Diagnosing and treating the causes of azoospermia

At our Manhattan male fertility center, we occasionally see hopeful fathers with azoospermia, which is the absence of viable sperm. The workup to diagnose azoospermia includes semen cultures and blood tests. Blood tests can detect Chlamydia antibodies and measure the man’s follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone levels. The workup for azoospermia may also include selective testicular biopsies to confirm the diagnosis and develop the treatment plan.

Understanding the test results for azoospermia

The blood test during the initial testing for azoospermia provides important information regarding the man’s FSH, LH and testosterone levels. The pituitary gland produces FSH and LH, and they greatly affect testicular function. Azoospermia can occur when there is:

  • Obstruction of the sperm ducts. If the FSH, LH and testosterone levels are in the normal range, this suggests that there is an obstruction in both sperm ducts. A urological exam can confirm this diagnosis. Treatment may consist of testicular epididymal sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI). TESE involves removing tissue from the testicles, which a laboratory professional immediately examines for the presence of sperm. ICSI consists of an embryologist injecting a single healthy sperm into an egg to achieve fertilization.
  • Under-stimulation of sperm production. If the FSH, LH and testosterone levels are low, the man may be experiencing an under-stimulation of sperm production. Potential treatment could include stimulation of sperm production with medications such as Clomiphene or gonadotropins.
  • Testicular failure. If the FSH and LH levels are high, it is likely that the hopeful father is experiencing testicular failure. In some cases, hormonal medications or in vitro fertilization (IVF) can treat testicular failure.

These test results will help our Manhattan male fertility specialist determine what is causing a hopeful father’s azoospermia.

Two categories of azoospermia

The categories of azoospermia include obstructive and non-obstructive.

  • Obstructive azoospermia is present when sperm is being produced in the testicles, but a blockage in the male genital tract does not allow it to be ejaculated. The causes of obstructive azoospermia include vasectomy, infections that affect the reproductive organs, scar tissue from surgery and congenital conditions.
  • Non-obstructive azoospermia occurs when a man produces very low quantities of sperm or no sperm at all. The levels of sperm are often so low they never make it out of the testicles. The reasons include genetic issues, varicose veins around the testicles, a problem with the maturation of sperm and the use of testosterone or other anabolic steroids, chemotherapy, or radiation.

The expert staff at our Manhattan male fertility center is here to help hopeful fathers who are faced with azoospermia create a customized treatment plan that gives them the best possible chance of becoming a father.

Contact us for more information.