What Is Azoospermia? Symptoms, Causes and Treatment

Created: 09.06.2026  ·  Last Updated: 22.07.2026  ·  Category: Urology  ·  Prepared by the Academic Hospital Web and Editorial Board.

Azoospermia is the absence of sperm cells in semen. As one of the important causes of male infertility, azoospermia may be detected during the evaluation of couples who have difficulty having children. However, receiving this diagnosis does not always mean that having a child is impossible.

Important Information: Azoospermia is diagnosed when no sperm cells are seen in semen analysis. A final conclusion should not be made based on a single result; evaluation should be performed by a urology specialist together with semen analysis, physical examination, hormone tests and further investigations when necessary.

What Is Azoospermia?

It is the condition in which no sperm cells are detected in the semen analysis. Semen is the reproductive fluid that carries sperm cells. It may be seen in approximately 1 out of every 100 men in the general population and in approximately 10-15% of men evaluated due to infertility. It is not a disease on its own, but a condition that may develop due to different underlying causes.

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What Are the Symptoms of Azoospermia?

It is most often discovered during investigations performed because pregnancy does not occur.

  • Failure to achieve pregnancy despite long-term unprotected intercourse
  • Decreased sexual desire
  • Erectile problems
  • Shrinkage of the testicles
  • Body changes related to hormonal disorders
  • History of previous infection or surgery

However, azoospermia may also be detected in many men without any symptoms.

What Causes Azoospermia?

Sperm Production Disorders

This is the condition in which sperm production in the testicles is insufficient or does not occur at all. Causes may include:

  • Genetic diseases
  • Hormonal disorders
  • History of undescended testicle
  • Chemotherapy or radiotherapy
  • Some infections
  • Testicular damage.

Obstructive Azoospermia

Although sperm may be produced in the testicles, there may be a blockage in the ducts that carry sperm. This condition may be seen after:

  • Congenital absence of ducts
  • Previous infections
  • Surgical procedures
  • Vasectomy.
Clinical note: Azoospermia may be caused by obstruction, or it may be related to reduced or stopped sperm production in the testicles. This distinction is important for determining the treatment plan and sperm retrieval methods.

What Are the Types of Azoospermia?

Obstructive Azoospermia

Sperm production is present, but sperm cannot reach the semen because of a blockage in the sperm ducts. In this group, the success rate of obtaining sperm is generally higher.

Non-Obstructive Azoospermia

Sperm production in the testicles may be reduced or completely stopped. The treatment plan is determined according to the underlying cause.

How Is Azoospermia Diagnosed?

The diagnostic process primarily begins with semen analysis. When necessary, the following may be performed:

  • Hormone tests
  • Genetic examinations
  • Scrotal ultrasonography
  • Physical examination
  • Advanced urological evaluations.

For a definitive diagnosis, semen analysis may need to be repeated at certain intervals.

Can Azoospermia Be Treated?

Treatment varies depending on the cause of azoospermia.

  • Hormonal treatments
  • Surgical corrections
  • Correction of duct obstruction
  • Planning of reproductive techniques

Therefore, every patient diagnosed with azoospermia should be evaluated individually.

Topics considered during the evaluation process:

  • Repeating semen analysis and interpreting the results together
  • Testicular volume, hormone profile and physical examination findings
  • Obstruction, genetic causes or history of previous surgery
  • The couple’s goal of having a child and suitability for assisted reproductive techniques

What Is Micro-TESE in Azoospermia?

Micro-TESE is a procedure in which sperm is searched for in testicular tissue with the help of a microscope. It may be used especially in non-obstructive azoospermia to increase the chance of retrieving sperm. The sperm obtained can be used in in vitro fertilization treatment.

Do Not Delay Evaluation After an Azoospermia Diagnosis

For azoospermia and male infertility complaints, you can book an appointment with Academic Hospital specialists for a personalized evaluation and the necessary treatment plan.

Frequently Asked Questions

Can men with azoospermia have children?
Yes. A diagnosis of azoospermia does not mean that having a child is impossible. Proper evaluation and specialist follow-up are very important.
Can azoospermia develop later in life?
Yes. Azoospermia may develop after infections, hormonal disorders, some medications, surgical procedures or trauma.
How is azoospermia detected?
Azoospermia often does not cause a specific complaint. It is usually detected after semen analysis performed because pregnancy does not occur.
What is the difference between obstructive and non-obstructive azoospermia?
In obstructive azoospermia, sperm production is present but sperm cannot reach the semen because of a blockage in the ducts. In non-obstructive azoospermia, sperm production in the testicles may be reduced or stopped.
When can Micro-TESE be performed?
Micro-TESE may be performed especially in non-obstructive azoospermia to search for sperm in testicular tissue. Suitability is determined by a urology specialist’s evaluation.
Is azoospermia treatment the same for everyone?
No. Treatment varies depending on whether azoospermia is related to obstruction, hormonal disorder, genetic causes, previous surgery or sperm production problems in the testicles.
Academic Hospital note: Azoospermia is one of the important causes of male infertility, but being diagnosed does not always mean that having a child is impossible. To determine the cause and evaluate personalized treatment options, you can book an appointment.

References

The general information in this article about azoospermia, male infertility, semen analysis, obstructive and non-obstructive azoospermia and Micro-TESE is supported by the following authoritative health sources.

  1. Cleveland Clinic, "Azoospermia (Zero Sperm Count): Causes & Treatment", clevelandclinic.org
  2. Mayo Clinic, "Low sperm count - Diagnosis and treatment", mayoclinic.org
  3. American Society for Reproductive Medicine, "Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I", asrm.org
  4. American Society for Reproductive Medicine, "Diagnosis and treatment of infertility in men: AUA/ASRM guideline part II", asrm.org