Zero sperm count? What next?

Zero sperm count in ejaculation is known as Azoospermia. A man with azoospermia has no measurable sperm in his ejaculate (semen). A sperm production defect can cause azoospermia, which is triggered by hormonal and genetic factors. In addition, azoospermia may occur when any part of the sperm’s path from the testicle to the outside is blocked. Sperm count can be checked by a simple painless test-Semen analysis where men have to give semen samples after abstinence of 3-4 days. An estimated 1% of men and 10% to 15% of infertile men have azoospermia. Many causes of infertility can be treated and fertility can be restored.

Pretesticular azoospermia is when your testicles are normal, but your body cannot make sperm from them. The problem may occur if your hormone levels are low or if you’ve been through chemotherapy. Testicular azoospermia occurs when your testicles are damaged and cannot produce sperm normally. The following factors can cause it:

There are three main types of azoospermia:

  • Infections of your reproductive tract, such as epididymitis and urethritis
  • A childhood illness that causes swelling of one or both testicles, such as viral orchitis
  • An injury to the groin
  • The treatment of cancer, such as radiation,
  • Genetic conditions like Klinefelter’s syndrome

Post-testicular azoospermia is when Your testicles produce normal sperm, but something prevents them from exiting, such as:

  • Due to a blockage in the tubes, sperm cannot travel from your testicles to your penis. It is known as obstructive azoospermia.
  • A vasectomy
  • During an orgasm, the semen goes into the bladder instead of the penis

It is estimated that 40% of men with azoospermia have post-testicular azoospermia.

Symptoms of azoospermia: what are they?

If your efforts to conceive fail, you may not even realize you have azoospermia until you experience symptoms. It may be more helpful to look for underlying causes, such as hormonal imbalances or genetic chromosomal disorders.

Other possible symptoms include:

  • Sexual drive at a low level
  • Dysfunction of the erectile system
  • Testicular lumps, swelling, or discomfort
  • A decrease in facial or body hair

How to Find Out if You Have Azoospermia?

If you have been trying unsuccessfully to get your partner pregnant, Dr. Prakash Patel and Team from Shukan Hospital and IVF Center may test you for this condition. You can visit Shukan Hospital and IVF Center in Ahmedabad for your tests. The first step will be to provide a sample of your semen, which will then be examined under a microscope in a laboratory. When no sperm can be found in two separate tests, you have azoospermia. In order to determine what’s causing the problem, Infertility & IVF Specialist Dr. Prakash Patel from Shukan IVF will examine you. They will conduct a complete physical exam, ask about your medical history, and measure the hormone levels in your blood. In the case of normal hormone levels, a doctor may order an ultrasound to check for obstructions in your scrotum or transrectal. The diagnosis may be confirmed by an MRI. In some cases, surgery is the only way to find the obstruction. If you don’t have a blockage, a genetic test can diagnose a gene problem.

What is the treatment for azoospermia?

Depending on the cause, azoospermia can be treated. Azoospermia is often understood and treated through genetic testing and counseling. The following treatment approaches can be used:

  • An abnormal or never-developed tube can be reconstructed and connected if there is a blockage causing your azoospermia.
  • It may be necessary to take hormone treatments if you have low hormone production. The most common hormones are follicle-stimulating hormone (FSH), human chorionic gonadotropin (HCG), clomiphene, anastrozole, and letrozole.
  • In cases of varicocele that affect sperm production, the problem veins can be tied off surgically, preserving surrounding structures.
  • In some men, sperm can be retrieved directly from the testes during an extensive biopsy

It is possible to retrieve living sperm from the testes, epididymis, or vas deferens for assisted pregnancy procedures such as in vitro fertilization or intracytoplasmic sperm injection (the injection of one sperm into one egg). Before assisted fertilization procedures are considered, your healthcare provider may recommend genetic testing of your sperm if the cause of azoospermia could be passed on to children.

What can be done to prevent azoospermia?

Genetic problems causing azoospermia cannot be prevented. If your azoospermia isn’t genetic, follow these steps to reduce the risk:

  • Avoid activities that could harm the reproductive system.
  • Stay away from radiation.
  • Be aware of medications that may harm sperm production.
  • Don’t expose your testes to prolonged heat.

The bottom line

Hearing the words “no sperm count” or being diagnosed with azoospermia can be frightening. Having this condition doesn’t necessarily mean you can’t have biological children. Understanding the problem is the first step. A number of treatment options may be available to you after your doctor discusses and addresses the cause of the blockage. Alternatively, you may be able to become pregnant with the help of procedures such as IVF/ISCI.

Author Bio

Dr. Ajay Prajapati

He is a highly respected specialist in the fields of infertility, IVF, and fetal medicine. With over a decade of hands-on experience, he has successfully treated numerous patients facing complex fertility and pregnancy-related challenges. His expertise in advanced laparoscopy has made him a trusted name for minimally invasive surgeries, providing patients with cutting-edge treatments and compassionate care.

As a FOGSI-certified sonologist, he ensures accurate and detailed assessments during pregnancies, particularly in high-risk cases. His commitment to excellence is reflected in the numerous successful outcomes and the trust he has earned from patients across Gujarat and beyond.

Frequently Asked Questions On Azoospermia

  1. Is azoospermia common?

    Yes, it is. Approximately 10 percent of infertile men and 1 percent of all men suffer from
    azoospermia. So we can say out of 50000 men, 5,000 to 7,500 are infertile of which 500 will be
    azoospermic!

  2. What should I do if my semen analysis shows azoospermia?

    Apart from seeing a specialist in male infertility at Shukan Hospital and IVF Center in
    Ahmedabad
    , you should have a repeat semen analysis done at a lab with extensive experience
    in performing semen and sperm tests. This is because results can vary greatly from test to test.
    Having fewer sperm can also alter management/treatment options significantly, so getting proper
    confirmation of the finding is the first step.

  3. Is azoospermia a condition in which the testis does not produce sperm?

    It is not necessary. Sperm can be produced in the testis, but not enough to be detected in
    ejaculation.

  4. Are there any ways to tell whether this is due to a blockage or a problem with the factory?

    There are some good indicators, but not 100 percent accurate. As a first step, a thorough physical
    examination is crucial in order to determine the reproductive structures. Further, lab tests such as
    FSH and inhibin B can indicate testicular function.

  5. If I have zero sperm count, can I still get my partner pregnant?

    The diagnosis made by your fertility specialist will determine whether you can impregnate your
    partner or not depending on the cause of your azoospermia and the available treatments, a qualified male
    fertility specialist at Shukan Hospital
    can help you conceive.

    You should not give up until you are confident that there is no sperm present, as determined by a
    trained male fertility specialist. About 50% of the time, even if no sperm is found in the
    ejaculate, sperm can be retrieved from the testicles for IVF. In cases where only a few sperm were inside a
    man’s testicle, Shukan Hospital and IVF Center have helped achieve pregnancies. Never give
    up.

  6. Is it necessary for azoospermic men to undergo diagnostic testis biopsy?

    In the past, The majority of men with azoospermia used to undergo a biopsy to distinguish
    obstructive from non-obstructive causes and to get a more specific diagnosis. Nevertheless, biopsy
    alone is rarely performed in modern medicine. It is usually possible to predict with high accuracy
    whether a man has an obstructive cause of azoospermia. As we perform testicular dissections to
    search for sperm, we have learned that different areas of the testis might show different patterns
    of nonobstructive azoospermia. As an example, one area may have decreased maturation of mature sperm
    (hypospermatogenesis), while another might have no sperm precursor cells (Sertoli-cell-only
    syndrome). Therefore, a diagnostic biopsy is rarely necessary for men with nonobstructive
    azoospermia in today’s world. For these men, we offer testicular sperm extraction by microdissection
    (microTESE), which helps us locate sperm that we can use for assisted reproductive techniques (ART).
    Occasionally, when a microTESE is performed, a tiny specimen is sent for pathological
    analysis to rule out intratubular germ cell neoplasia (ITGCN).

  7. What is the procedure for retrieving sperm?

    When sperm are abundant within the reproductive structures of men with obstructive azoospermia,
    various procedures can be used to obtain them. Among them are testicular sperm extraction,
    testicular sperm aspiration, and microsurgical epididymal sperm aspiration. The choice depends on
    patient factors, patient priorities, and reproductive endocrinologists’ preferences. Various
    approaches are available for men with nonobstructive azoospermia, but microTESE is most
    likely to produce usable sperm for use with in vitro fertilization and intracytoplasmic sperm
    injection. This procedure involves carefully dissecting the testis tubules by an expert in the field
    to locate the tissue most likely to be actively producing sperm. Sperm yield can be maximized while
    other testis tissues, such as the Leydig cells that produce testosterone, are preserved.

  8. What Is a Normal Sperm Count?

    When trying to conceive, sperm count is important. It may also indicate an underlying health
    problem if the sperm count is abnormal.

    Generally, the sperm count per milliliter (mL) of semen ranges from 15 million to over 200 million
    sperm. Sperm counts less than 15 million per milliliter, or 39 million per ejaculate, are considered
    low. Low sperm counts are often referred to as oligospermia. Sperm counts over 200 million per
    millimeter are considered high, or above average.

    Using a semen analysis, you can determine your sperm count. You can get the analysis done at Shukan
    Hospital and IVF Center, a fertility clinic.

  9. How can I improve my sperm count through lifestyle choices?

    Medical problems often cause low sperm counts, but lifestyle choices can also have an impact. Sperm
    count may be improved by:

    • Lose weight. Low sperm counts can be caused by obesity or being overweight. Maintain a healthy
      lifestyle through diet and exercise.
    • You should take vitamin supplements. Test for vitamin deficiencies with a blood test from our
      doctor. You may be recommended to add new foods to your diet or take supplements to restore your
      vitamin and mineral levels.
    • Avoid tobacco smoking and alcohol.
    • You should wear cotton boxers that are loose.
  10. In the case of a zero sperm count, are there any natural remedies that can help?

    With azoospermia, home remedies for sperm production may or may not be effective. Certain herbs and dietary changes may help lower sperm counts, but sperm that’s absent because of an obstruction or genetic condition may not.

    The good news is that taking care of yourself by eating a balanced diet, getting plenty of rest, drinking enough fluids, and managing stress can help. Along with taking care of your general health, consult the Best IVF doctor in Ahmedabad Dr. Prakash Patel from Shukan Hospital and IVF centre about any natural remedies that may help you.

    Here are some things to try:

    • For healthy sperm production, eat a diet rich in whole, nutrient-dense foods
    • Regular exercise is essential. As a result, testosterone levels may be boosted.
    • Reduce your stress levels by practicing yoga or meditation. Testosterone production can be affected by cortisol (the stress hormone).
    • You can ask Shukan IVF’s expert doctors about supplements and herbs that may help promote male fertility, like Tribulus Terrestris, Black seed, Coenzyme Q10, Folate, Horse Chestnut, L-carnitine, Panax ginseng, and Zinc.
  11. How much does azoospermia treatment cost In India?

    In India, treatment for azoospermia varies from place to place. Treatment costs also depend on the cause of azoospermia. The price of Azoospermia treatment is cheaper in a city like Ahmedabad compared to metropolitan cities like Mumbai, Bangalore, Chennai, and Delhi. For a price quote at Shukan Hospital and IVF center in Ahmedabad, please contact us.

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