Understanding azoospermia

Azoospermia is the condition that occurs when no sperm are present in the ejaculated fluid. This is a different problem from one in which men have no ejaculated fluid. For men with azoospermia, our San Antonio male infertility doctor will help determine the cause and options for treatment.

There are two basic causes of azoospermia:

• A blockage in the anatomic pathway that sperm takes from the testicles to the urethra. This is called obstructive azoospermia.
• The lack of sperm production in the testicles. This is called non-obstructive azoospermia.

Obstructive azoospermia

Men with obstructive azoospermia have a blockage in the male reproductive tract that prevents the sperm from getting from the testicles to the penis. This can happen at any point along the way, from the testicles to the tip of the urethra.

Most commonly, this can be seen in men who have had a vasectomy (where part of the internal tubular system has been cut or removed). However, some men with obstructive azoospermia may have had prior trauma or an infection that caused scarring of the pathway. Very rarely, some men can be born without any tubular system at all. Fortunately, for most men with obstructive azoospermia, normal sperm can be acquired through a day-surgical procedure performed by a urologist.

Non-obstructive azoospermia

When a blockage isn’t the problem, the reason for azoospermia is decreased or absent sperm production from the testicles. This situation can result from inefficient testicular sperm production, or because the testicles are not getting the right signals from the brain to do their job.

The causes of non-obstructive azoospermia include chemotherapy and radiation therapy – where the sperm-producing cells are damaged or destroyed. Other causes include chromosomal abnormalities in which the DNA responsible for sperm production is missing or absent. Azoospermia due to these causes should be evaluated by a San Antonio male infertility doctor (fertility urologist), who can help determine the best path to follow to make an appropriate diagnosis and develop an optimal treatment plan.

What you can do – get tested

If you and your partner are trying to conceive, a semen analysis is a quick way to see whether there are enough sperm present. Our San Antonio male infertility doctor will review your results and give you advice as to the best way to move forward. Our doctors work very closely with some of the best urologists in South Texas. Together, they will help you achieve your family-building goals. If you suspect you may have sperm production issues because of your past medical history, you don’t have to wait before getting evaluated.

Some men with low or absent sperm production may think that testosterone injections may help boost their male hormones. This is not true. When a man takes testosterone, it makes the brain and the pituitary gland think that there is enough testosterone in the man’s body and the body responds by not making follicle-stimulating hormone (FSH) and luteinizing hormone (LH) – the hormones responsible for sperm and testosterone production. When this happens, sperm production falls – occasionally to zero.

If you’re trying for pregnancy and are on testosterone, let your primary physician know, so they can refer you to our San Antonio fertility clinic. We can get your sperm count and serum testosterone level checked, and get you on the path to pregnancy. You can also contact us directly for a semen analysis or a new patient consultation.