Azoospermia is the absence of sperm in a man’s semen or ejaculate. It is one of the leading causes of male infertility, affecting about one percent of men in a pathological sense, meaning as a disease state. (Of course, the goal of a vasectomy is also azoospermia, but that’s a separate topic since sperm flow can often be restored with a vasectomy reversal, called a vasovasostomy.)
Getting Pregnant Naturally With Azoospermia
Azoospermia doesn’t necessarily mean a man can’t father a child. It just means natural conception isn’t possible. At Georgia Urology, surgeons Dr. Ronald Anglade and Dr. Akash Kapadia perform minimally invasive and highly accurate procedures to detect and harvest sperm.
There are two main types of azoospermia:
Obstructive azoospermia occurs when a blockage prevents sperm from entering the seminal fluid.
Non-obstructive azoospermia, where the issue lies in the testicles’ ability to produce sperm.
Testicular Mapping
Sperm is produced in the testicles, and azoospermia does not always mean the testicles are not making any. Testicular mapping is an innovative diagnostic procedure that uses fine needle aspiration to search for viable sperm throughout the testicles. Each testicle is divided into 12 sections, resulting in 24 total aspirations.
Under local (or rarely general) anesthesia, your fertility doctor inserts a tiny needle into the tissue and extracts a core sample for microscopic analysis. If sperm are found, the results guide a subsequent sperm retrieval procedure—such as micro-TESE.
Why Testicular Mapping Is a Game-Changer
Testicular mapping offers a more affordable, less invasive, and more targeted approach to finding sperm than traditional procedures. Mapping allows us to locate sperm precisely, so we only perform more invasive procedures if there’s a high chance of success. Among patients undergoing TESE, sperm are found in about 60% of cases – approximately 40% of those result in a successful pregnancy with assisted reproductive technologies like IVF, but outcomes depend on patient age, female partner’s fertility, and IVF/ICSI quality. (Learn more about testicular mapping.)
How a Micro-TESE Works
Micro-TESE, or testicular sperm extraction, is used to retrieve sperm directly from the testicles in men with azoospermia. Performed under general or local anesthesia, the procedure involves making a microscopic incision into the testicle to remove tissue. This tissue is then examined for the presence of viable sperm.
Thanks to advances in microsurgical technology and expert techniques, such as those employed by Drs. Anglade and Kapadia, even men diagnosed with non-obstructive azoospermia, often have hope for fatherhood. (Learn more about sperm extraction techniques.)
Bottom Line
Testicular mapping and micro-TESE are a highly effective combination for any patient evaluating fertility options due to azoospermia.
Rather than jumping straight into an invasive procedure, we now have a safer, less invasive alternative, which, combined with the microscopically precise extraction technique of micro-TESE, offers patients hope for fathering a child.
