Azoospermia

Azoospermia (No Sperm in the Ejaculate)

Azoospermia is a condition where no sperm are found in the semen. It affects about 1 in 100 men—and up to 10–15% of men with infertility.

If you’ve been told you have azoospermia, it does not automatically mean you can’t have biological children. The key is understanding why it’s happening.

TYPES OF AZOOSPERMIA:

1. Obstructive Azoospermia
   Sperm are being produced normally, but a blockage prevents them from reaching the ejaculate.
   Common causes include prior vasectomy, infection, or congenital absence of the vas deferens.
2. Non-Obstructive Azoospermia
   The testicles are not producing enough sperm, or production is severely impaired.
   This may be related to genetics, hormone imbalances, varicocele, or prior medical treatments.

Evaluation Matters

A proper evaluation is critical—and often rushed or incomplete elsewhere.

At our practice, your workup may include:

• Detailed history and physical exam
• Hormone testing
• Genetic testing (when appropriate)
• Scrotal ultrasound
• Review of prior semen analyses

We don’t take a “one-size-fits-all” approach—because azoospermia isn’t one condition.

Treatment Options

Treatment depends entirely on the cause:

• Surgical repair (for obstruction)
• Varicocele repair (in selected cases)
• Hormonal optimization
• Sperm retrieval procedures such as TESE or microTESE

Even in cases of severe non-obstructive azoospermia, sperm can often still be found with advanced microsurgical techniques.

Our Approach

This is where experience matters.

Dr. Zeitlin takes a methodical, high-effort approach—especially in complex cases like non-obstructive azoospermia. His microTESE procedures are meticulous and can take several hours, maximizing the chance of finding sperm when it exists.

Because in this situation, details matter—and shortcuts cost outcomes.

The Bottom Line

Azoospermia is not the end of the road.
But it does require the right diagnosis, the right strategy, and the right surgeon.

If you’ve been diagnosed with azoospermia or told your options are limited, we’re happy to review your case and discuss next steps.