Can I be a biological father with azoospermia?

When you hear the diagnosis of azoospermia, probably the first thought is: “No chance.” But modern andrology and reproductive medicine say: do not rush to conclusions.

What is azoospermia?

Azoospermia means a complete absence of sperm in the ejaculate. The diagnosis is made after at least two spermograms, in which no sperm are detected even after centrifugation of the seminal fluid.

But here comes the important clarification: There are two types of azoospermia, and it is this that determines what your chances of paternity are.

1. Obstructive azoospermia (OA)

Cause: obstruction in the sperm pathway — e.g. blocked vas deferens, lack of tubules, inflammation, surgery (vasectomy).
In this type, the testicles produce sperm, but they cannot come out.

The good news:‍
- In most cases, it is possible to extract sperm by TESA (testicular sperm aspiration), PESA (Percutaneous Epididymal Sperm Aspiration) or MESA (microepididymal sperm aspiration);
- The resulting cells can be used for intracytoplasmic injection (ICSI);
- The chances of pregnancy are comparable to classic in vitro fertilization (IVF)

2. Non-obstructive azoospermia (NOA)

Cause: impaired or missing sperm production — due to genetic factors, hormonal problems, radiation, chemotherapy, etc.

This is the more complex type, but still:
- In a part of men, localized foci of spermatogenesis still exist;
- Through microsurgical testicular biopsy (micro-TESE), single sperm can sometimes be extracted;
- If these cells are detected, they can be used for ICSI and achieve pregnancy, that is, biological paternity is possible.

What else can we do?

- Hormonal tests — for the levels of FSH, LH, testosterone;
- Genetic analysis — for chromosomal abnormalities, Y-chromosome deletions;
- Scrotal and transrectal ultrasound — for the detection of obstructions;
- Consultation with an andrologist and reproductive specialist.

What if no sperm is found?

In such cases, the possibility of donor sperm is discussed, but:
- This decision is personal and sensitive;
- Requires time, support and empathy;
- There are many couples who find the path to parenthood in this way.

Conclusion

Yes, it is possible to be a biological father even with azoospermia. But the answer depends on the cause, the diagnostic approach and the attention with which your team approaches the case.

Technologies that were once unthinkable, today give a real chance.
The most important thing is not to give up before you have exhausted the possibilities.

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