Azoospermia: Issues and Treatments


A lot of males have fertility issues. While male fertility problems are not as publicly discussed as female fertility problems, they are just as real, and they present just as much of an obstacle to getting pregnant. One of the biggest male infertility issues is azoospermia. This condition affects roughly 1% of all males.

The term “azoospermia” is a medical term that refers to the absence of spermatozoa from seminal fluid. While most males are able to produce copious quantities of sperm on a regular basis, a small portion of males struggle to produce the necessary amount of sperm for conception. Although only one sperm ends up fertilizing the egg, millions of sperm are needed as only a few are able to travel from the vagina to the uterus.

There are roughly 3 different types of azoospermia: pre-testicular azoospermia, testicular azoospermia, and post-testicular azoospermia. Of these different types, testicular azoospermia presents the most formidable problems. However, both pre-testicular azoospermia and post-testicular azoospermia are also challenging to work with.

In pre-testicular azoospermia, the testes are not receiving enough hormonal stimulation to produce appropriate amounts of sperm. Most males with pre-testicular azoospermia lack sufficient quantities of follicle-stimulating hormone (FSH). Excessive testosterone levels are often associated with inadequate levels of follicle-stimulating hormone. Because of this, steroid abusers often develop pre-testicular azoospermia.

Testicular azoospermia is much more difficult to work with than pre-testicular azoospermia. In fact, it can be devastating and is usually untreatable. Testicular azoospermia is usually caused by significant problems with the testes. Most males with testicular azoospermia have testes with significant cellular damage or are missing testes altogether.

A lot of different chemical agents can cause damage to the testes. Radiation exposure can damage the testes and cause azoospermia. Also certain kinds of chemotherapy can easily cost testicular damage. Unfortunately, more and more males are being exposed to chemical agents with the potential to cause testicular damage. Pesticide use in home and garden settings is on the rise, and most pesticides have negative effects on sperm production. Some pesticides even cause permanent damage to the testes.

Although there are in-vitro-fertilization strategies to resolve fertility issues related to pre-testicular azoospermia and post-testicular azoospermia, it is not common to use in vitro fertilization strategies when there is testicular azoospermia caused by severe damage to the testes. Males with testicular azoospermia often end up having their partner use a sperm donor to conceive or consider adoption. Please see my medical disclaimers on the site that this author is not a medical professional, rather a medical reporter at best, and you should take advise with a reputable medical professional for the answers to these issues.


Post-testicular azoospermia is unique amongst the different types of azoospermia because it is the only one most commonly caused by a voluntary surgical procedure: vasectomy. While most men that opt for vasectomies never regret their decision, a small number try to have children later in life. These men often receive treatment for male infertility with post-testicular azoospermia.

Fortunately, vasectomy induced post-testicular azoospermia is very treatable. As long as viable sperm are being produced within the testes, sperm can be surgically removed from within the testes and used to fertilize the egg using in vitro fertilization. This procedure is known as intracytoplasmic sperm injection. While relatively new, it is becoming increasingly popular.

Assuming they have viable testes, males diagnosed with azoospermia are encouraged to make lifestyle changes before seriously considering in vitro fertilization. Most of the recommended lifestyle changes are relatively easy to implement. Their efficacy varies from person to person, but they cost virtually nothing to implement and are worth a try.

Most fertility specialists recommend that men with azoospermia try switching from briefs to boxers. Heat is very efficient at lowering sperm levels. The more heat the testicles are exposed to, the less viable sperm they will produce. Briefs allow more heat to build up around the testicles, while boxers help cool the testicles by enabling more airflow around them.

Excessive alcohol and marijuana use can also lower sperm count. While the exact reasons why this is so are not yet completely understood, it is generally recommended that men with azoospermia abstain from drinking excessive levels of alcohol and avoid marijuana use entirely. Sometimes even just a small increase in sperm count is enough to make conception possible.

Over the last 50 years, the number of males with azoospermia has been increasing. Fertility specialists are worried about the implications. However, by making lifestyle changes and using in vitro fertilization if necessary, most males with azoospermia can have a child. For many, achieving conception makes all lifestyle changes and financial sacrifices worthwhile.

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