Azoospermia is a medical condition in which a man's semen is devoid of sperm. Which causes infertility and difficulty conceiving. This condition affects 1% of men, and is responsible for about 15% of male infertility cases. (1)

What are the causes of azoospermia and how is it treated?


Causes of Azoospermia in men

The causes of azoospermia in men are divided into 3 categories, which we explain as follows:


1. Obstruction in the reproductive tract

  • This type is the most common, Represents approximately 40% of cases. (1)
  • In this case the production of Sperm is Normal, But There is a blockage in the epididymis, ejaculatory duct, or vas deferens, and it prevents the passage of sperm from the testicles into the semen. (2)
  • Among the causes of obstruction of the reproductive tract: (3)

○ Surgical injuries: such as surgery in the pelvic area, thigh, or reproductive organs.

○ Genital inflammations and infections: such as epididymitis or orchitis.

○ A congenital problem: A person may be born with an obstruction, deformity, or absence in the epididymis or the ejaculatory and semen ducts, etc.

○ Tumors and cysts: in the testicle or prostate.

○ Retrograde ejaculation: a condition in which semen moves to the bladder instead of to the penis.


2- Low or no sperm production

  • In this case, the testicles actually cannot produce sperm or produce very few sperm, due to a disorder or damage to the structure or function of the testicles. (2)
  • Among the reasons for low or no sperm production are: (3)

○ Testicular failure: resulting from damage to testicular tissue or malfunction.

○ Chemotherapy or radiation: to treat certain types of cancer.

○ Exposure to high temperatures: such as prolonged exposure to high temperatures in workplaces or saunas.

○ Misuse of certain medications: such as steroids or corticosteroids.


3- Weak hormonal stimulation

  • In this case, the testicles and reproductive system are completely Normal, however they are not stimulated enough of the pituitary gland in the brain to produce sperm. (2)
  • Causes of poor hormonal stimulation include: (3)

○ Hormonal imbalance, such as: deficiency of the male hormone (testosterone), or high levels of the milk hormone (prolactin) and androgens.

○ Exposure to some treatments such as: radiation or chemotherapy.

○ Heavy metal poisoning.

○ Some genetic disorders such as: Klinefelter syndrome, Kallmann syndrome.


How is azoospermia treated?

Treatment for azoospermia in men depends on its cause, and we explain that as follows:


Treating obstruction

The goal: Surgically removing the obstruction to allow sperm to pass through and to conceive naturally, or the doctor withdraws sperm through a thin needle for use in IVF.

Treatment options: (3)

  • Using a thin needle to withdraw sperm from the testicle: It is done by inserting a needle to withdraw sperm directly from the testicle for later use in IVF.
  • Transurethral resection of the ejaculatory ducts (TURED): Suitable for men who suffer from obstruction in the ejaculatory ducts, where a thin, flexible tube is inserted that contains a camera at the end to view the obstruction and remove it, which allows sperm to flow naturally into the ejaculatory ducts.
  • Surgical correction of scars: This is done by inserting a thin, flexible tube (endoscope) through the urethra and looking for any scarring or obstruction to remove them by cauterization.


Treating cases of azoospermia production that are not caused by obstruction

The goal: Depending on the cause of the problem it may be possible Stimulating sperm production by treating the cause, such as treating hormonal imbalances if they are the cause.

Treatment options: (4)

  • Hormone therapy: Medications can be used to treat hormonal imbalances, such as low testosterone, that may hinder sperm production.
  • Medications to improve sperm quality: Certain medications may be helpful in some cases.
  • Surgical treatment.


Success rates for treating azoospermia depend on the underlying cause of the condition and individual factors. It is important to discuss this with a healthcare professional who specializes in male infertility.





Reclaim Your Fertility! At Al-Ahli Hospital’s Urology Department, we provide advanced diagnosis and expert treatments for azoospermia, led by specialists in male infertility. Book your appointment today to explore the best treatment options for you.



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