Semen Without Sperm: What Causes Azoospermia?
Share This Article
Learn about donation options.
Subscribe our newsletter
to be notified when we publish
Sperm production in a male shows the normal functioning of the reproductive system. The fertility of a male is all associated with the sperm production in his body. Semen is a fluid secreted by the male reproductive system that contains sperm cells. The sperm cells fertilize the egg cell in the female’s reproductive tract. Therefore for an individual to conceive, fertility of sperms is necessary. A human male ejaculates about 15 to 200 million sperms per ejaculation. And it is interesting to note that the human semen comprises just 2-5% of sperms in the total semen ejaculated at a time. Along with sperms, there are other components present in the semen secreted from various glands of the male reproductive system.
Sperm count is an important measure in semen analysis. Sperm count explains the fertility of a male with reference to sperm quantity in semen. Low sperm count creates infertility issues in males and makes the pregnancy harder. And even in some cases, there is a condition called zero sperm count was seen in males. In this article, we shall discuss the condition of no sperm in a man’s semen and related causes and complications.
No sperm in semen: Azoospermia
First of all, let us understand that what this condition of zero sperm count is. In this condition, a male’s reproductive system is defective and is unable to ejaculate sperms in the semen. The condition is particularly known as Azoospermia, in which the semen does not contain detectable amounts of sperms. Azoospermia is referred to as a leading cause of male infertility. The epidemiology of the disorder tells us that this defect is almost 10-15% in prevalence in infertile males overall.
So we can define azoospermia as a state in which there is the absence of sperms in the male’s semen. There can be multiple reasons for this state in males including, blocked ducts, hormonal imbalance, organ damage, and even ejaculation issues lead to azoospermia. As a result of this issue, a man could not have sperms in his semen. And this cause of infertility poses many complications in pregnancy for couples. Azoospermia is also referred to as “no sperm count,” which is not the same state as low sperm count.
What causes Azoospermia (No sperm in semen)?
There can be two possible states or causes of azoospermia, i.e., obstructive and non-obstructive azoospermia briefed below;
a. Obstructive azoospermia:
The state in which there is a blockage in any duct of the male reproductive tract is referred to as obstructive azoospermia. If any structure of the reproductive tract is defective and the sperm production is hindered, then there is the possibility that the semen will be completely absent of sperm. In this condition, most of the time, sperms are being produced, but they are not ejaculated due to hindrance by tracts. The obstructions can be diagnosed in vas deferens, epididymis, or ejaculatory ducts.
This type is also called post-testicular azoospermia because, in this type, testicles are working fine and producing sperm, but the blockage stops the sperm from flowing through the semen. Almost 40% of the azoospermia is obstructive type.
There can be many reasons for obstructive azoospermia, including:
- Injury due to an accident or trauma
- Infection or inflammation in the area
- Congenital absence of vas deferens (cystic fibrosis)
- Previous surgery or radiation in the pelvic area
b. Nonobstructive Azoospermia:
In this type, there is poor or no production of sperms at all. There is no blockage issue of any duct, but the structures that are responsible for sperm production are inoperative, and hence there is no sperm detected in semen. In this state, a male’s testes or prostate gland can be impaired enough to function properly. The production of sperm is called spermatogenesis. This state is the main testicular type of azoospermia in which the main organ, i.e., testes, are dysfunctional.
The factors that contribute to the non-obstructive azoospermia include:
- Genetic mutations that cause no production of sperms in the body congenitally. That may include chromosomal abnormalities like; Klinefelter’s syndrome, Kallmann syndrome, or any abnormality that may lead to the abnormal number of chromosomes in an individual’s body. In such chromosomal abnormalities, there are mostly conditions like XXY, XXXY are seen instead of normal XY set of chromosomes.
- Hormonal disorders include the imbalance of hormones from gonadotropins. Males reproductive hormones have the most impact on the nature of semen and so the sperm production in the body.
- Varicocele may also lead to no sperm production in a male’s body.
c. Pre-testicular azoospermia
There can be pre-testicular azoospermia as well. In this condition, the body is unable to produce sperms even the testicles are normal and not dysfunctional. Such a situation can be due to an imbalance of male reproductive hormones that stops the body from producing sperms.
How do I know if I have azoospermia?
There are not any specific symptoms of this disorder but there are some conditions that may show that a man is likely to have zero sperm count. Sometimes most of the men do not know they have azoospermia until they face difficulty conceiving. Therefore in such cases, individuals do not really get to know the underlying causes of infertility.
The possible symptoms of no sperms in semen may include;
- Decreased masculine characters like hair growth on the body due to imbalance of hormones
- Erectile dysfunction
- Low sex drive (decreased interest in sexual activity)
- Low levels of testosterone
- Puberty issues
- Complications of erection or ejaculation
- Testicles swelling
- Pelvic pain
- Painful sex and pain after sex
- Painful urination
If you or your partner suffer any of the main symptoms or a combination of two or three symptoms, then it may signify that they may have any issue with normal sperm production.
How is azoospermia diagnosed?
The semen analysis can diagnose azoospermia or no sperm in the semen. The most common way to detect the zero sperm count is by the sperm count test itself. In the diagnosis phase of azoospermia, there are two steps i.e.
- In the first step, a simple casual semen analysis is done. The reports of semen analysis directly predict the sperm count of the patient after diagnosing the zero sperm count state in reports. The next thing doctors do is go for the cause of the problem.
- In the second step, the doctors proceed to identify where exactly the issue is. Whether the defect is in the track, or the testicles, or the hormones. Physical examination of reproductive parts (penis and testes) is done to ensure if the structure is abnormal.
The rest of the testing and screenings can be of different types, including;
- Blood tests to know the hormonal levels, e.g., testosterone levels
- Genetic testing to identify syndromes and chromosomal abnormalities discussed before
- Testicular biopsy
- Ultrasound to visualize the blockages in the whole tract
Which testing is going to be preferred by your doctor depends upon what is the root cause of your ailment and how it is been diagnosed. However, in some cases, multiple and intense screenings are required to diagnose the complex abnormalities.
What can be the possible treatment?
First of all, any fertility treatment depends upon the root cause of the disease. Doctors recommend different procedures for different types of ailments of sperm production. For instance, in azoospermia, there is an entirely different approach of doctors to proceed with as we have already discussed tens of the possible causes of what causes a man to have no sperm in his semen. Sometimes it’s an infection or inflammation and other times it can be an entirely natural congenital defect of a patient. However, in some cases, azoospermia treatment success stories are seen.
And the possible treatments can be;
- Surgery: In certain cases, varicocele or organ dysfunction can treat a patient and reverse fertility. However, there is little probability of the surgery being successful. However, medications can increase the chances.
- Medications: Hormonal treatments can be done via medications and fertility can be restored.
- Fertility treatments for no sperm count like ICSI/IVF are considered helpful to mimic male fertility actions.
Azoospermia, as we have learned that is a leading cause of male infertility. And by certain treatments, it can be reversed as well depending upon the prognosis of the case. A healthcare worker can devote his efforts towards his patients to help them in their struggle with such a stressful disorder. So many new treatments are being used to deal with these problems.
To know more about the causes and advanced treatments of male infertility reach out to us and we shall come up with the most advanced researches and knowledge for you.
We are supporting women all around the world before, during, and after their pregnancy by providing up-to-date information and advice, and tools.
We kindly ask for your support to continue to produce content for you and to enable you.