HomeAnswersUrologyazoospermiaI have no sperm in my semen. What should I do?

They could not find a single sperm in my testes. Should I look for a sperm donor?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At July 2, 2018
Reviewed AtFebruary 21, 2024

Patient's Query

Hi doctor,

I am a 33 year old male. Today, I had a surgical sperm retrieval procedure at a reputable fertility clinic here. They could not find a single sperm anywhere, motile or otherwise, in my testes, and they said I simply was not producing sperm, for reasons unknown. Before my wife and I give up and start looking for a sperm donor, I wanted to get a second opinion. Is that truly the final word or is there some next step I could take, however unlikely the odds of success? I eat mostly fruits and vegetables, work out every other day, have no history of trauma to the groin or exposure to extreme environmental toxins. Testicle size and firmness, as well as hormone (testosterone, prolactin, and thyroid function) levels, were all normal. Is it even remotely possible to go from producing zero sperm to producing some sperm? Thanks in advance for your help.

Answered by Dr. Karthik Rajan

Hi,

Welcome to icliniq.com.

I have gone through your query. I would like to know a few more details to answer your query better. Were your serum gonadotropin levels measured during the evaluation? What was the exact procedure performed? The chances of sperms appearing naturally in semen is next to impossible. If just a normal testicular biopsy has been performed, an intra-op microscopic testicular biopsy may give you an additional chance of finding sperms. If it has been already performed, then a sperm donor will be the next choice for you.

Hope this was helpful.

Patient's Query

Hello doctor,

Thank you for the reply. The doctor's secretary just replied that they did not check serum gonadotropin levels because testosterone levels were in the normal range, so they thought gonadotropin levels should also be normal. The procedure they did was PESA first, and when that did not work, he did conventional TESE (not microTESE). When you say 'intra-op testicular biopsy', does that mean the same as microTESE? If so, that means I still have a chance of finding sperm? This is my last allowable message to you. So, I would like to say thanks for your thorough and clear response. I look forward to hearing your thoughts on the above input as well.

Answered by Dr. Karthik Rajan

Hi,

Welcome to icliniq.com.

Yes, I did mean a microTESE (microsurgical testicular sperm extraction). Since you have a normal hormonal profile with a normal testicular exam, it is indeed surprising that there are no sperms identifiable in the biopsy. The possibility could be some genetic component which prevents stem cells from maturing into sperms. In such an event, microTESE would be the final option to assess for any possibility of sperms in your testis. However, in the event that your condition is due to a genetic defect, there would also be the possibility of transmission of the same to your children (more chance if it is a male child as most of these defects are in the Y-chromosome). So, it is a difficult choice to make, and in my medical opinion, I would advise you to consider a sperm donor as it will have the maximum chances of success.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Karthik Rajan
Dr. Karthik Rajan

Urology

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