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So What Is Azoospermia?

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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More to explore


Wearing tight pants and underwear

Studies show that men who wear looser underwear have higher sperm concentration and total sperm count compared to men who wear tighter underwear. So, lose the tight clothes and wear something loose to give your testicles some air.

CONCLUSION: learn more about how heat can affect sperm quality here.


Besides higher mortality rate and various diseases, stress is associated with low sperm quality. Stress is known to be associated with lower testosterone levels and oxidative stress with both playing an essential role in producing and maintaining healthy sperm cells.

CONCLUSION: If you feel stressed, we recommend you get some help so you can have a balanced mental health. For a stress management guide, download the ExSeed app for free and start your personalized action plan today.

Physical activity

Scientific studies show that men who are physically active have better semen parameters than men who are inactive. Fertility specialists also state that regular physical activity has beneficial impact on sperm fertility parameters and such a lifestyle can enhance the fertility status of men.

Prioritizing exercise can help improve your overall health and result in healthy, fast swimming sperm cells that have good chances of fertilizing an egg.

CONCLUSION: Try incorporating exercise in your weekly schedule to you ensure exercising at least twice weekly. We recommend a combination of cardio training and strength exercise. Read more about exercise and male fertility on our blog.


Fast Food
Processed foods damage the health of sperm-producing cells and cause oxidative stress, which lead to poorer sperm quality. Heavy consumption of junk food (every week) can increase the likelihood of infertility since men who consume vast amounts of unhealthy food are at risk of having poor sperm quality. Besides harming your fertility, junk food enlarges your waistline, harms your cardiovascular system, kidneys, and more.

Eating more fruit and vegetables can increase your sperm concentration and motility. It’s important that you consume a healthy diet filled with antioxidants and that you eat vegetables every day. Foods such as apricots and red bell peppers are high in vitamin A, which improves male fertility by nurturing healthier sperm. Men who are deficient in this vitamin tend to have slow and sluggish sperm.

Sugary snacks/beverages: several times a week Excessive consumption of high sugar items can lead to oxidative stress, which negatively impacts testosterone levels and sperm motility. Sugary snacks and beverages are also highly associated with obesity and low fertility.
CONCLUSION: To boost sperm quality, stay away from fast food, processed food, and sugary snacks or beverages. You need to implement a healthy prudent diet filled with necessary superfoods needed for good sperm production. Check out our guide to Male Fertility Superfoods. For personalized guidance and support on how you can start improving your sperm health, check out the Bootcamp.


Direct heat can inhibit optimal sperm production and cause Sperm DNA damage. Sperm cells like environments that are a couple of degrees lower than body temperature. Avoid overheating from warm blankets, seat warmers, heat from your laptop, hot showers, and saunas.

Cigarette smoking

The exposure to tobacco smoke has significant negative effects on semen quality. The damage of cigarettes and nicotine of course depends on how many cigarettes you smoke per day and for how long, but even low usage (up to 10 cigarettes / day) can inhibit healthy sperm production.  

CONCLUSION: Stay as far away from cigarette smoking as possible if you care about your general health and your fertility. Read more here.

Cell phone

When you have your cell phone in your front pocket, your testicles are exposed to electromagnetic radiation, which studies have shown to damage the sperm cells. Put your phone in the back pocket of your pants or in your jacket pocket.


There is a clear association between obesity and reduced sperm quality. At least part of the reason for this is that obese men may have abnormal reproductive hormonal profiles, which can impair sperm production and lead to infertility. 

A BMI higher than 30 can lead to several processes in the body (overheating, increase in oxidative stress in the testes, sperm DNA damage, erectile dysfunction) that can have a negative impact on male fertility. This can result in problems when trying to conceive.  

CONCLUSION: BMI is one of the risk factors that influence semen quality and, for example, sperm motility.  


A beer or glass of wine now and then do not really harm sperm quality. But excess alcohol drinking (more than 20 units per week) can reduce the production of normally formed sperm needed for a successful pregnancy.

CONCLUSION: If you want to stay safe, stay under 14 units of alcohol per week. For more information on how alcohol can affect male fertility, take a look at our blog: “Alcohol and Sperm Quality”.


Studies show that women younger than 35 and men younger than 40 have a better chance of getting pregnant. Men can produce sperm cells almost through their entire life, but the sperm cell DNA is more fragile and prone to damage after the age of 40.

As men age, their testes tend to get smaller and softer resulting in a decline in sperm quality and production. These changes are partly because of an age-related decrease in testosterone level, which plays a very important role in sperm

production. Higher male age (>40 years) is not only associated with a decline in sperm production but also with increased sperm DNA fragmentation and worsened morphology (shape) and motility (movement). These negative effects make the sperm cells less qualified for egg fertilization.

CONCLUSION: with an age under 40, you shouldn’t have to worry much about age as a factor in itself. However, studies have shown a slow decline after the age of 30-35 years

and if you are above 40 years of age, your sperm quality can be affected due to increased sperm DNA damage resulting in a decrease of sperm motility and concentration. Remember that you cannot evaluate the quality of a sperm sample by just looking at it – this requires a sperm analysis.