Definition

azoospermiaAzoospermia is a medical condition in males that is characterized by the absence of sperm in the ejaculate or semen. This is a major cause of male subfertility – a condition in which a man is unable to impregnate a woman after one year of regular unprotected sex, which means that the couple has had sex without the use of birth control methods such as pills, condoms, diaphragms or the rhythm method. Azoospermia occurs in 15-20% of men who undergo evaluation for infertility and register very low levels of fertility.Most of these men would appear very healthy without showing any indications that a fertility problem may exist.

There are two forms of azoospermia: Obstructive Azoospermia and Non-Obstructive Azoospermia.

Obstructive Azoospermia

This is a condition in which sperm are created normally but are blocked from reaching and mixing with the rest of the ejaculatory fluid due to a physical obstruction. This blockage may be due to a prior infection, prostatic cysts, surgery, injury or congenital absence of the vas deferens or CAVD.

Non-Obstructive Azoospermia

In this condition, there is an inadequate production of sperm due to a problem with spermatogenesis. In such cases, it is assumed that an obstruction does not exist but that the sperm production levels are abnormal and thereby insufficient to get into the ejaculate.

Azoospermia may be further classified as follows:

  1. Pre-testicular – Abnormal Hypothalamo-Pituitary-Gonadal hormonal axis
  2. Testicular – Secondary to abnormal testicular function
  3. Post-testicular – Obstruction or ejaculatory dysfunction.

Although physiologically correct, this classification is not always practical for making decisions on the type of treatment to use. On the other hand, the division of azoospermia into obstructive and non-obstructive categories allows the physician to better determine the specific treatment options available to a particular patient. This is also critically important seeing as patients with non-obstructive azoospermia typically have different genetic problems.

Possible symptoms of azoospermia:

  • Inability to impregnate your partner
  • Cleary, watery or whitish discharge emanating from the penis
  • Increased body hair, body fat and breast tissue
  • Presence of a swelling or a mass on the scrotum which feels like a bag of worms (possible indicator of varicocele)
  • Emotional pressure or stress arising from the inability to conceive
  • Small, soft or non-palpable testicle that cannot be felt
  • Veins that are twisted, enlarged and may be visible in the scrotum (possible indicator of varicocele)