Antega South Africa · Learning Videos
What follows a semen sample with no sperm in it: repeating the test, examination, hormone tests, sometimes genetic tests, and the difference between a blockage and a production problem.
Being told there were no sperm in the sample is one of the hardest moments in a fertility assessment, and this explains what usually happens next rather than leaving you to guess. The test is repeated, because a single sample can mislead. There is a physical examination of the testicles and the tubes that carry sperm. Blood tests check the hormones from the brain that instruct the testicles, along with testosterone and often oestrogen and thyroid. Genetic tests may be arranged depending on what everything else shows. The central distinction is between obstructive azoospermia, where sperm are being made normally but cannot get out because the pathway is blocked or absent - after vasectomy, infection, injury, surgery, or an inherited absence of the vas deferens - and non-obstructive azoospermia, where the testicles are producing little or no sperm, from causes including hormonal problems, previous chemotherapy or radiotherapy, undescended testicles, genetic conditions or no identified cause. It matters because obstructive azoospermia usually means sperm can be recovered surgically, while in non-obstructive azoospermia retrieval sometimes finds sperm and sometimes does not. Where sperm are recovered they are used with ICSI. Donor sperm is a route some couples choose, either instead of retrieval or after it has not succeeded. Two Antega clarifications. Not every man with azoospermia needs the same genetic tests: what is appropriate depends on history, examination, hormone levels and the suspected diagnosis, and is decided by a reproductive specialist, urologist or andrologist - genetic counselling should be offered where testing is considered. And no surgical retrieval technique can be promised to find sperm; ask your own team what it expects in your situation and what happens if none are found.
Produced by Cape Fertility, a SASREG-accredited fertility centre in Cape Town and a recognised training unit in reproductive medicine and embryology. Antega does not endorse or recommend any clinic.
Use these guides for general background, and check the South Africa organisations named on this page for local detail.
Filmmaker Molatelo Mainetje-Bossman speaks about the social and cultural side of infertility in African communities, including silence, stigma and family expectations.
A short laboratory demonstration of specialist sperm processing, as used for therapeutic sperm preparation and viral decontamination.
Dr Tasneem Mohamed, obstetrician and gynaecologist at BioART Fertility Centre, sets out how infertility is investigated and what the first round of tests looks for.
This video was produced by Cape Fertility, South Africa and is shared for education only. It is not medical advice and does not replace guidance from your own doctor or fertility clinic. Naming an organisation does not imply a partnership with Antega.
