What is azoospermia? – This refers to a condition where there is no sperm cell in your semen. It is a major cause of infertility, which some men are born with while others develop it during their teenage or adult life. Normally, sperm cells are produced from the testicles and transported through a pipe that passes through the penis during ejaculation.

Along the way, they mix with fluids produced from other sites (seminal fluid). Together, they form semen, which is released during ejaculation. In men with azoospermia (no sperm cells), the seminal fluid released during ejaculation is without sperm cells. This may be the only cause of infertility for a couple. Without analyzing the semen, the man may think he is normal.

What are the causes of azoospermia?

There are different reasons why sperm cells may not be present in semen:

1. Blockage of the sperm channel: In this case, sperm is produced by the testicles but cannot come out because the channel they are supposed to pass through is blocked (obstructive azoospermia). This may be due to an abnormality in the formation of the channel, complication of surgery or infection.
2. Testicular abnormality: In this case, the testicles either did not develop well due to genetic problem or got damaged after development. This damage may be due to infection (such as mumps orchitis), excessive heat from the body (undescended testes) or environment, irradiation or cancer of the testes.
3. Hormonal abnormality: In this case, the testicles and channel for sperm passage are normal but sperm is not produced because the hormones that should stimulate sperm production are either not present or not adequate.

How can azoospermia be treated?

The treatment of azoospermia depends on the cause:

1. Channel blockage: Surgery to unblock the channel or connect the ones that are poorly formed may resolve the problem. In cases where connections are difficult to achieve, sperm retrieval for assisted reproductive technology may be done in order to achieve pregnancy.
2. Hormone imbalance: Hormone treatment may restore normal sperm production and fertility.
3. Poor testicular development or testicular damage: In cases with severe testicular damage, the only solution for reproduction is sperm donation for assisted reproductive technology.

How can azoospermia be prevented?

Genetic causes of azoospermia cannot be prevented. Acquired causes of azoospermia can be prevented by:

1. Avoiding exposure to radiation
2. Avoiding injury to the testicles by wearing a protective devise if you engage in activities that can put the testicles at risk of injury.
3. Avoiding prolonged exposure of the testicles to heat or hot environment such as placing hot objects (e.g. laptop) on or near the testicles.
4. Avoiding self-medication, as some medications suppress sperm production
5. Prompt correction of undescended testes so they are not damaged by body heat.