testicles.

Treatment Options For Azoospermia

Surgical Correction

Surgical techniques like vasectomy reversal to reopen the vas deferens or epididymal reconstruction to remove blockages and restore sperm flow are used to treat obstructive azoospermia.

Hormonal Therapy

In cases of hormonal imbalance affecting sperm production, hormone replacement therapy or medications like clomiphene citrate or gonadotropins are done to stimulate sperm production.

Assisted Reproductive Techniques (ART)

Methods like microsurgical sperm retrieval (MESA) and testicular sperm extraction (TESE) for non-obstructive azoospermia are used to extract sperm from testicles. To become pregnant by Assisted reproductive techniques (ART), the recovered sperm may be used with intracytoplasmic sperm injection (ICSI) or in vitro fertilization (IVF).

Lifestyle Factors and Management

A healthy lifestyle can significantly influence sperm production and overall fertility. Here are four key recommendations for managing lifestyle factors to improve fertility

Maintain a Healthy Weight

Obesity and being underweight can disrupt hormone levels and impair sperm production. Achieving and maintaining a healthy weight through balanced nutrition and regular exercise is crucial.

Avoid Excessive Heat

Extended exposure to high temperatures, as those seen in saunas or hot tubs, can raise the scrotal temperature and reduce the ability of sperm to increase. Sperm health can be preserved by avoiding activities that result in excessive heat exposure and by wearing loose-fitting underpants.

Avoid Smoking and Excessive Alcohol

Both heavy alcohol use and tobacco smoke can have a harmful effect on sperm quality and fertility. Reproductive health can be enhanced by cutting back on alcohol consumption and quitting smoking.

Manage Stress

Prolonged stress can alter sperm production and upset the balance of hormones. Using stress-reduction methods like yoga, meditation, or therapy can improve the quality of reproductive outcomes.

Conclusion

Azoospermia is a complex condition for those who want to make their partner conceive, as there are no symptoms we could find other than failure in attempts to conceive. Men who face azoospermia should visit a sexologist or urology doctor to identify the type of azoospermia they have and treatment options to avoid the emotions of having no sperm in the semen. 

FAQs

+ What does azoospermia look like?

Azoospermia is characterized by the absence of sperm in the ejaculate, which can only be confirmed through semen analysis. Visually, there are no specific signs, as men may experience normal semen volume without sperm presence. It often goes unnoticed until couples face difficulties conceiving.

+ How do you know if you have azoospermia?

To determine if you have azoospermia, a semen analysis is required. This involves providing a sample that is examined under a microscope. If no sperm is found in two separate tests, azoospermia is diagnosed. Additional tests may follow to identify underlying causes, such as hormonal imbalances or genetic issues.

+ How many sperm count in precum?

Precum, or pre-ejaculatory fluid, typically contains very few sperm, if any. While it can occasionally carry sperm from previous ejaculations, the sperm count in precum is generally low, making it an unreliable source for conception. Most studies suggest that it is not a significant contributor to fertility.

+ What are the causes of non obstructive azoospermia?

Non-obstructive azoospermia can result from various factors, including hormonal imbalances, genetic disorders, testicular injuries, and conditions like varicocele. These issues affect sperm production rather than obstructing sperm transport. Identifying the specific cause often requires further medical evaluation and testing.