What Are the Common Causes of Having No Sperm?

Three consecutive times of semen and urine after ejaculation, centrifugation of the specimen at> 3000g for 15 minutes, no sperm was found after microscopic examination of the sediment, which is called azoospermia, which is the main cause of male infertility.

Visiting department: Urology
Common causes: Testicular spermatogenic dysfunction or blocked vas deferens

Common symptoms: In addition to infertility, there are no clinical symptoms and signs
Contagious: no

Causes of azoospermia

Azoospermia can be divided into two categories: The first type is testicular spermatogenesis dysfunction, and sperm cannot be produced, also known as true azoospermia. The second type is that the testicular spermatogenesis is normal, but the insemination duct is blocked, and sperm cannot be discharged from the body. It is also called obstructive azoospermia.

Disorder of spermatogenesis

(1) Hereditary diseases: Autosomal or sex chromosomal abnormalities affect testicular sperm production, such as Klinefelter syndrome.

(2) Congenital testicular abnormalities: abnormal testicular development or abnormal testicular position can cause sperm production disorders.

(3) Testicular lesions: such as testicular trauma, inflammation, torsion, and testicular vascular disease.

(4) Endocrine diseases: hyperthyroidism or hypothyroidism, pituitary tumors, hyperadrenalism or hypothyroidism, hyperthyroidism or hypothyroidism can affect spermatogenesis and cause azoospermia.

(5) Severe systemic diseases and malnutrition: can cause azoospermia.

(6) Radiation damage and drugs: Especially cytotoxic drugs can damage the spermatogenic cells of the testis, and in severe cases can cause azoospermia.

2. Obstructive azoospermia

Congenital malformations: epitopic epididymis, epididymal atresia, absent or undeveloped vas deferens.

Infection: Neisseria gonorrhoeae, tuberculosis and other bacterial infections can cause epididymis and vas deferens obstruction.

epididymal cyst: compression of the epididymal duct causes obstruction.

damage: block the insemination pipeline.

Clinical manifestations of azoospermia

In addition to infertility, the disease has no clinical signs and symptoms. Some patients may be accompanied by sexual dysfunction, including erection difficulties and inability to ejaculate. If secondary to other diseases may be associated with symptoms, such as those with abnormal thyroid function may be associated with symptoms of hyperthyroidism or hypothyroidism. Pituitary dysfunction, pituitary tumors may be associated with symptoms, trauma may be accompanied by headaches and other symptoms.

Azoospermia test

1. Fine night analysis

No spermatozoa were found in the three examinations, and it was confirmed as azoospermia.

2. Endocrine examination

Serum FSH (Follicle Stimulating Hormone), LH (Luteinizing Hormone), PRL (Prolactin), T (Testosterone), DHT (Dihydrotestosterone) can help distinguish between primary or secondary testicular failure . Other tests include pituitary function, adrenal function, and thyroid function tests.

3. Genetic testing

Examine chromosomes, including autosomes and sex chromosomes, to determine if it is a genetic disease caused by a chromosomal abnormality.

4.B-ultrasound

Gross testicular lesions can be found. Color Doppler ultrasonography can detect sperm obstruction, which is helpful to determine whether it is obstructive azoospermia. Testicular biopsy can provide more reliable diagnosis and treatment basis.

Azoospermia diagnosis

According to the medical history and clinical manifestations, combined with fine-night analysis, B-ultrasound and testicular biopsy and other auxiliary examinations can confirm the diagnosis.

Azoospermia treatment

1.Treatment of true azoospermia due to spermatogenesis disorders

The treatment effect of this kind of diseases is relatively poor, especially those with severe testicular pathology and testicular pathological changes.

(1) In patients with bilateral cryptorchidism, fertility can be preserved if early surgery is performed, but no surgery is performed for patients older than 5 years, and the prognosis is poor.

(2) For the low spermatogenic function, FSH value is within the normal range, and clomiphene, moxifen and other drugs can be selected for treatment.

2. Treatment of obstructive azoospermia

For inflammation of the inferior duct, edema and obstruction, it can be treated with antibiotics and glucocorticoids; those who cause cyst compression (such as cysts in the ejaculatory duct area) can be cut through the urethra. Feasible seminal endoscopy is available. For those with obstructions such as congenital malformations or severe dysplasia that cannot be resolved, the donor's semen artificial insemination (AID) can be considered.