Being told you have zero sperm count can feel devastating. But azoospermia — the medical term for no sperm in the semen — is treatable in most cases. Dr. Kalpesh Kapadia, MCh Uroandrologist and Gold Medallist from B.J. Medical College, Ahmedabad, specialises in diagnosing and treating azoospermia with advanced surgical and assisted reproductive techniques.

With the right diagnosis and treatment, pregnancy is possible even with zero sperm count.

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What is Azoospermia?

Azoospermia means there are no sperm detected in a semen sample. It affects approximately 1% of all men and is responsible for around 10–15% of male infertility cases. It is diagnosed through semen analysis — ideally repeated on two separate occasions after 3 days of abstinence from ejaculation.

An absence of sperm in semen does not mean the testicles cannot produce sperm. In many men, sperm are being produced but cannot reach the semen due to a blockage — and in others, targeted surgical extraction can still retrieve viable sperm for IVF.

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Types of Azoospermia

1. Obstructive Azoospermia (OA)

Sperm are being produced normally in the testicles, but a blockage in the reproductive tract prevents them from reaching the semen. This is the more treatable form of azoospermia.

Common causes: prior vasectomy, infections (epididymitis), congenital absence of the vas deferens (CBAVD), or injury.

2. Non-Obstructive Azoospermia (NOA)

The testicles are not producing sperm normally, or are producing very few. This can be due to a hormonal problem, genetic condition, or damage to the testicles.

Common causes: Klinefelter syndrome, Y-chromosome microdeletion, hormonal imbalances (FSH, LH, testosterone), varicocele, chemotherapy or radiation, or undescended testicles.

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How is Azoospermia Diagnosed?

A thorough evaluation by Dr. Kalpesh Kapadia includes:

• Semen analysis — repeated twice to confirm the diagnosis
• Physical examination — testicular size measured using an orchidometer; presence of vas deferens and epididymis confirmed
• Hormonal blood tests — FSH, LH, testosterone, prolactin levels
• Genetic testing — karyotype, Y-chromosome microdeletion analysis
• Scrotal ultrasound — to detect varicocele, blockages, or testicular abnormalities
• Testicular biopsy — in selected cases, to assess sperm production directly

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Treatment Options

TESE – Testicular Sperm Extraction

A minor surgical procedure in which a small piece of testicular tissue is removed and examined for sperm. Used in obstructive azoospermia to retrieve sperm for use in IVF/ICSI.

PESA – Percutaneous Epididymal Sperm Aspiration

A needle is used to aspirate sperm directly from the epididymis. Minimally invasive and effective for men with obstructive azoospermia, particularly after vasectomy.

Micro-TESE – Microsurgical Testicular Sperm Extraction

The most advanced technique for non-obstructive azoospermia. The testicle is opened and examined under 20–30× magnification to identify and extract the tiny tubules most likely to contain sperm. Performed in the IVF laboratory in the presence of an expert embryologist.

Micro-TESE offers significantly higher sperm retrieval rates compared to conventional TESE — approximately 40–60% success even in severe non-obstructive cases. It is Dr. Kalpesh Kapadia’s area of special expertise.

Surgical Correction of Obstruction

In cases of obstructive azoospermia, the blockage itself can sometimes be surgically repaired — restoring natural sperm flow and allowing natural conception or IUI.

ICSI – Intracytoplasmic Sperm Injection

Once sperm are retrieved (via TESE, PESA, or Micro-TESE), a single sperm is injected directly into an egg in the IVF laboratory. This is the standard fertilisation technique used alongside sperm retrieval procedures.

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Why Choose Dr. Kalpesh Kapadia?

• MCh (Genitourinary Surgery) — Gold Medallist, B.J. Medical College, Ahmedabad
• Over 15 years of experience in urology and andrology
• Specialist in Micro-TESE, TESE, and PESA for azoospermia
• Works in close collaboration with embryologists at IVF centres
• Personalised, compassionate care for a sensitive condition
• Patients from across Gujarat and India

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Frequently Asked Questions

Can azoospermia be cured?

In many cases, yes. Obstructive azoospermia can often be corrected surgically. For non-obstructive azoospermia, sperm retrieval via Micro-TESE combined with ICSI offers real chances of achieving pregnancy — even when no sperm are visible in the semen.

Is Micro-TESE painful?

The procedure is performed under general or spinal anaesthesia, so there is no pain during the surgery. Post-operative discomfort is mild and manageable with medication. Most patients return to normal activity within a few days.

What is the success rate of Micro-TESE?

Sperm retrieval is successful in approximately 40–60% of non-obstructive azoospermia cases using Micro-TESE — significantly higher than conventional TESE. Success depends on the underlying cause and is discussed in detail during consultation.

How long does diagnosis and treatment take?

Initial evaluation including semen analysis, blood tests, and physical examination can be completed within 1–2 weeks. A treatment plan is then discussed based on results. The actual sperm retrieval procedure is typically a day procedure.

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Book a Consultation

If you have been diagnosed with azoospermia or zero sperm count, do not lose hope. Dr. Kalpesh Kapadia offers a thorough, personalised evaluation and will guide you through every step of the treatment process.

📞 Call or WhatsApp: +91 99984 78633
📧 Email: ahmedabadandrology@gmail.com
🌐 Website: Book an appointment