Azoospermia means there is no sperm in the semen. It can be very hard news, but it does not always mean a man cannot become a father. In many men, sperm can still be found or sperm production can be restored. The right treatment depends on where the problem lies, so the first step is always a careful assessment.
Our Team
Our team has treated men with azoospermia for 16 years and has performed about 600 micro-TESE operations. Dr. Mehmet Koç plans and manages each treatment, together with the andrology specialist on our team, who performs the sperm retrieval. We see men from Turkey and from abroad every month.
Finding the Cause
Hormone tests show whether the problem is a blockage in the sperm ducts, a problem in the testis, or a problem with hormone production in the brain. We never plan an operation without seeing these results. The tests are:
- FSH, LH and testosterone (blood tests)
- Karyotype (a chromosome test)
- Y-chromosome microdeletion test
- Scrotal ultrasound
You can do all of these tests in your own country and send us the results before you travel. If you cannot have them done at home, you can come to Istanbul for a consultation of one or two days. We do the tests here, give you any medication you need, and you return later for treatment.
Treatment Depends on the Cause
- A blockage in the sperm ducts (obstructive azoospermia): sperm production in the testis is normal, so sperm can usually be found easily, often with a simple procedure called TESA. The chance of finding sperm is very high.
- A problem in the testis (non-obstructive azoospermia): sperm is searched for with micro-TESE. The chance is lower than with a blockage, but at our office we find sperm in most of our patients. Some men are given medication first.
- A problem with hormone production in the brain: hormone treatment for several months often brings back sperm production, and many of these men do not need an operation at all.
Testis size and FSH, LH and testosterone levels also affect the chance of finding sperm. We use all of your results to give you a personal assessment.
Hormone Treatment Before Surgery
We decide on hormone treatment entirely by your hormone levels, together with our andrologist. Treatment usually lasts 3 to 6 months, and for some men longer.
Using the Sperm
Sperm found in the testis is used for ICSI, where a single sperm is placed in each egg. We prefer to use fresh sperm on the day of your wife’s egg collection. Read why on our micro-TESE page.
If Micro-TESE Elsewhere Found No Sperm
We can perform a new sperm search for men whose micro-TESE at another centre found no sperm. We first review your hormone tests and other results. If needed, we give medication and operate again about 6 months later, searching different areas of the testis. To be honest with you: the chance of finding sperm in a repeat operation is clearly lower than in a first one. We make this decision together with you.
Low Sperm Count
If you have some sperm but a low count, we also start with hormone tests to find where the problem lies. We review the results with our andrologist and give medication if needed, usually for 3 to 6 months. Read more about male infertility treatments.
Talk to Us
Send us your test results on WhatsApp or through our contact form, and Dr. Koç will review them. You can also get a free second opinion.