Sexual Medicine, Fertility, Urology and Andrology in Seville and Canary Isl.


What is Azoospermia?

The WHO (World Health Organization) defined azoospermia as the absence of sperm in the semen or ejaculate. This diagnosis should be based on at least two semen samples with a gap between them of about 4 weeks.

How frequent is this condition?

Its prevalence is 2% in the general population and 10-20% in men studied for sterility.

Why does it happen? What are its causes?

In practice, we distinguish two types of azoospermia: obstructive, in which sperm do not appear in the ejaculate due to an obstruction of the seminal duct, and non-obstructive, in which no sperm are produced in the testis, either due to a lack of hormones, or because of a congenital or acquired condition.

How is it diagnosed?

The minimum initial evaluation should include a complete medical history, physical examination and hormonal profile, including at least FSH and testosterone in blood. Genetic testing may be of interest and recommended in some cases (suspected Cystic Fibrosis, karyotype, microdeletions of the Y chromosome, etc.).

What is the treatment protocol?

This protocol will depend on the initial assessment and FSH levels. Hormonal treatment can be included to stimulate sperm production or a testicular biopsy may be carried out.

How is a Testicular Biopsy performed?

If it is necessary, a testicular biopsy can be performed to obtain testicular sperm. Although there are different methods, currently the most used are TESE and microTESE. Both are usually performed under local anesthesia, but can be performed with sedation if necessary depending on the case, and on an outpatient basis (no need to be admitted to the clinic)

What is microTESE?

In borderline cases, in which sperm retrieval by biopsy is believed to be virtually impossible, or in cases where conventional biopsy or TESE failed in previous attempts, the MICRO-TESE can offer an additional percentage of successful sperm retrieval. According to some authors, the success rate increases from 45 to 65% with this technique, in which a search with surgical microscope is employed.

Dr. Natalio CruzJefe del servicio de Andrología
El Dr. Cruz, con 25 años de experiencia médica, ha sido hasta 2016 Jefe de la Unidad de Andrología en el Servicio de Urología del Hospital Virgen del Rocío de Sevilla, Coordinador Nacional de Andrología de la Asociación Española de Urología (AEU) y Secretario General de la ESSM, cargos que ha delgado para centrarse de lleno en el ilusionante proyecto de ofrecer una consulta médica privada de alto nivel en Sevilla.

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4 Responses to AZOOSPERMIA

  • Jose Mendoza United States says:

    Creo que tengo azoospermia no me sale esperma donde esta localizado su consultorio

    • Clínica Urología y Andrología Andromedi Spain says:

      Hola José, nuestra consulta ses encuentra en Sevilla, puede escribirnos a través de nuestra zona de contacto, o a través de los datos que encontrará en la parte superior de la página.

  • Daniel Wells Costa Rica says:

    I am from USA living in Costa Rica, 64 years old, had a espermogram done, and it came back NO SPERM, would like to have a child, is there anything I can do? Is there a Doctor in Costa Rica that you recommend?
    I am a little over weight, but in perfect health
    Thank you for you time
    Have a GREAT day

    • Clínica Urología y Andrología Andromedi Spain says:

      Hi Daniels, really don´t know an spezialised center in Costa Rica, sorry. About the “no sperm” result, we should review it carefully in our clinic to find the reason, and to think about possible treatments or options to have a child.