Understanding Azoospermia and Your Fertility Options
Azoospermia is one of the leading causes of male infertility, affecting about 1% of all men and up to 15% of infertile men. It refers to the complete absence of sperm in the ejaculate. While this can be distressing, advances in diagnosis and microsurgical techniques have made it possible for many men to achieve biological fatherhood.
Medically reviewed by Dr Ho Siew Hong
Senior Consultant Urologist
MBBS (NUS), FRCS (Edinburgh, Glasgow), FAMS (Urology), Singapore Board Certified Urologist
What Is Azoospermia?
Azoospermia means that no sperm cells are found in a man’s semen after microscopic examination.
There are two main types:
Symptoms of Azoospermia
In most cases, azoospermia is discovered during semen analysis done for evaluation of infertility
Azoospermia does not always mean infertility. Find out if sperm retrieval or microsurgery can help you and your partner.
How Azoospermia Is Diagnosed
A comprehensive assessment is essential to identify the underlying cause and determine if sperm retrieval is possible.
Treatment Options & Related Procedures
Management of azoospermia focuses on identifying reversible causes, restoring sperm flow, or retrieving viable sperm for assisted reproduction.
- Microsurgical Vasovasostomy / Vasoepididymostomy – Reconnects the vas deferens or epididymis to restore sperm flow.
- Sperm Retrieval (TESA – Testicular Sperm Aspiration) – A minimally invasive procedure under local anaesthesia to obtain sperm for IVF/ICSI.
- Microsurgical Vasectomy Reversal – Restores fertility in men with previous vasectomy where obstruction is at the vas level.
- Micro-TESE (Microsurgical Testicular Sperm Extraction) – A precise microsurgical technique to locate small areas of sperm production within the testes.
- Hormonal Therapy – Used when hormonal imbalance (e.g. low FSH or testosterone) contributes to impaired sperm production.
- Microsurgical Varicocele Repair – Improves sperm production when varicocele is identified as a contributing factor.
- Genetic Counselling – Recommended if genetic abnormalities are detected.
- IVF with ICSI (Intracytoplasmic Sperm Injection) – Retrieved sperm are injected directly into an egg for fertilisation.
- Cryopreservation (Sperm Freezing) – Preserves retrieved sperm for future IVF cycles.
Post-Treatment Care
Potential Risks
Take the First Step in Fertility Evaluation
Azoospermia does not always mean infertility. Schedule a consultation with Dr Ho Siew Hong to explore diagnostic and treatment options.
Frequently Asked Questions
Some forms of azoospermia (especially obstructive types) can be surgically corrected. In non-obstructive cases, sperm may be found through micro-TESE for use in IVF.
Yes. With advanced microsurgical sperm retrieval and ICSI, many men with azoospermia can father biological children.
Micro-TESE can retrieve sperm in up to 50–60% of men with non-obstructive azoospermia, depending on the underlying cause.
Most men recover within a few days and can return to work within a week.
Yes. A fertility evaluation of both partners provides a complete picture and helps plan the most effective treatment.
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