Why is there no sperm in my semen?

In her latest online article, renowned fertility specialist Dr Irfana Koita explains the different causes of an absence of sperm in the semen, and the treatments available.

Why is sperm absent from my semen?

Azoospermia is the medical term used to describe the complete absence of sperm in your semen, falling into two main categories:

• Obstructive: Where viable sperm face a physical blockage, unable to leave the body normally.
• Non-obstructive: The testes do not adequately produce sperm in terms of quality or quantity.

What is obstructive azoospermia?

Obstructive azoospermia involves the production of healthy sperm in the testes that are unable to exit due to physical obstructions. This could be due to a congenital absence of reproductive tubes (vas deferens), cysts causing blockages, testicular swelling from infection or injury, or scarring from previous surgeries.

A vasectomy is an obstructive procedure to cease semen delivery. Men usually choose to have this done for personal or family planning reasons.

What is non-obstructive azoospermia?

Non-obstructive azoospermia is diagnosed when there's a reduced or absent production of sperm in the testicles. This can be attributed to lifestyle factors, testicular abnormalities, reduced reproductive hormone levels, genetic conditions (like Klinefelter syndrome or Y-Chromosome absence), cancer treatments, steroid overuse, or varicocele causing scrotal vein enlargement.

What is retrograde ejaculation?

Retrograde ejaculation, known as a dry orgasm, occurs when semen travels back into the bladder instead of forward through the urethra due to a relaxed bladder muscle. This condition can result from certain medications or various health conditions, including diabetes, multiple sclerosis, Parkinson’s disease, and spinal cord injury.

Diagnosis involves a semen analysis test. A fertility specialist will review your medical history and may conduct further investigations, such as a physical examination, blood tests for reproductive hormones, chromosomal evaluation, ultrasound scans, or a biopsy.

Treatment options are based on the diagnosis and medical history, with the consultant recommending the most suitable course of action if the condition is treatable.

If you would like to book a consultation with Dr Irfana Koita, you can do so today via her Top Doctors profile.