Azoospermia – not easy to spell and not easy to deal with. The condition is pretty rare – impacting only 1% of men – but it is the root cause of between 10% and 15% of infertility cases. But what exactly is it and what can you do if you are one of the men it impacts? We’ve broken it all down here.
What does azoospermia mean?
Firstly let’s get our heads around what azoospermia is. Generally speaking, azoospermia refers to cases where men have no sperm cells in their semen.
A quick biology lesson pit stop: sperm is made in the testicles and when you ejaculate it travels through your reproductive tract and mixes with fluid in your seminal ducts – making semen. With azoospermia there are no sperm cells – so whilst your semen might look normal, it isn’t going to help you make a baby.
Types of azoospermia
There are actually three different types of azoospermia and they can be broken down into non-obstructive and obstructive.
The two non-obstructive types are Pre-Testicular Azoospermia and testicular Azoospermia. Pre-testicular azoospermia occurs when the hormones responsible for creating sperm aren’t working as they should. Testicular azoospermia is caused by issues with the function or structure of the testicles.
And then there’s Post-testicular azoospermia which is known as ‘obstructive’. This is caused by problems with ejaculation and usually down to an obstruction of some sort in the reproductive tract.
Causes of azoospermia
Different types of azoospermia have different root causes.
Pre-testicular Azoospermia
This type of azoospermia is all about your hormones. A common cause of this type of azoospermia is genetic disorders. Klinefelter syndrome – where the body has an extra X chromosome – can impact testosterone production and other factors of the reproductive system. Another example is Kallmann syndrome, which affects the body’s ability to produce gonadotropin-releasing hormone (GnRH) which can impact sperm production. Damage to the brain – specifically the hypothalamus or pituitary gland, may also trigger this type of azoospermia.
Testicular azoospermia
This is down to issues with the testicles themselves. Again Klinefelter syndrome can be the culprit here, as other symptoms of the condition include the absence of testicles or having testicles that haven’t dropped. You might also find you have issues with your testicular function if you had mumps or have had surgery or radiation therapy for cancer. Varicoceles – a condition where the veins in the testicles are swollen or tangled can also cause this type of azoospermia. You can read more about varicoceles here.
Post-testicular azoospermia
This is actually the most common kind, present in around 40% of azoospermia cases. It basically means that there is a blockage or missed connection with the tubes involved in semen production. This can be caused by previous injury or cysts and also if you’ve had a vasectomy (although that’s kind of the point of them!)
You can also have genetic conditions that mean the tubes in your reproductive system haven’t developed properly. For example, congenital bilateral absence of the vas deferens (CBAVD) is a genetic condition where the vas deferens ducts that carry sperm from the testes are missing.
How do I know if you have azoospermia?
The interesting thing about azoospermia is that for a condition which has such a big impact on your life – there are often no symptoms. Many guys don’t find out they have azoospermia until they try – and sadly – fail to conceive.
The best way to find out if you have azoospermia is to get your sperm tested ahead of trying to conceive. Our ExSeed At-Home Sperm test makes it swift and easy to get a semen analysis in the comfort of your own home. If you notice a real lack of sperm cells in your semen sample, it might mean that you have azoospermia. If you’re concerned you can contact our medical team straight away and they will be able to advise you on the next steps. You then may be referred to a specialist who will do blood and hormone tests as well as a physical examination to determine what could be the issue.
Some of the few signs of azoospermia relate to connected issues. For example, if you have problems with your hormones you might notice that you have a low sex drive or erectile dysfunction, or you may have swollen and uncomfortable testicles if you are dealing with a blockage.
Can I have kids if I have azoospermia?
Having no sperm obviously is a hurdle to starting a family, but it’s not impossible. For guys with low sperm count, this can often be improved with diet and lifestyle changes, but if you are dealing with azoospermia, you may need a bit more medical intervention.
If the issue is a blockage, this can sometimes be rectified with surgery, whilst hormonal treatments might help if you are struggling to produce sperm There is also a procedure called micro-TESE where a small needle goes into the testicles and extracts sperm which can then be used in assisted fertility treatments. This can be amazing for men with non-obstructive azoospermia, but in some cases, no viable sperm can be found.
It’s important to remember that even if azoospermia stops you haven’t biological children, that doesn’t mean that you can’t become a father. Many men with azoospermia turn to donor sperm to help them build their families. You can find more info about finding a sperm donor in the UK here and whilst you’re at it, check out our interview with Emma Grønbæk aka Donor Child to hear how happy life with donor conception can be!
The key azoospermia takeaways
As always, early detection of any condition impacting your fertility will help you find the right road to parenthood faster. If you are struggling to conceive or suspect you may have azoospermia, don’t bury your head in the sand. Knowledge is power so get your sperm tested as soon as possible and then you’ll know all of your options.
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