Azoospermia — the complete absence of sperm in the ejaculate — affects about 1% of all men. As frightening as it sounds, a significant proportion of men diagnosed with azoospermia can today become biological fathers thanks to microsurgical techniques.
What causes azoospermia?
There are two main groups. In obstructive azoospermia the testes produce sperm, but a blockage in the ducts prevents them from reaching the ejaculate. In non-obstructive azoospermia the problem is production itself — hormonal disorders, genetic causes (Klinefelter syndrome, Y-chromosome microdeletions), past infections or chemotherapy may have suppressed it.
Micro-TESE: a sperm hunt under the microscope
Even in non-obstructive azoospermia, production often continues in small focal areas. In micro-TESE the testicular tissue is examined under an operating microscope at 20-25x magnification and only the enlarged, sperm-producing tubules are selected. Tissue damage is minimal while the chance of finding sperm rises to 30-60%.
During micro-TESE at our center, the embryology team is present in the operating room and examines the tissue simultaneously. When sperm are found, they are injected into the partner’s eggs by ICSI on the same day; the remainder are frozen for future attempts.
What affects success?
- The cause of azoospermia (obstructive cases have the highest chance)
- Hormone levels (FSH, testosterone) and genetic findings
- The experience of the surgeon and embryology team
- The partner’s age and ovarian reserve
If you have been diagnosed with azoospermia, do not lose hope: at the right center, with urology and embryology working together, your chance of fatherhood may be higher than you think.