Azoospermia is the total absence of sperm in the ejaculate. This seminal pathology may be due to the male not being able to produce sperm (secretory azoospermia) or to an obstruction that prevents the sperm from passing into the ejaculate (obstructive azoospermia).
The causes of azoospermia are varied, it can be due to hormonal problems, genetic conditions, aggressive drug treatments of certain diseases such as cancer, testicular inflammations or trauma, cryptorchidism, or obstruction or absence of the seminal ducts, of course to a previous vasectomy or other surgeries.
When after a seminal analysis we find a diagnosis of azoospermia, it is very important to analyze what it is due to. For this, hormonal and genetic studies, testicular exploration, ultrasound, etc. will be carried out.
A testicular biopsy, to obtain spermatozoa to be used in the in vitro fertilization process, is the most common treatment for azoospermia. In obstructive azoospermia, sperm are usually found in all cases, but in secretory azoospermia, they are only obtained in 50% of men. In patients where no sperm is obtained, the only possible treatment is the use of anonymous donor sperm.
Obstructive azoospermia can be treated by microsurgery, removing the obstruction and joining the ducts, epididymovasostomy or vasovasostomy.
If the azoospermia is secretory and is caused by hormonal imbalances, hormonal treatment can be tried, but this should always be personalized.