Can I have children if I don’t have sperm in my ejaculated fluid?

Azoospermia is considered for 20% of infertility. According to guidelines, there are 2 types of azoospermia and each has a special treatment but both have the same diagnostic steps.

Years ago, patients and even inexperienced doctors were thinking that it is not possible to have a child in the absence of sperm.

From my experience, I classify the absence of sperm in the ejaculatory fluid into two types:

1. The production of sperm is sufficient but cannot come outside of the body due to obstruction in transporting canal. Repetition of the infection and some operations in the genital area are usually the main reasons for this.
2. The production is of a small amount which is not enough to get out of the testicles. Because sperms are not moved inside the testis, we need a lot of production to push the sperms out of the testicles. Three Classifications:
   1. There is production but not enough to push outside the testis. I usually increase the production by medication to the point that we get sperm during ejaculation. Some of the patients need sperm extraction with some procedures.
   2. Production is only too little amount. To get the sperm, I do microscopic sperm extraction. It depends upon the reason but we get sperm more than 60%.
   3. No production at all because the development of some cells in the testicles is stopped. The patient needs an injection and medication to stimulate the testis.

Do we have diagnostic methods or treatment plans for each of these causes? Yes, there are certain methods and treatments. I would be glad to give you my advice even if you are coming from abroad