{"id":3465,"date":"2026-02-19T12:07:17","date_gmt":"2026-02-19T09:07:17","guid":{"rendered":"https:\/\/www.sonerduzguner.com\/?p=3465"},"modified":"2026-03-01T03:14:26","modified_gmt":"2026-03-01T00:14:26","slug":"azospermia-treatment-where-are-we-now","status":"publish","type":"post","link":"https:\/\/www.sonerduzguner.com\/en\/azospermia-treatment-where-are-we-now\/","title":{"rendered":"Where Are We in the Treatment of Azoospermia?"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><div      class=\"vc_row wpb_row section vc_row-fluid\" style=' padding-bottom:40px; text-align:left;'><div class=\"full_section_inner clearfix\"><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\">\n\t<div class=\"wpb_raw_code wpb_raw_html wpb_content_element\" >\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<p><iframe loading=\"lazy\" class=\"icerik-video\" width=\"560\" height=\"316\" src=\"https:\/\/www.youtube.com\/embed\/ZjN83H86sME\" title=\"AMH: Kehanet De\u011fil, Erken Uyar\u0131 Sistemi\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/p>\r\n\r\n\n\t\t<\/div>\n\t<\/div>\n<\/div><\/div><\/div><\/div><\/div><div      class=\"vc_row wpb_row section vc_row-fluid\" style=' text-align:left;'><div class=\"full_section_inner clearfix\"><div class=\"blog-detay wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\">\n\t<div class=\"wpb_text_column wpb_content_element\">\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<h2><span class=\"ez-toc-section\" id=\"i\"><\/span>Micro-TESE, Success Rates, and Current Approaches<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>When discussing IVF treatment, the focus is often thought to be primarily on the woman. However, when it comes to infertility, the picture is much more balanced. In couples who wish to have a child, male factors play a role in approximately 50% of infertility cases. Azoospermia accounts for about 10\u201315% of male factor infertility.<\/p>\n<p>So, what is azoospermia? Are we truly making progress in treatment? Is Micro-TESE still the gold standard? Do newer approaches such as stem cell therapy or PRP offer real hope? In this article, we address all the frequently asked questions about azoospermia within a scientific framework.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"i-2\"><\/span>What Is Azoospermia?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Azoospermia is the condition in which no sperm cells are found in a man\u2019s ejaculate (semen). This diagnosis can be quite distressing for a couple. However, it is important to clearly state: Receiving a diagnosis of azoospermia does not mean that having a child is impossible.<\/p>\n<p>Azoospermia is divided into two main groups:<\/p>\n<ol>\n<li><strong> Obstructive Azoospermia<\/strong><\/li>\n<\/ol>\n<p>In this condition, sperm production in the testes is present, but due to a blockage in the sperm ducts, sperm cannot be ejaculated. This group generally has a better prognosis. The likelihood of finding sperm with Micro-TESE is quite high.<\/p>\n<ol start=\"2\">\n<li><strong> Non-Obstructive (Production Failure) Azoospermia<\/strong><\/li>\n<\/ol>\n<p>In this case, the problem is not in the sperm ducts but in the sperm-producing capacity of the testes. Sperm production is either very low or absent. In this type, sperm retrieval rates are lower, and the process must be planned more carefully.<\/p>\n<h3>The Gold Standard in Azoospermia Treatment: Micro-TESE<\/h3>\n<p>Today, the gold standard method in the treatment of azoospermia is still Micro-TESE.<\/p>\n<p>Micro-TESE (Microsurgical Testicular Sperm Extraction) is a procedure in which testicular tissue is examined under an operating microscope to identify areas with active sperm production, and sperm is retrieved from those areas.<\/p>\n<p>Compared to conventional TESE, this is a much more delicate surgical technique and offers several advantages:<\/p>\n<ul>\n<li>More targeted tissue sampling<\/li>\n<li>Less damage to the testis<\/li>\n<li>Increased likelihood of finding sperm<\/li>\n<\/ul>\n<p>The generally accepted sperm retrieval rate, considering all factors, is approximately 55\u201360%. However, this rate varies depending on the type of azoospermia, genetic factors, and the experience of the center.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"i-3\"><\/span>Is Micro-TESE a One-Time Procedure?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>There is a common misconception in society:\n\u201cIf sperm were not found during the first Micro-TESE, there is no hope anymore.\u201d<\/p>\n<p>This is not true.<\/p>\n<p>If no sperm are found during the first Micro-TESE, a second or even a third attempt may be considered. However, the critical question is:<\/p>\n<ul>\n<li>Should the procedure be performed at the same center?<\/li>\n<li>Should it be evaluated by a different andrologist and team?<\/li>\n<\/ul>\n<p>One of the most important factors affecting success in Micro-TESE is the experience of the team performing the procedure.<\/p>\n<p>In experienced centers:<\/p>\n<ul>\n<li>Longer and more meticulous microscopic examination<\/li>\n<li>More extensive tubule sampling<\/li>\n<li>Detailed microscopic search by the embryologist can significantly influence the likelihood of sperm retrieval.<\/li>\n<\/ul>\n<p>In patients in whom sperm were not found at other centers, repeat Micro-TESE performed under appropriate conditions can result in sperm retrieval in approximately 15\u201320% of cases.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"i-4\"><\/span>Fresh Sperm or Frozen Sperm?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>There is an important strategic decision in the treatment of azoospermia: When should Micro-TESE be performed?<\/p>\n<p>Our approach is generally as follows:<\/p>\n<ul>\n<li>First, the woman is prepared.<\/li>\n<li>On the day of egg retrieval, the man undergoes Micro-TESE surgery.<\/li>\n<li>Goal: To use fresh sperm.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"i-5\"><\/span>Why fresh sperm?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Because using sperm fresh, rather than freezing and thawing mature sperm cells:<\/p>\n<ul>\n<li>In terms of fertilization rates<\/li>\n<li>It may be more advantageous in terms of embryo quality.<\/li>\n<\/ul>\n<p>However, it is necessary to clarify a common misunderstanding: Fresh sperm is used in the first procedure. If excess sperm is obtained during Micro-TESE, it is frozen. This way, if in the future there is a need for IVF again, the patient does not have to undergo surgery again.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"i-6\"><\/span>Genetic Factors and Success Rates<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>One of the most important factors affecting the success of Micro-TESE is the genetic condition.<\/p>\n<p>Especially:<\/p>\n<ul>\n<li>Chromosome analysis (karyotype)<\/li>\n<li>Klinefelter Syndrome<\/li>\n<li>Conditions such as Y chromosome microdeletions directly affect the likelihood of finding sperm.<\/li>\n<\/ul>\n<p>For example:<\/p>\n<ul>\n<li>The sperm retrieval rate in Klinefelter Syndrome is lower compared to the general population.<\/li>\n<li>In certain regions of Y chromosome microdeletions, the chance of finding sperm is very low.<\/li>\n<\/ul>\n<p>Therefore, when a diagnosis of azoospermia is made, a detailed genetic evaluation must be conducted.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"i-7\"><\/span>Testosterone Level and Metabolic Status<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>In the treatment of azoospermia, testicular surgery alone is not discussed. The man\u2019s overall metabolic condition is also important.<\/p>\n<p>For example:<\/p>\n<ul>\n<li>If diabetes is present, blood sugar regulation should be ensured.<\/li>\n<li>HbA1c levels should be within the ideal range.<\/li>\n<li>Testosterone levels should be evaluated.<\/li>\n<\/ul>\n<p>The topic of testosterone is still debated. Some experts advocate hormonal regulation first in patients with levels below a certain threshold (for example, above 3 ng\/mL). The decision on this is generally made by the andrology specialist based on an individual evaluation.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"i-8\"><\/span>Stem Cell, PRP, and Plasma Treatments \u2013 Are They Really Promising?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>In recent years, stem cell, PRP, and plasma applications have come into focus in the treatment of azoospermia.<\/p>\n<p>Theoretically, these methods:<\/p>\n<ul>\n<li>Stimulating testicular tissue<\/li>\n<li>It is applied with the aim of increasing sperm production.<\/li>\n<\/ul>\n<p>However, it should be clearly stated that:<\/p>\n<p>These methods have not yet been included in international guidelines or become routine treatments. Most are still at the study level, and their results are not yet conclusive.<\/p>\n<p>Unfortunately, this field is also prone to exploitation. Therefore, patients should be cautious of experimental methods presented with promises of a \"definite solution.\"<\/p>\n<p>Currently, the scientifically accepted and gold standard method is Micro-TESE.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"i-9\"><\/span>Factors Affecting Micro-TESE Success<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Success in Micro-TESE does not depend solely on the patient. There are many factors that influence the process:<\/p>\n<ol>\n<li>Type of azoospermia (obstructive vs non-obstructive)<\/li>\n<li>Genetic condition<\/li>\n<li>Hormonal profil<\/li>\n<li>Metabolic diseases<\/li>\n<li>Experience of the andrologist performing the procedure<\/li>\n<li>Time allocated for the surgery<\/li>\n<li>Number of tubules collected<\/li>\n<li>Quality of the embryologist\u2019s microscopic evaluation<\/li>\n<\/ol>\n<p>Therefore, the treatment of azoospermia is a team effort. It should be approached not only surgically but also with a multidisciplinary approach.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"i-10\"><\/span>Conclusion: Are We at the Same Point in Azoospermia Treatment?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>There has not been a major revolution in azoospermia treatment. However, current methods have become more systematic, safer, and experience-focused.<\/p>\n<p>Micro-TESE is still the gold standard.<\/p>\n<p>Success rates are high in experienced centers.<\/p>\n<p>The use of fresh sperm provides an important strategic advantage.<\/p>\n<p>Genetic and metabolic evaluation is an integral part of the process.<\/p>\n<p>Methods such as stem cells and PRP are still in the experimental stage.<\/p>\n<p>Most importantly: A diagnosis of azoospermia does not mean hopelessness.<\/p>\n<p>With the right evaluation, the right center, and proper timing, many couples can achieve healthy embryos and pregnancies.<\/p>\n\n\t\t<\/div>\n\t<\/div><\/div><\/div><\/div><\/div><\/div><div      class=\"vc_row wpb_row section vc_row-fluid  sizi-arayalim vc_custom_1748634241618\" style=' text-align:left;'><div class=\"full_section_inner clearfix\"><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner\"><div class=\"wpb_wrapper\"><div      class=\"vc_row wpb_row section vc_row-fluid vc_inner\" style=' text-align:left;'><div class=\"full_section_inner clearfix\"><div class=\"wpb_column vc_column_container vc_col-sm-12\"><div class=\"vc_column-inner vc_custom_1746548174605\"><div class=\"wpb_wrapper\">\n\t<div class=\"wpb_text_column wpb_content_element\">\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<h2><span class=\"ez-toc-section\" id=\"i-11\"><\/span><span style=\"color: #ffffff;\">Let Us Call You<\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\t\t<\/div>\n\t<\/div><div class=\"vc_empty_space\"  style=\"height: 15px\" >\n\t<span class=\"vc_empty_space_inner\">\n\t\t<span class=\"empty_space_image\"  ><\/span>\n\t<\/span>\n<\/div>\n\t<div class=\"wpb_text_column wpb_content_element\">\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<p><span style=\"color: #ffffff;\">Let us reach you quickly about the topics you want to consult.<\/span><\/p>\n\n\t\t<\/div>\n\t<\/div><div class=\"vc_empty_space\"  style=\"height: 15px\" >\n\t<span class=\"vc_empty_space_inner\">\n\t\t<span class=\"empty_space_image\"  ><\/span>\n\t<\/span>\n<\/div>\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1517-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"1517\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/en\/wp-json\/wp\/v2\/posts\/3465#wpcf7-f1517-o1\" method=\"post\" class=\"wpcf7-form init cf7_custom_style_1\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\" data-trp-original-action=\"\/en\/wp-json\/wp\/v2\/posts\/3465#wpcf7-f1517-o1\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"1517\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.6\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1517-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<div class=\"mobil-full-form\"  style=\"width:70%; 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Dr. Soner D\u00dcZG\u00dcNER<\/h4>\n\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"wpb_text_column wpb_content_element  blog-detay-unvan\">\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<p>Obstetrics and Gynaecology Specialist<\/p>\n\n\t\t<\/div>\n\t<\/div><div class=\"vc_empty_space\"  style=\"height: 5px\" >\n\t<span class=\"vc_empty_space_inner\">\n\t\t<span class=\"empty_space_image\"  ><\/span>\n\t<\/span>\n<\/div>\n\t<div class=\"wpb_text_column wpb_content_element  blog-detay-unvan-desc\">\n\t\t<div class=\"wpb_wrapper\">\n\t\t\t<p>Op. Dr. Soner D\u00fczg\u00fcner: Provides diagnosis and treatment in areas such as in vitro fertilization, women's health, infertility, gynecological surgery and pregnancy follow-up.<\/p>\n\n\t\t<\/div>\n\t<\/div><div class=\"vc_empty_space\"  style=\"height: 15px\" >\n\t<span class=\"vc_empty_space_inner\">\n\t\t<span class=\"empty_space_image\"  ><\/span>\n\t<\/span>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>T\u00fcp bebek tedavisi konu\u015fulurken \u00e7o\u011fu zaman oda\u011f\u0131n kad\u0131n \u00fczerinde oldu\u011fu d\u00fc\u015f\u00fcn\u00fcl\u00fcr.<\/p>","protected":false},"author":1,"featured_media":3466,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3465","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog-icerikleri"],"_links":{"self":[{"href":"https:\/\/www.sonerduzguner.com\/en\/wp-json\/wp\/v2\/posts\/3465","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.sonerduzguner.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.sonerduzguner.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.sonerduzguner.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.sonerduzguner.com\/en\/wp-json\/wp\/v2\/comments?post=3465"}],"version-history":[{"count":6,"href":"https:\/\/www.sonerduzguner.com\/en\/wp-json\/wp\/v2\/posts\/3465\/revisions"}],"predecessor-version":[{"id":3491,"href":"https:\/\/www.sonerduzguner.com\/en\/wp-json\/wp\/v2\/posts\/3465\/revisions\/3491"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.sonerduzguner.com\/en\/wp-json\/wp\/v2\/media\/3466"}],"wp:attachment":[{"href":"https:\/\/www.sonerduzguner.com\/en\/wp-json\/wp\/v2\/media?parent=3465"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.sonerduzguner.com\/en\/wp-json\/wp\/v2\/categories?post=3465"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.sonerduzguner.com\/en\/wp-json\/wp\/v2\/tags?post=3465"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}