Unfortunately, pregnancy is not possible without assistance in azoospermia.
Azoospermia means the absence of sperm in the ejaculate as measured in a semen analysis (under the microscope). If there's no ejaculated sperm, then there is no chance of pregnancy via natural conception (sexual intercourse).
Men with azoospermia fall into 2 categories. The first category is obstructive azoospermia (OA). This implies normal sperm production in the testicles, but there is an obstruction blocking sperm from exiting the testicles and joining the rest of the semen. There are several possible causes for this, including scarring from a previous infection or injury, mesh that's placed during prior hernia repair surgery, or even having a prior vasectomy to purposefully cause obstructive azoospermia.
The other category is non-obstructive azoospermia (NOA). NOA means that there is a problem with sperm production in the testicles. The reason that no sperm is being ejaculated in NOA is that there is little or no sperm being produced in the first place. Possible causes include genetic abnormalities, prior chemotherapy or radiation treatment, or idiopathic (meaning that no specific reason can be determined).
Men with either OA or NOA need assistance to get their partners pregnant. An increasingly common procedure to obtain sperm directly from the testes, when sperm is not being produced in the ejaculate, is surgically removing sperm directly from the testicles. Sperm is nearly always found in cases of OA, because there are plenty of sperm being created. Sperm are not always in cases of NOA, because there are few or sometimes no sperm being created. If sperm can be harvested from the testicle, regardless of the underlying problem is OA or NOA, then it can only result in pregnancy when it's used as part of in vitro fertilization, or IVF. In IVF, individual sperm cells are placed into individual egg cells that have been retrieved from the female partner. The fertilized eggs are closely monitored for several days in the laboratory, and then 1 or 2 healthy ones are placed into the uterus. At that point, the hope is that fertilized eggs will attach to the lining of the uterus and proceed as normal pregnancies.
There is no simple way to reverse or treat azoospermia. Men with azoospermia should see a urologist specializing in male fertility to discuss treatment options in conjunction with the female partner and a doctor specializing in female fertility. Men with azoospermia who are part of a couple seeking pregnancy should do everything they reasonably can to maximize the health of their sperm prior to surgical retrieval (which are not always big surgeries, by the way, and can include 5-minute testis biopsies with local anesthesia in some cases). Maintaining a good diet and exercise provides a healthy environment for sperm.
At goswimmers.com you can access a free assessment that can provide individualized recommendations for sperm-healthy living.
At swimmers.com our goal is to support men and couples who are seeking fertility. We look forward to partnering with you!
