Azoospermia is a condition in which there are no sperm in the ejaculate.

If ejaculate has no sperm in the semen specimen, and there is no history of a vasectomy, this condition is called non-obstructive azoospermia. It is very important that if a standard semen analysis shows no sperm, that the next semen specimen is processed with a centrifuge, and that the pellet is examined according to a specialized protocol. Even if a few sperm are found in the semen specimen, it could eliminate the need for a surgical procedure to harvest sperm.

At Urology Austin, our urologists work with highly-skilled embryologists and reproductive endocrinologists to maximize a patient’s odds of achieving a successful pregnancy – even if there is no sperm in their semen analysis.

If there is no sperm in the semen analysis, what is the process of getting pregnant?

Our urologists perform specialized testing of the male partner’s chromosomes, a Y microdeletion and a hormonal profile. These tests help the provider determine if there is the potential of harvesting sperm from the testes or epididymus (a structure on the back of the testicle). If sperm are successfully harvested, they are used for in vitro fertilization (IVF) along with intracytoplasmic sperm injection (IVF with ICSI).

How is sperm obtained when no sperm is present in the semen analysis?

Testicles often have sperm production (spermatogenesis) even though sperm may not be present in ejaculate. Several different patterns of sperm production may be seen in non-obstructive azoospermia such as hypospermatogenesis, sertoli cell only, and maturation arrest. The process of harvesting sperm from the testicle is called Testicular Sperm Extraction (TESE), and the process of harvesting sperm from the epididymus is called Microscopic Epididymal Sperm Aspiration (MESA). In certain surgical cases, a more extensive search for sperm is required. In these cases, a micro-TESE procedure is performed. The exact procedure required depends on the individual circumstances and is either determined before surgery or at the time of surgery.

The entire process of obtaining sperm and ultimately getting pregnant is involved, and can be emotionally challenging. If you have concerns about male infertility, contact the Urology Austin office nearest you to schedule an appointment with one of our urologists.