What is azoospermia? causes, diagnosis and treatment

Medically Reviewed by Dr Sravya, MBBS, MS 


Obstructive Azoospermia

John, a 35-year-old male, decided ten years ago not to have any more children and underwent a vasectomy. But now that he has remarried, he wants to have children with his new wife. He sees a fertility specialist, who determines that his vasectomy-related obstruction of the vas deferens results in obstructive azoospermia. 

The doctor advises surgery to reattach the vas deferens and restore sperm flow and this is the perfect example of azoospermia treatment. Which would enable John to become a parent.


Non-Obstructive Azoospermia

A 28-year-old man named Michael and his wife have been trying to get pregnant for more than a year now without any luck. They choose to go to a reproductive health clinic for assistance. Michael is identified as having non-obstructive azoospermia following a complete evaluation that includes hormone tests and a testicular biopsy. His testes are not successfully producing sperm as a result of a hereditary issue, according to the biopsy. 

For the treatment of azoospermia the couple is advised on their options, which may involve sperm retrieval procedures followed by donor egg in vitro fertilization (IVF).

Varicocele-related azoospermia

A 30-year-old man named David has developed pain and swelling in his scrotum. He sees a urologist, who gives him the diagnosis of having a varicocele, or swelling of the scrotal veins. His sperm production is being hampered by the varicocele, which results in non-obstructive azoospermia. To increase blood flow and perhaps restart sperm production, the urologist advises surgical removal of the varicocele.

Genetic disorder-related azoospermia

Early-forties Sarah and James have been trying to conceive for a number of years without any luck. James is found to have Klinefelter syndrome, a genetic disorder that results in the existence of an extra X chromosome, after they undergo fertility testing. Testicular dysfunction and non-obstructive azoospermia have resulted from this disorder. The couple is informed about donor sperm use and assisted reproductive technology as possible pregnancy options for the treatment of azoospermia.

 These cases show the variety of azoospermia’s causes and potential outcomes. Each person’s situation is unique, and the best course of action depends on the underlying cause, degree of severity, and fertility goals of the couple. For a precise diagnosis and individualized advice, it’s critical for individuals and couples struggling with infertility to speak with medical specialists who specializes in reproductive health.

Table of Contents


Diagnosis of obstructive azoospermia

Diagnosis of non-obstructive azoospermia

Treatment of obstructive azoospermia

Treatment of non-obstructive azoospermia


Developing a differentiation between OA and NOA is necessary to provide therapy and diagnostic alternatives for people with azoospermia.

The diagnosis of obstructive azoospermia is made using a combination of physical and medical history, laboratory tests, genetics, and imaging investigations as necessary.

OA develops as a result of blockage of the male reproductive system. If there is a vassal or epididymal blockage, microsurgical repair, based on multifactorial decision analysis, gives effective, safe, and economical results employing the most contemporary methods.

Although normal spermatogenesis usually exists in OA, microsurgical sperm extraction offers great results when used along with ART when the patient or obstructive etiology precludes microsurgical regeneration. 

Clinical evaluation, testing in the laboratory (FSH), as well as genetic testing, are used to distinguish those suffering from NOA (which encompasses primary testicular failure as well as subsequent testicular failure) from those with OA. 

Microdissection, testicular semen extraction procedure, and IVF/ICSI are all part of the treatment

Varicocelectomy may be helpful in cases of varicocele with NOA. The diagnosis and outlook for patients with azoospermia will be improved by future research into biological and genetic processes.