Azoospermia may be due to poor production of sperm, a problem in transport of sperm, or a problem with the ejaculatory process. TESA (testicular sperm aspiration) and TESE (testicular sperm extraction) are indicated when normal motile spermatozoa cannot be produced in adequate numbers to fertilize all of the woman’s oocytes

There are different reasons for this condition. One of the most common is Acquired Obstructive Azoospermia. It results from vasectomy, or inflammatory infections. In Congenital Obstructive Azoospermia, the patient is born without the vas deferens. This condition, known as Congenital Absence of the Vas Deferens (CAVD) indicates the patient may be carrying genes responsible for cystic fibrosis. Because of this relationship, genetic testing and counseling may be required prior to attempting fertilization.

In Non-obstructive azoospermia, the capacity of the testes to produce spermatozoa is so low that virtually no sperm are present in the ejaculate. Under those circumstances, attempts are made to retrieve spermatozoa directly from the testis. Genetic counseling is advised in this group of patients since the genes responsible for the infertility problem in the patient may be passed on to the offspring. However, no other major congenital abnormalities have been demonstrated to occur more frequently than in the normal population..