How Is Azoospermia Diagnosed?

We know that an infertility diagnosis is deeply disturbing for many men. But successful azoospermia treatment starts with determining the cause. Normally, sperm is produced in your scrotum’s testicles (testes) and flows through your reproductive tract to mix with fluid in the seminal ducts. That forms semen: the thick, white fluid released from the penis during ejaculation.

Up to 2 percent of the world's men lack measurable sperm in their semen – with azoospermia representing up to 10 percent of male infertility cases. The problem is either present at birth or develops later in life, and is sometimes referred to as "no sperm count." We provide a comprehensive evaluation to get to the exact cause of your condition.

Types of azoospermia

During diagnosis, your doctors will determine which kind of azoospermia you have:

• Obstructive Azoospermia: Sperm are produced but then get blocked in your reproductive tract
• Nonobstructive Azoospermia: Sperm production is impaired

Our doctors have the expertise and tools to diagnose both types, and to tailor your treatment accordingly. The goal is to correct the problem so the easiest (and often most affordable) form of conception is possible—though the exact approach is up to you and your partner. Generally, you need:

• 10 to 20 million moving sperm for unassisted conception
• 3 to 5 million for intrauterine insemination
• 1 million sperm for in vitro fertilization (IVF)
• 1 to 20 sperm for intra-cytoplasmic sperm injection (ICSI)

Sperm samples

Accurately diagnosing azoospermia starts with two sperm samples, collected at different times to account for natural variability. You can either provide the sample at our office or bring it in, provided that:

• You bring the sample in within the hour.
• The container remains at body temperature, such as in a pocket.

Regardless of the method, we ask that you refrain from ejaculating two to five days before giving the sample, so your body can replenish any sperm it is producing. The sperm samples undergo at least one test:

• The first step involves a basic analysis.
• If no sperm are found, then we spin the samples in a centrifuge to create a concentrated "pellet" and examined further. Our technicians look for evidence of any hidden sperm (cryptospermia).

Azoospermia versus oligospermia

During your diagnosis, you may find you have an abnormally low amount of sperm (oligospermia), rather than no sperm at all. In these cases, you may receive treatment at our Male Reproductive Medicine and Surgery Program.

Other diagnostic procedures

Your diagnosis may also include:

• A detailed medical history: includes review of any existing records (while patients may have already seen a doctor for infertility, it is not a requirement for visiting our center)
• Physical examination
• Hormone testing
• Genetic screening
• Genital tract imaging: uses ultrasound, MRI (magnetic resonance imaging) or CT (computed tomography) scan