Can a man with seminal fluid but no sperm at all father a child, naturally?
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Azoospermia is an infertility condition in men which is characterized by a sperm count of zero. Although the man can produce ejaculate, it does not contain any sperm. This condition is estimated to affect less than one in 50 men, although it accounts for a high percentage of men seeking fertility treatment and is a relatively common cause of male infertility. A reproductive endocrinologist or fertility specialist can diagnose azoospermia and make treatment recommendations.
When couples experience infertility, one of the easiest diagnostic tests to run involves testing the man's ejaculate, which often makes it the first avenue a doctor pursues, before getting involved in more invasive diagnostic tests for the woman. In a sperm count test, a man submits a sample of semen and it is analyzed in the laboratory to see how many sperm can be found and what condition they are in. If none are visible, the man has azoospermia.
There are two different types of azoospermia. In obstructive forms of the condition, a man is producing sperm, but it cannot be delivered due to an obstruction in the reproductive tract. This may be caused by a congenital condition. Non-obstructive azoospermia is characterized by an inability to produce sperm, or sperm production in low numbers. Some causes of non-obstructive forms can include hormone imbalances, medications, and underlying disease processes.
Having azoospermia does not necessarily mean that a man cannot reproduce. For men with obstructive azoospermia, it may be possible to collect a sperm sample which can be used to impregnate a woman with assisted reproductive technology. Non-obstructive forms may be addressed by changing medications or through medical treatment of the underlying cause. Even if a man's sperm count is very low after this, it is still possible to harvest sperm to use in a fertility treatment. Seeing a skilled fertility specialist can greatly increase the chances of a successful pregnancy.
Being diagnosed with azoospermia can be upsetting for some men, because sperm are often viewed as a symbol of virility in many cultures and having a sperm count of zero can feel like an assault on someone's manhood. Men should be assured that a low sperm count is usually not their fault, and that treatments are available to address the situation. For men who want to have children, low sperm counts do not have to be a barrier to reproduction, and sometimes they can be very treatable.
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