Male Infertility Treatment
No sperm in your semen doesn't mean no path to fatherhood. With advanced sperm retrieval techniques — TESA, PESA, and Micro-TESE — most men with azoospermia can father biological children through IVF-ICSI.
Azoospermia is the medical condition where a man's semen contains no measurable sperm. It affects approximately 1% of all men and accounts for around 10-15% of male infertility cases. While the diagnosis can be distressing, it is important to understand that azoospermia is not the same as sterility — many men with this condition can still father biological children with the right treatment.
Azoospermia is diagnosed when two separate semen analyses, conducted at least 2 weeks apart, confirm the complete absence of sperm even after centrifugation of the sample. A thorough evaluation is then performed to determine the cause and the best treatment approach.
Understanding the type is critical — it determines the treatment approach and success rates
Sperm is produced normally but a physical blockage prevents it from reaching the semen. Common causes include vasectomy, prior infections (epididymitis, STIs), congenital absence of the vas deferens (CAVD), or previous surgeries. Sperm retrieval is highly successful.
The testes do not produce sperm or produce very few. Causes include hormonal disorders, genetic factors (Klinefelter syndrome, Y-chromosome microdeletions), radiation or chemotherapy exposure, varicocele, or undescended testes. Sperm retrieval is possible in 30-60% of cases.
Identifying the underlying cause guides the most effective treatment
Klinefelter syndrome (XXY), Y-chromosome microdeletions, cystic fibrosis gene mutations (CFTR)
Epididymitis, orchitis (mumps), sexually transmitted infections causing scarring and blockage
Low FSH, LH, or testosterone; hypogonadotropic hypogonadism; pituitary gland disorders
Enlarged veins in the scrotum that raise testicular temperature, impairing sperm production
Surgical sterilisation that can be reversed or bypassed via sperm retrieval + IVF-ICSI
Cancer treatments that damage sperm-producing cells in the testes
Cryptorchidism treated late may cause reduced or absent sperm production
Hernia repair, bladder or prostate surgery causing obstruction or retrograde ejaculation
A systematic evaluation to pinpoint the exact cause
Two separate semen analyses confirming zero sperm in ejaculate, taken at least 2 weeks apart
FSH, LH, testosterone, prolactin, and inhibin B to determine testicular function and identify hormonal causes
Identify varicocele, obstruction, testicular volume, and structural abnormalities
Karyotype (chromosome analysis), Y-chromosome microdeletion assay, CFTR mutation screening
In select cases to determine if sperm production is occurring — guides retrieval procedure choice
Checks for retrograde ejaculation where sperm enters the bladder instead of being ejaculated
World-class sperm retrieval techniques performed by our experienced embryologists and urologists
Testicular Sperm Aspiration
Success Rate
80-90% (OA)
A fine needle is used to aspirate sperm directly from the testis under local anaesthesia. Minimally invasive, minimal recovery time. Best for obstructive azoospermia.
Percutaneous Epididymal Sperm Aspiration
Success Rate
80-90% (OA)
Sperm is aspirated from the epididymis — the tube attached to the testis where sperm matures and is stored. Suitable for men with obstruction in the vas deferens or epididymis.
Microsurgical Testicular Sperm Extraction
Success Rate
40-60% (NOA)
Under high-power microscopy, seminiferous tubules that appear to contain sperm are identified and extracted. The gold standard for non-obstructive azoospermia. Maximises sperm yield while minimising testicular tissue removal.
Testicular Sperm Extraction
Success Rate
40-70%
Small biopsy samples are taken from multiple areas of the testis to locate sperm. Used when TESA is not successful or when a larger sample is needed.
Retrieved sperm is immediately used with IVF-ICSI (Intracytoplasmic Sperm Injection) — where a single healthy sperm is directly injected into the egg. Any extra sperm can be cryopreserved (frozen) for future cycles. The female partner undergoes ovarian stimulation, egg retrieval, and embryo transfer in a coordinated cycle.
MBBS, MD (OBG), Fellowship in Reproductive Medicine
One of the first few doctors in India with M.Ch in Reproductive Medicine & Surgery
Dr. Arun Muthuvel has performed thousands of sperm retrieval procedures including Micro-TESE for non-obstructive azoospermia. His advanced embryology expertise combined with the latest laboratory technology at Iswarya Fertility delivers some of the highest success rates for azoospermia treatment in India.
From diagnosis to holding your baby — here is the complete process
Two semen analyses are conducted to confirm azoospermia. Detailed medical history is reviewed.
Blood tests for FSH, LH, testosterone. Karyotype analysis and Y-chromosome microdeletion testing if indicated.
Scrotal ultrasound to assess testicular volume and anatomy. Fine needle aspiration biopsy to check for sperm production.
Appropriate sperm retrieval procedure is performed. Retrieved sperm is evaluated by our senior embryologists.
Female partner undergoes ovarian stimulation and egg retrieval. ICSI is performed — a single sperm is injected into each mature egg.
Embryos are cultured for 3-5 days in our state-of-the-art lab. Best-quality embryo is selected for transfer using AI-assisted grading.
Selected embryo is gently transferred into the uterus. Beta-hCG blood test 12-14 days later confirms pregnancy.
Answers from our fertility specialists
Expert azoospermia treatment at 75+ centres across India
