What Are the Causes of Azoospermia?

Azoospermia is the absence of sperm cells in the semen in men and leads to infertility. The causes of azoospermia can be listed as follows:

1. Obstructive azoospermia: This is the condition where sperm cannot be released due to a blockage in the reproductive tract. The factors causing the obstruction include:

1. Congenital absence or obstruction of the vas deferens
2. nfections (e.g., prostatitis, epididymitis)
3. Injuries occurring after scrotal or inguinal surgery
4. Cysts, stones, or tumors

2. Non-obstructive azoospermia: Insufficient or absent sperm production

It refers to the absence of sperm production. The main causes of this condition are as follows:

1. Genetic factors (e.g., Klinefelter syndrome, Y chromosome microdeletions)
2. Hormonal disorders (e.g., hypogonadism, hypothyroidism)
3. Underdevelopment of the testes
4. Varicocele (enlargement of the veins in the testes)
5. Exposure to radiation, chemotherapy, or other toxic substances
6. Medication use (e.g., testosterone-based drugs, anabolic steroids)
7. Chronic diseases (e.g., kidney failure, liver diseases)

Azospermia Symptoms

Azospermia symptoms are usually not observed through direct symptoms, but certain clues and signs may suggest the condition. The symptoms of azospermia include:

Infertility: The most obvious symptom of azoospermia is the inability to achieve pregnancy despite regular, unprotected intercourse with a partner. If pregnancy does not occur after one year of regular intercourse, it is important to consult a specialist for evaluation.

Sexual dysfunction: Problems with erection or ejaculation may be considered among the possible causes related to azoospermia.

Signs of hormonal imbalance: Weight gain, lack of energy, loss of libido, depression, and anxiety may be observed in men with azoospermia and can indicate hormonal imbalances.

Pain, swelling, or tenderness in the testicles: Conditions such as varicocele, infection, or tumors in the testicles can lead to azoospermia and may present with pain, swelling, or tenderness.

Physical changes such as decreased body hair or breast enlargement: In cases of azoospermia related to hormonal imbalances or genetic causes, physical changes such as reduced body hair or breast enlargement (gynecomastia) may be observed.

How is Azoospermia Treated?

Azoospermia treatment varies depending on the cause and severity of the condition. There are two main types of azoospermia: obstructive azoospermia (due to blockage) and non-obstructive azoospermia (insufficient or absent sperm production).

Treatment options include:

Treatment for Obstructive Azoospermia (due to blockage):

Surgical correction: The underlying cause of the obstruction can be surgically corrected. For example, conditions such as vas deferens obstruction, epididymitis inflammation, or varicocele can be treated through surgical intervention.

Sperm Retrieval Methods: In cases where sperm cannot be obtained through surgical intervention, sperm can be directly retrieved from the testes or epididymis. These methods include testicular sperm aspiration (TESA), microsurgical testicular sperm extraction (Micro-TESE), and percutaneous epididymal sperm aspiration (PESA).

Treatment of inadequate or absent sperm production (non-obstructive azoospermia):

Hormonal treatment: Sperm production can be increased by correcting hormonal imbalances. For example, if there is a deficiency in testosterone or thyroid hormones, treatment with the deficient hormones can be applied.

Sperm Retrieval Methods: In cases where sperm cannot be obtained surgically, sperm can be directly retrieved from the testes or epididymis. These methods include testicular sperm aspiration (TESA), microsurgical testicular sperm extraction (Micro-TESE), and percutaneous epididymal sperm aspiration (PESA).

Who can be affected by azoospermia?

Azoospermia can be seen in men of any age group and ethnic background. It accounts for approximately 10–15% of male infertility cases.

Can a man with azoospermia have children?

The chance of men with azoospermia having children depends on the cause, severity, and applicable treatment methods. There are two main types of azoospermia: obstructive and non-obstructive, and each has different treatment options. Today, Micro-TESE surgery is used to help men with azoospermia become fathers. The average sperm retrieval rate with Micro-TESE is between 54% and 58%.

Are there men with azoospermia who have had children?

A diagnosis of azoospermia is made through a test called semen analysis; in this test, a semen sample taken from the patient is examined under a microscope, and if no sperm is found, azoospermia is diagnosed.

How is azoospermia diagnosed?

A diagnosis of azoospermia is made through a test called semen analysis; in this test, a semen sample taken from the patient is examined under a microscope, and if no sperm is found, azoospermia is diagnosed.