Fertility • January 19, 2012

What are the options when the man has no sperm in the semen sample?

Terje Sordal

Fertility specialist dedicated to helping patients expand their family and stay informed through evidence-based insights.

At Medicus you can get took a semen sample to find out more about your fertility. In some men, we find no sperm in the semen sample. This is called azoospermia. This affects about 5% of men trying to have children.

Investigation to find the cause

If a semen sample is submitted and the laboratory does not find sperm, further investigation must be considered. To find the cause of the lack of sperm, it is common to take a hormonal examination, genetic examination and possibly an ultrasound of the testicles. Even if a man does not have sperm, he will have seminal fluid, sperm only make up 1% of the seminal fluid. The reasons for the lack of sperm can be hormonal, there can be a production failure, and there can be "transport problems" or ejaculation problems.

Various reasons

If the cause is hormonal, it may be possible to treat it in some cases. This is done by administering hormones over a long period of time, with the goal of increasing sperm production. Other causes may include mumps as a child, spinal cord/testicular injuries, cancer, genetics, medications, radiation, infections, missing sperm ducts, diabetes, fever, etc. If you take anabolic steroids, some people will experience a cessation of sperm production.

Operative sperm retrieval can solve "transport problems"

Sperm cells - Sperm quality - Sperm

If the problem lies in the transport, that is, it is assumed that the production is in order, but that the sperm are not coming out, a testicular and/or epididymal aspiration (TESA/PESA) can be performed, possibly a TESE, where a larger piece of tissue is removed. These are simple procedures that are performed under local anesthesia. If sperm are found during this procedure, you can proceed with in vitro fertilization.

When we can't find sperm

In some cases, sperm will not be found. It can be a tough message to receive; that you will not be able to become a biological father. For most people, it will be a shock, and it may take a long time to come to terms with this. If you are in a relationship where the desire for children is strong, you will then have two options; assisted fertilization with donor sperm or adoption.

Assisted fertilization with donor sperm

If the couple chooses assisted fertilization, the man will be listed as the father on all public papers, and it is only the child themselves, upon reaching the age of 18, who chooses whether she/he wants to know the identity of the donor.

Many people find it difficult to take the step of starting a family where you have to use a donor. There are many ethical issues that you have to decide on, and the decision will have consequences for the rest of your life. Should you tell the child about how it came about? When is the right time to tell? Would you be just as happy with a child who is not your biological child? How much do you want to know about the donor? Etc.

There is no answer to these questions, and each individual couple finds what is right for them. Medicus offers treatment with a donor, and will be able to provide advice and guidance to those who wish to do so prior to the treatment.

Book an appointment for semen sample delivery

COMMENTS · 2

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Kristine March 06, 2012

Hey!
We will hopefully be making the trip down to you soon. But if the tests show that we need to use a donor, how long will it take before that can be done?

1 answer SVAR
- Terje Sordal March 06, 2012
  
  Hi! If you need a donor, it will not delay a possible attempt. We will take care of the practicalities of ordering and shipping the donor.
  
  SVAR

What are the options when the man has no sperm in the semen sample?

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