Dr.sathya balasubramanyam

MD DNB MRCOG (UK) FNB(Reprod med)

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A major contributor to male infertility, Azoospermia is a condition characterised by very low or no sperm concentration in the ejaculate. Affecting about 1 in every 100 men globally, the condition is responsible for infertility in about 10% of couples affected by issues of subfertility. It can be caused due to various abnormalities related to the production or delivery of sperm.


The condition can occur due to several reasons such as primary testicular failure or disorders like Klinefelter syndrome. Genetic disorders such as Y chromosome microdeletion and abnormalities in the chromosome (karyotype) are known to contribute to the condition as well. Other factors that are known to interfere with sperm production or mobility include Varicocele, hyperprolactinemia, unexplained gonadotropin deficiency and so on.

Ejaculatory duct obstruction, obstruction or congenital defects in vas deferens, undescended testicles at the time of birth, scrotal trauma due to injury or previous surgeries are some of the reproductive system abnormalities that cause azoospermia. Sickle cell anaemia, diabetes mellitus and severe liver or kidney diseases and cancer might result in the condition as well.

Azoospermia is classified into two as obstructive azoospermia and non-obstructive azoospermia. Obstructive azoospermia is caused due to a blockage or obstruction which prevents the delivery of sperm into the ejaculate while non-obstructive azoospermia is caused due to inadequacies in sperm production. The type of azoospermia can be identified with the help of the various diagnostic tests and examinations conducted by the doctor.

Azoospermia can be diagnosed with the help of a semen analysis. The procedure is repeated to ascertain the condition if the first result indicates a low concentration of sperm. Azoospermia is evaluated with the help of a careful analysis of the patient's history, physical examination and hormonal assessment.

History evaluation of the patient involves noting down the occupational history of the patient, probability of exposure towards radiation or chemicals, drug intake as in antibiotics, chemothereupatic agents, cimetidine and the sort, presence of the condition in the family or the presence of viral infections such as mumps.

The physical examination includes the documenting of height, weight, arms span, detection of gynecomastia, testicular volume and degree of androgenization. The test for testicular volume is conducted with the help of an orchidometer. Hormone tests to detect the levels of testosterone, serum FSH and LH are also conducted. In the case of decreased libido, the level of prolactin is checked as well.

A normal body proportion along with normal levels of all required hormones rules out the possibility of non-obstructive azoospermia. A few cases of non-obstructive azoospermia can be treated medically with the help of medications or hormonal therapy. Some cases of obstructive azoospermia can be treated with the help of surgical correction procedures to correct the blockage. ART (Artificial Reproductive Techniques) can be helpful in the successful conception of a baby in couples battling this disorder.


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Dr. Sathya Balasubramanyam

FNB(Reprod med)

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