azoospermi

Azoospermia is the medical condition in which a man's semen contains no measurable sperm, leading to infertility. It affects about 1% of all men and up to 10–15% of men evaluated for infertility. The term azoospermia is used in English, while some languages render it as azoospermi.

Causes are divided into obstructive azoospermia (OA) and non-obstructive azoospermia (NOA). OA results from a blockage in the ducts that transport sperm, such as congenital absence of the vas deferens, vasectomy, infections with scarring, or surgical injury. NOA reflects impaired sperm production in the testes and can be caused by genetic conditions (for example, Klinefelter syndrome), Y chromosome deletions, hormonal disorders, testicular injury or disease, or prior chemotherapy or radiation.

Diagnosis typically begins with semen analyses showing no sperm on two occasions. A physical examination and hormonal tests (FSH, LH, testosterone) help distinguish OA from NOA. Additional tests may include scrotal ultrasound, genetic testing (for CFTR mutations or Y-chromosome deletions), and a testicular biopsy to determine the presence of sperm and guide treatment.

Treatment and prognosis depend on the underlying cause. OA may be managed with reconstructive surgery or by retrieving sperm for assisted reproduction (such as IVF with ICSI). NOA is commonly treated with sperm retrieval techniques such as micro-TESE to obtain sperm for IVF/ICSI; if sperm cannot be retrieved, donor sperm is an option. Hormonal therapy is used only in select NOA cases. Natural conception is generally unlikely, with prognosis varying by cause and access to fertility services.