Azoospermia: absence of sperm. Is pregnancy possible? Treatment 2026

It is estimated that with each intimate relationship without contraceptive protection, the chances of pregnancy are around 20 percent. As long as, of course, there is no type of condition or health problem that could negatively affect fertility. This means that, for conception to occur, it is necessary that both the woman and the man do not have fertility problems, since if so, these probabilities will obviously end up decreasing.

Sometimes, when there is some type of problem when it comes to getting pregnant, the condition is only related to the man; at other times with the woman, and in most cases, the problem usually affects both members of the couple by 50 percent.

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In the case of male infertility, azoospermia is a rare but serious form, which affects around 1 in 100 men, although it is estimated that 1 in 10 men have some type of infertility problem. Treatment depends on the specific cause of azoospermia, which will, in turn, be influenced by your partner's fertility potential.

What is azoospermia? What does it consist of?

Sperm is produced in the testicles, which are kept slightly outside the body, in the scrotum, in order to keep them at a lower temperature than the body temperature of the rest of the body (sperm are known to be very sensitive to heat, so higher body temperature can negatively affect fertility).

Sperm travels through the male reproductive tract, mixing with the seminal fluid found in the seminal ducts. Then, together with the sperm and this fluid, semen is produced, which contains both sperm and other compounds and basic substances to promote conception.

But the process begins in a system of small tubes, known as the seminiferous tubules, where the different sperm cells develop. These cells, when exposed to certain reproductive hormones, such as testosterone, follicle-stimulating hormone (FSH) and luteinizing hormone (LH), mature and become the sperm that we normally know. Thus, once they have matured, they move to the epididymis, a long, coiled tubal area, where they continue their development for a few weeks.

Subsequently, the sperm move into the vas deferens. From there to the vesicle or seminal gland, the place where most of the liquid that forms semen is produced, and which helps the sperm to be nourished. Finally, they reach the prostate gland, immediately before passing to the urethra, during the moment of ejaculation.

You may be certainly familiar with the term “low sperm count.” But, however, in the case of azoospermia it means that no sperm are found in the semen after orgasm (that is, in ejaculation).

What are the main causes of azoospermia?

Before discovering what causes azoospermia, it is necessary to keep in mind that, in reality, there are three types of azoospermia, which means that its causes will be different:

• Pretesticular azoospermia (non-obstructive). It is caused by a decreased or impaired production of the different hormones responsible for the creation of sperm.
• Testicular azoospermia (non-obstructive). It is caused by the existence of any abnormality in both testicular structure and function.
• Postesticular azoosmeria (obstructive). Although the testicles and hormones may function normally, it is caused by problems with ejaculation, due to the existence of an obstruction of some type in the reproductive tract.

Once we have known what types of azoospermia exist, it is time to investigate its main causes. And each type of azoospermia has its own set of possible causes, as well as associated conditions and conditions.

On the one hand, genetic conditions, which affect the Y chromosome, usually cause between 10 to 15 percent of cases. But, obviously, they are not the only causes.

Causes of pretesticular azoospermia

This type of non-obstructive azoospermia can be caused by some disorders of genetic origin, such as what is known as Kallmann syndrome, which affects the body's ability to produce GnRH (gonadotropin-releasing hormone), in turn affecting sperm production.

Causes of testicular azoospermia

On this occasion, there are several causes that can influence the appearance of this type of azoospermia. It can occur, for example, as a consequence of the absence of testicles, cryptorchidism (undescended testicles), testicles that do not produce sperm, or testicles that do not produce mature sperm.

However, they are not the only causes. Diabetes, reactions to certain drugs, varicocele (when the veins in the testicles dilate or widen), mumps at the end of puberty, tumors or radiation can also play a role.

Causes of posttesticular azoospermia

As we have told you, it is a type of obstructive azoospermia, and it is estimated that it is present in around 40 percent of total cases of azoospermia. Obstruction, for example, can occur as a result of a lack of connection somewhere, such as in the vas deferens or epididymis.

Some congenital conditions and diseases can cause the obstruction. This is what happens with congenital bilateral absence of the vas deferens. Vasectomy, certain lesions or cysts, or a previous or current infection can also play a role.

Can it be treated? Is it possible to get pregnant?

Once the presence of azoospermia has been diagnosed (or, in other words, the absence of sperm in the semen), it is time to find a treatment. In this sense, fertility treatment will depend on the specific type of azoospermia, and therefore, the cause that caused the problem. Of course, the couple's fertility situation also determines the different treatment options.

If it is, for example, obstructive azoospermia, it can be treated by reconstructing or reconnecting the affected tubes or ducts, which do not allow sperm to flow normally. In this sense, surgery or any other surgical procedure can be helpful.

If the cause is caused by low hormone production, hormonal treatments and certain medications can be extremely useful.

In the case of non-obstructive azoospermia, it is known that medical treatment may or may not help. However, it is possible to achieve pregnancy with a biological child through intracytoplasmic sperm injection, or in vitro fertilization.

To achieve this, the doctor can extract the sperm from the testicles, with the help of a small needle, and then continue with the couple's fertility treatment.