Diagnosis of azoospermia

Azoospermia is an alteration characterised by the lack of sperm in the ejaculate, there are no symptoms or referred pain that may raise suspicion about the presence of the disease.

In order to diagnose azoopsermia, it is necessary, according to the recommendations of the WHO, to perform two seminograms with at least two months of separation between each one, so as to confirm the results obtained.

After months, even years, of failing to conceive, a couple ends up resorting to a specialist that will assess their fertility. Regarding the male, he will undergo a simple exploration to check the condition of his sexual organs and whether his testicles are properly descended or not. Hormone levels will be determined by blood testing. Finally, the evaluation will be completed with a seminogram.


The seminogram or spermiogram is a semen analysis. First, the sample is going to be observed macroscopically, determining the range of the following parameters:

  • Volume
  • Aspect
  • Liquefaction
  • Color
  • Viscosity

Later, semen will be studied at a microscopic level. A small quantity of the sample will be placed in a Makler chamber to count the existing spermatozoa.

Once the diagnosis of azoospermia by means of semimogran is done, the next step is to analyse hormone levels, considering that this type of patient may present imbalances in some hormones, such as FSH or testosterone.

FSH is produced in the hypophysis (a gland located at the base of the brain), and regulates the production of sperm by the testicles. High FSH values indicate low population of spermatogonial stem cells in the testis. Therefore, men with azoospermia tend to present higher values of this hormone.

Testosterone, on the contrary, follows the opposite way, since spermatogenesis (or sperm production) does not occur, men with azoopsermia have lower testosterone levels.

Nonetheless, we have to bear in mind that this scenario is typical of the secretory azoospermia, the most common and serious type. By contrast, hormone levels in obstructive azoospermia(in which there is sperm production that cannot be transported because of a problem in the ducts that carry the fluid), are closer to normal.

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