Non-Obstructive Azoospermia

Last updated: May 20, 2019

What Does Non-Obstructive Azoospermia Mean?

Non-obstructive azoospermia is a condition in which a man's semen contains no sperm. The problem is either due to a dysfunction of the testes or insufficiency in the hormones that trigger sperm production. Non-obstructive azoospermia accounts for about 10% of cases of male infertility.

FertilitySmarts Explains Non-Obstructive Azoospermia

In men with non-obstructive azoospermia, the testes do not produce adequate amounts of sperm to be released in the semen. This leads to infertility.

Non-obstructive azoospermia differs from obstructive azoospermia, a condition in which adequate sperm is produced but is blocked from being expelled in the semen. In contrast, non-obstructive azoospermia is caused by hormone issues or testicular problems that decrease sperm production. Causes of non-obstructive azoospermia include:

  • Hormonal imbalances
  • Infection
  • Genetic abnormalities
  • Certain medications (including testosterone and other anabolic steroids)
  • Radiation
  • Varicocele
  • Maturation arrest (sperm that stops maturing after a certain point)
  • Testicular torsion (twisting of the testicles)
  • Sertoli-cell only syndrome (SCO) or germ cell aplasia (GCA) (absence of the germ cells in the testes that divide and become sperm)

Diagnosis involves collecting semen samples to assess whether or not quality sperm is present. Other tests that may be performed include imaging of the genital tract (e.g. ultrasound, CT scan, or MRI).

Treatment for non-obstructive azoospermia depends on the cause. In individuals with a hormone problem, called hypogonadotropic hypogonadism, treatment involves the administration of missing hormones. In other cases, men may undergo a surgical procedure, called microsurgical testicular sperm extraction (Micro TESE), in order to have sperm collected from their testicles. This sperm can then either be used to fertilize an egg in a laboratory setting or frozen for later use.

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