Surgery of Azoospermia

Discover how our advanced azoospermia surgery techniques can help restore fertility

A revolutionary surgical technique called Micro TESE has been developed to identify sperm in the testicles of men who experience poor sperm production, a condition known as non-obstructive azoospermia. Prior to the advent of intracytoplasmic sperm injection (ICSI), these men were considered unable to father children.

Currently, the most reliable diagnostic method is a testicular biopsy. This minimally invasive procedure takes approximately 30 minutes and involves creating a small opening in the testicle to extract a tiny piece of tissue, similar in size to a grain of rice.

These various procedures are utilized to retrieve sperm from the testes in specific cases of male infertility. They are commonly performed in instances of obstructive azoospermia, whether it is congenital or acquired due to factors such as infection or vasectomy. These procedures are considered minor and are conducted under local anesthesia on the same day that the female partner’s eggs are retrieved.

If sperm is not present in the ejaculate, it indicates the possibility of either a blockage or obstruction in the reproductive tract, or insufficient sperm production to reach the ejaculate. The blockage can be caused by factors like prior infection, surgery, prostatic cysts, injury, or congenital absence of the vas deferens (CAVD). With the exception of congenital absence, most cases of obstruction can be repaired through microsurgical or endoscopic reconstruction.


There are various conditions that can lead to azoospermia, which is the absence of sperm in the ejaculate. If feasible, addressing the specific underlying condition causing azoospermia may reverse the process and restore sperm production. This is particularly true for cases related to factors like hot tubs, hot baths, or testosterone supplements. However, in cases of genetic infertility, it may not be possible to reverse the condition, and assisted reproduction techniques provide the most viable option for achieving parenthood.


  • Primary testicular failure Klinefelter syndrome
  • Y chromosome microdeletions
  • Genetic infertility due to abnormal chromosomes (karyotype)
  • Unexplained genetic infertility
  • Secondary testicular failure Kallman Syndrome
  • Unexplained gonadotropin deficiency
  • Hypothalamic/pituitary tumor
  • Hyperprolactinemia
  • Cancer treatment (chemotherapy, radiation, surgery)

Varicocele Effect

  • Pituitary suppression Drug induced (anabolic steroids, alcohol, glucocorticoids)

Testosterone Supplements

  • Congenital adrenal hyperplasia
  • Severe illness (cancer, kidney or liver failure)
  • Diabetes mellitus
  • Sickle cell anemia
  • Hemachromatosis
  • Sperm autoimmunity
  • Pesticide/toxin exposure (including hot tubs and baths)
  • Undescended testicles at birth
  • Obstruction Congenital absence of the vas deferens (CAVD)
Ejaculatory Duct Obstruction
  • Epididymitis
  • Scrotal trauma or surgery
  • Young syndrome

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