Why Sperm may be Missing from Semen

There is a strong presumption that, when a man ejaculates, the sperm will be a major part of the semen. Couples for whom conception is not happening as quickly as they would like may question some potential causes. The complete lack of sperm is not one of them. It is true that only about 1 percent of men are affected by the condition referred to as azoospermia. However, this equates to 15 percent of men who are infertile. Here, we discuss the reasons why sperm may be absent from semen, and what may be done to help a man father a biological child.

Causes of Azoospermia

There are three general types of azoospermia:

• A rarer type of sperm-less semen, pretesticular azoospermia may occur in men with the hormone imbalance that has significantly diminished testosterone levels. Chemotherapy has also been linked to this particular condition, in which the testicles are normal except for their inability to make sperm.
• When the problem lies in the testicles, it could be due to damage. Testicular azoospermia may occur after cancer or cancer treatment. It could also stem from a genetic condition, groin injury, or infection within the reproductive tract.
• Post-testicular. This form of azoospermia, which is the most common type, occurs when sperm is made by the testicles but gets lost somewhere along the path out. This could be an obstruction in a sperm-carrying tube or retrograde ejaculation. A vasectomy is a purposeful block off the tubes that would normally carry sperm.

Diagnosis and Treatment

The first indicator of azoospermia may be infertility. Semen analysis may coincide with diagnostic testing for the female partner for the most comprehensive assessment. In a lab, semen samples are observed microscopically to evaluate presence, numbers, and mobility. An initial semen sample that has no sperm is usually followed by a second. If the second analysis also finds the absence of sperm, the diagnoses may be azoospermia. The next step is to determine where sperm have been interrupted. Testing may include lab-work for hormone levels, a biopsy, and radiography.

When an obstruction is found, surgery may be recommended to correct azoospermia. However, some men prefer the alternative of sperm retrieval. This procedure may successfully harvest sperm which may then be frozen for future use or used right away in an invitro fertilization process.

Learn more about the urology services available in our Chattanooga office. Call (423) 778-4MEN (4636).