Treatments for Nonobstructive Azoospermia

Thanks to our advanced treatments, some men with nonobstructive azoospermia may experience the return of sperm to their semen—enough so that unassisted conception is a real possibility. For many others, we can identify pockets of sperm production in the testicles, even if many areas are barren and our patients do not create enough to send through their reproductive tracts.

Such success is possible because of our experience and expertise with sperm extraction.

Your doctor will talk to you about your specific condition and make treatment recommendations. For some men, the solution is fairly straightforward: make a lifestyle change, swap out a medication or start avoiding certain toxins. Also, the reproductive system is fairly resilient if you have undergone chemo or radiation therapy—your body just needs time to recover. But we may also recommend a more direct intervention. In any case, you need to give your body 2-3 months to make enough sperm afterward to see a clear benefit.

Hormone treatment

Depending on their existing levels, some men with nonobstructive azoospermia benefit from treatment with certain hormones, coaxing sperm back to their semen or increasing the likelihood of find sperm during extraction. These hormones include: 

• Follicle-stimulating hormone (FSH)
• Human chorionic gonadotropin (HCG)
• Clomiphene
• Anastrazole
• Letrazole

Varicocelectomy

Some men may have a varicocele, enlarged and widened veins on the scrotum that can impede sperm production. During a microscopic varicocelectomy, we use an operating microscope to identify and tie off the offending veins while preserving important surrounding structures (e.g., arteries, vas deferens, lymphatic channels). Up to 40 percent of men see sperm return to their semen with this procedure. Those who are unsuccessful may opt to try sperm extraction. Learn more about our sperm extraction.