The word itself is a bit of a mouthful and, like many medical terms, one you’re not likely to come across unless it personally affects you.
Characterised by the absence of sperm in the ejaculate, Azoospermia affects approximately 1% of the male population and accounts for between 10% and 15% of infertility cases in men.*
Diagnosing azoospermia involves a comprehensive approach, including semen analysis, physical examination, and hormonal evaluation. Understanding the underlying causes, such as obstructive azoospermia, non-obstructive azoospermia, and pre-testicular azoospermia, is crucial for developing effective treatment plans.
The condition can be a challenging diagnosis for individuals and couples trying to conceive, but advancements in medical science offer various treatment options and hope for parenthood.
Assisted reproductive techniques, including in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI), have revolutionised the treatment of azoospermia, offering hope to individuals and couples struggling with male infertility.
If you've just had this diagnosis, our podcast Workplace Benefits Unwrapped has an episode on the male experience of fertility — breaking the silence around a subject many men find hard to talk about.
What is Azoospermia, and how does it impact male fertility?
Azoospermia is diagnosed when no sperm are found in a man’s semen sample. The condition is typically identified through semen analysis, often conducted during fertility evaluations that might take place when couples enlist the help of a fertility specialist and can help determine what the best fertility treatment path is.
Hormonal evaluation, including assessing testosterone levels, can provide insights into the underlying causes of azoospermia.
While Azoospermia can present a serious challenge to fertility, diagnosis doesn’t necessarily preclude the possibility of biological parenthood. Advancements in reproductive technologies have made it possible for many men with azoospermia to father children.
Azoospermia is broadly categorised into three types:
1. Obstructive azoospermia (post-testicular)
This occurs when sperm production is normal, but there’s a blockage or missing connection along your reproductive tract. Blockages can occur in the ejaculatory duct, preventing sperm from being ejaculated. You’re producing sperm, but it’s getting blocked from exiting. This type is also referred to as obstructive azoospermia. It’s the most common type and affects up to 40% of people with azoospermia.
2. Non-obstructive azoospermia (testicular)
This type of azoospermia means you have poor or no sperm production due to a disorder in (or damage to) the structure or function of your testicles. Primary testicular failure is a key condition associated with elevated serum FSH levels and low testosterone, often diagnosed through testicular biopsies. This is sometimes also called non-obstructive azoospermia.
3. Pretesticular azoospermia
This is when your testicles and reproductive tract appear normal but aren't stimulated enough by hormones to make sperm. The pituitary gland plays a crucial role in hormonal stimulation necessary for sperm production. This can happen after chemotherapy or due to a hormone imbalance and is also considered a type of non-obstructive azoospermia.
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