Azoospermia: Meaning, Causes, and Proven Treatments (TESE, PESA, and ICSI)


While many reproductive health concerns affect men across the globe, one particular condition that can be distressing is Azoospermia. Since thousands of men in India struggle with this condition that stops men from starting a family, we have decided to shed some light on Azoospermia. 

From explaining what it means, exploring potential causes, and discussing proven treatments, Apex Hospital – home to the best general surgeon in Sirsa – will cover all crucial aspects. By the end of this read, you’ll be equipped with knowledge that can help you comprehend, manage, and potentially overcome this medical condition. 

Let’s start! 

What is Azoospermia? 

Azoospermia is a condition where a man doesn’t have any sperm in his semen. Normally, testicles in a male’s body produce sperm. It then travels through the reproductive system and mixes with fluids to form semen. When a man ejaculates, semen is released from the penis. 

But if the person has azoospermia, semen will be there but there won’t be any sperm in it. Some men have this problem by birth, others may develop it later in life. 

Do Different Types of Azoospermia Exist? 

Yes, there are three main types of azoospermia: 

1 Post-testicular azoospermia: Also called obstructive azoospermia, it occurs when sperm is produced but can’t reach outside of your body either because of blockage or a problem in the reproductive system. One can think of it as a traffic jam on the road. The sperm is there but it can’t get through. 

Medical experts state it is the most common type of azoospermia.  

2 Testicular azoospermia: As the name suggests, it occurs in men who have a problem with their testicles. One can also call it nonobstructive azoospermia. It prevents testicles from producing sperm or enough sperm. 

3 Pre-testicular azoospermia: In this case, the testicles and reproductive system are okay but there’s a problem with hormones that signal testicles to make sperm. It’s like factory workers are not getting the right direction to produce goods. 

Recommended watch: Learn everything about male infertility: 

What are the Reasons Behind Azoospermia? 

As we said before, this male reproductive health issue is triggered either by a blockage in the reproductive system or problems with the testicles themselves or hormones that regulate them. But wait, there’s more to the story! 

Post-testicular azoospermia can also be caused by: 

  • Injuries or trauma to testicles
  • Infections like epididymitis
  • Inflammation
  • Retrograde ejaculation (a condition in which semen flows backward into the bladder rather than coming out of the penis)
  • Previous surgeries in the pelvic area 
  • Cysts or growths
  • Vasectomy 
  • Genetic conditions like cystic fibrosis 

Talking about testicular and pre-testicular azoospermia, well, these conditions can also be triggered by the following reasons: 

  • Genetic conditions like Klinefelter syndrome or Y chromosome deletion
  • Hormonal imbalances or endocrine disorders like low testosterone or hyperprolactinemia
  • Varicocele (enlarged veins in the scrotum)
  • Medications that can harm sperm production
  • Radiation treatments, chemotherapy, or exposure to toxins
  • Undescended testicles or absence of testicles
  • Orchitis 
  • Lifestyle factors like doing extreme drugs, drinking too much alcohol, and exposing oneself to high temperatures  

Note: These are just some of the possible reasons behind azoospermia. The exact cause can vary from person to person. 

Here are some sperm FAQs for young parents to consider in 2024!

What Are Treatments for Azoospermia? 

We bet now you understand the causes of different azoospermia conditions. This brings us to the next question, “Are there any treatments available?” Yes, several options may allow men with this condition to have biological children. 

Here are some popular ones: 

1 TESE 

Testicular Sperm Extraction (TESE) is a treatment in which surgeons extract sperm directly from the testicles. This procedure is performed especially when there’s a blockage in the reproductive tract. Surgeons will first make a small incision in the scrotum. Then, the testicles will be examined under a microscope and small tissue samples will be taken from them. 

These samples will then be processed to extract any sperm that may be present. TESE can be used in conjunction with other ART procedures like ICSI. One of the biggest benefits is that it doesn’t require any hormonal treatments. 

2 PESA 

Next up, we have Percutaneous Epididymal Sperm Aspiration (PESA). Now comparatively, it is a less invasive procedure used to deal with azoospermia. It involves extracting sperm from the epididymis. For those who don’t know, it’s a coiled tube located on the back of your testicles. 

A small needle will be inserted through the scrotum into the epididymis so that fluid can be withdrawn. PESA is a good option for men with obstructive azoospermia. It can be performed under local anesthesia by experienced doctors at Apex Hospital in Sirsa, Haryana. 

3 ISCI 

Our list of treatments for azoospermia will be considered incomplete without talking about ISCI. Short for Intracytoplasmic Sperm Injection, it is a specialized fertilization technique used in conjunction with TESE or PESA. In this, a team of urologists and surgeons inject a single sperm directly into an egg. Want to know how exactly this works? 

Well, sperm will be extracted first using the aforementioned treatments. Then, the egg will be retrieved from the ovary of your other half a.k.a your spouse. Once done, single sperm will be injected directly into the egg and then transferred to the uterus. 

ISCI can be highly effective even if you have very low sperm counts. It can help couples with infertility issues due to male factors. 

Learn about the best surgeon in Sirsa!

Everything About Azoospermia: Final Words 

There you have it! 

We’ve covered the basics of azoospermia. Remember, if you’re someone facing this problem, it’s best to seek medical advice. At Apex Hospital, our team of highly experienced urologists and fertility experts is dedicated to providing comprehensive care for men with azoospermia. Using our state-of-the-art facilities and the latest techniques, we can help you explore your options and achieve your family planning goals. 

So, what are you waiting for? Contact us today by calling +91 91680 39000 or +91 82229-66666

Check out our recently published posts as well: 

Everything about laparoscopic myomectomy 

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Laparoscopic surgery Sirsa

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