Azoospermia | Semen with no sperm

What is Azoospermia?

Azoospermia is the absence of sperm in the semen and often leads to male infertility. It can be due to several factors such as a blockage somewhere in the reproductive system, problems with hormones or ejaculation or structural or functional deformities in the testes.

However, it’s not all gloomy, many causative factors can be treated, and there is hope for conception. For causes that are not treatable, it could be possible to get live sperm for use in reproductive methods such as IVF.

Couples must begin to take measures if they have been trying for over a year without conceiving even once.

Is Azoospermia a common condition?

Studies say that almost 1% of all males suffer from it. Whereas, about 10% to 15% of men with infertility have the condition.

How does Azoospermia occur?

Azoospermia is caused by factors that are directly related to its types. The causes can be because of obstructive or nonobstructive reasons.

The vas deferens, epididymis, or ejaculatory ducts are the common regions where obstructions that cause azoospermia to prevail. Here’s a list of reasons why these may occur:

Trauma or injury may cause Azoospermia
Infections can lead to Azoospermia
Inflammation causes Azoospermia
History of surgery in the pelvic area can cause Azoospermia
The occurrence of a cyst may cause Azoospermia
Vasectomy also causes Azoospermia
Cystic fibrosis gene mutation, a condition that causes developmental abnormalities in the vas deferens leading to blockage of the semen

Nonobstructive reasons for the occurrence of azoospermia include:

Genetic causes. Few genetic mutations can be responsible for infertility, including:
Kallmann syndrome
Klinefelter’s syndrome
Y chromosome deletion
Endocrine disorders, including hypogonadotropic hypogonadism, hyperprolactinemia and androgen resistance.
Issues with ejaculation like retrograde ejaculation where the semen enters the bladder.

Testicular reasons for Azoospermia include:

Absence of the testicles
Testicles not dropping into the scrotum
Testicles that do not produce living sperm cells
Testicles that do not create fully mature sperm cells
Inflamed testicles due to mumps in late puberty
Testicular torsion
Tumours
Adverse reactions to medications that harm sperm production.
Radiation treatments
Diabetes, cirrhosis, or kidney failure.
Varicocele

Symptoms of Azoospermia

To understand the condition better, it is essential to know the reproductive system in men. It consists of:

The testes that produce sperm
Seminiferous tubules are like small tubes that form a majority of the tissue portion of the testicles.
The epididymis is situated on the posterior part of the testicles in which developed sperm move and remain.
Vas deferens is a thick tube that goes from the epididymis to the pelvis then goes around and into the seminal vesicle.
The seminal vesicle secretes and keeps most of the liquid portion of semen. It narrows to create the seminal duct, that connects to the thick vas deferens
The ejaculatory duct is formed as the seminal vesicle duct connects to the tube. It meets the prostate and joins the urethra.

The urethra is a tube that travels to the penis to remove urine from the urinary bladder and ejaculate from the vas deferens.

At the time of ejaculation, sperm travel to reach the vas deferens from the testicles. Contraction or tightening of the tube helps the sperm move freely. The seminal vesicles release their secretions, and the fluid then goes to the urethra. Before this, the fluid comes across the prostate, that adds a fluid which is milky to the mixture to produce semen. Finally, the ejaculate or semen is released into the penis from the tubular urethra.

A count of 15 million/mL or higher sperm is deemed normal. Men with sperm counts below 15 million/mL are said to have oligozoospermia. If you’re suffering from azoospermia, your sperm count is not measurable.

Symptoms of azoospermia could be the following:

Issues with sexual function such as a diminished sex drive or problems getting and maintaining an erection.
Ache or inflammation in the testicle area.
A huge decrease in hair growth be it the face or the rest of the body.

Signs of a hormonal abnormality.

Major Types of Azoospermia

The three major kinds of azoospermia can be attributed to their causative factors. These include:

1) A number of pre-testicular factors that lead to low secretion of sex hormones which stops the testicle from creating sperm. It can be caused due to any of the following:

Kallmann Syndrome
Conditions affecting the endocrine glands, which can occur due to radiation or some medications.

2) Testicular factors which are deformities in the formation or functionality of the testes. The causes of these are mentioned above.

3) A range of post-testicular reasons can also be responsible: Ejaculation issues that stop the sperm from staying in the seminal fluid. This happens in over 40% of men with the condition. The reasons for it could be:

An absent joint in the epididymis, vas deferens, or in another area of the system
A genetic deformity that causes the vasa deferentia to be absent since birth
Infections
Occurrence of cysts
Injuries
Surgical procedures like vasectomies

How to prevent Azoospermia?

While genetic conditions can’t be prevented, you can try to prevent the condition from occurring in their absence by giving up on bad lifestyle habits. These include:

Quitting tobacco can prevent Azoospermia
Regulating alcohol intake can avoid Azoospermia
Maintaining a good weight can resolve Azoospermia
Limiting exposure to toxins can prevent Azoospermia
Eating healthy foods to increase your sperm count can cure Azoospermia
Practicing good sleep hygiene can resolve Azoospermia
Practicing Yoga to increase sperm count can cure Azoospermia

FAQs on Azoospermia

Can azoospermia be cured?

Yes, many cases of obstructive azoospermia can be treated by corrective surgeries or hormonal therapy. Using techniques such as IVF for conception is also recommended.

Can azoospermia be temporary?

Yes, certain diseases and exposure can cause temporary azoospermia.

Chances of pregnancy with azoospermia?

There is a chance of conceiving even if your azoospermia is caused by genetic factors. This can happen either naturally or by assisted techniques.

Difference between oligospermia and azoospermia?

While azoospermia indicates the absence of sperm in the semen, oligospermia is simply the presence of less than 5 million/mL sperm in the ejaculate.