A User’s Guide To Azoospermia

You’ve just been given what might be the worst news of your life. After trying unsuccessfully to have a child, you find out that you are sterile, no sperm, nada. “Azoospermic,” they told you. Now what?
We have had an overwhelming number of people reach out to us from all over the world seeking help for azoospermia. In response to this need, here are some real, down to earth, honest to goodness, helpful resources for you:

Not All Azoospermia is the Same

Azoospermia can be caused by a blockage or it can be due to a poorly functioning testicle (nonobstructive). Blockages can be congenital or acquired and can occur in the epididymis, vas deferens or ejaculatory ducts. Many blockages are treatable and can result in having babies naturally. That’s right, naturally.

Not All Azoospermia is True

Some men who are initially deemed “sterile” due to azoopermia will actually have small numbers of ejaculated sperm if the semen analysis is subjected to an “extended search” in a high quality fertility laboratory. We recently reported on a series of couples who used these scarce sperm and the fertility results were excellent. So make sure you take a closer look!

Most Azoospermia is Relative

Men with blockages have normal sperm production, so their fertility potential is high. But what is also true is that most men (up to 60%) with nonobstructive azoospermia can have sperm, usually in pockets in the testicles and can also be fertile. You just need to look hard enough.

Some Azoospermia is True

Yes, there are situations in which azoospermia can mean complete sterility and no usable sperm either in the ejaculate or the testicle. Chemotherapy and genetics are two classic causes of genuine azoospermia. Donor sperm and adoption are current family building options in these cases. Hopefully, our artificial testicle will be making sperm for these patients in the not too distant future.

Azoospermia Reflects Health

Whether sterility is due to blockage or not, there can be general health ramifications associated with it. A simple clinical condition called varicocele can do this. Rapid weight loss due to gastric bypass surgery, or recurrent fevers from an infection, or even hot tubbing can all cause temporary azoospermia. Medications such as Propecia and testosterone supplements can do exactly the same thing. So, don’t assume that azoospermia is a death sentence for family building; get checked out by a specialist instead!
On the flipside, we and others have shown that some forms of azoospermia can have implications for future health, including higher risks of developing testicular cancer, prostate cancer and low testosterone levels. So, think of azoospermia as a soft indicator of potential health issues and follow through with that visit with the specialist!
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