Some men have no sperm cells in their seminal fluid. This condition is called azoospermia. If there a small number of sperm cells are present, this is referred to as kryptozoospermia. It is absolutely necessary to repeat the semen analysis after approximately 6 weeks as there might be natural variations. Should the second analysis still show no sperm cells there is still hope of conceiving a child.
There are three causes of azoospermia:
- The spermatic cords are closed or missing. Hence, the sperm cells from the testicles, or the epididymis cannot reach the seminal fluid.
- Very few sperm cells are formed. They are degraded on the way from the testicles through the epididymis to the seminal cords, i.e. before they reach the seminal fluid, which is released by the prostate during ejaculation.
- No sperm cells are formed in the testicles.
Extraction of sperm cells through testicular biopsy (TESE / MESA)
The urologist/andrologist is the first person to contact in cases of diagnosed azoospermia. They conduct a clinical examination and give advice on the possibilities. Sperm cells can be obtained directly through a testicular biopsy (Testicular Sperm Extraction (TESE) or from the epididymis (Microepididymal Sperm Aspiration (MESA). In some patients the obtained material is very suitable for treatment, because it contains large amounts of sperm cells. This gives the possibility to freeze and store a part of them. Sometimes, however, there are no sperm cells to be found. An alternative would be to use semen from a third person. This procedure is regulated differently in individual countries.
Prim.Dr. Eugen Plas is available for further information!
IMPORTANT: Very few sperm cells can be obtained through TESE and MESA. Therefore it is always necessary to treat the female partner with in vitro fertilization (IVF), since this is the only way to achieve fertilization of the ovum with very few sperm cells.
Aspermia is the condition where no seminal fluid is ejected from the urethras despite muscle contractions. This dry orgasm is normal prior to puberty. Afterwards, it is most likely caused by a nerve disorder in the urogenital system, e.g. through paraplegia.