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Azoospermia Treatment in Hyderabad — Zero Sperm Count

Zero sperm in the semen report does not mean zero hope. Many men diagnosed with azoospermia have become biological fathers through TESA + ICSI at Mother Hospitals & IVF Center, Boduppal, Hyderabad. Dr. E. Prashanthi Reddy, TGMC Reg: 50624.

Quick Answer: Azoospermia (no sperm in semen) is treated at Mother Hospitals & IVF Center, Boduppal, Hyderabad using TESA (Testicular Sperm Aspiration) to retrieve sperm directly from the testis, followed by ICSI to achieve fertilisation. Call: 97059 93366 or WhatsApp: 90520 74999.
🔒 All azoospermia consultations are completely confidential. You may attend alone or with your partner. WhatsApp consultations available for initial enquiries.
📞 Call: 97059 93366 💬 WhatsApp Us
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Key Fact: Approximately 1 in 100 men has azoospermia. Of these, roughly 60% have obstructive azoospermia — sperm is produced but cannot exit. In obstructive cases, TESA successfully retrieves sperm in the majority of procedures, enabling ICSI and achieving pregnancy.

Two Types of Azoospermia

Understanding which type you have determines the treatment plan

Obstructive Azoospermia (OA)

Sperm produced — but blocked

The testes produce sperm normally, but a blockage prevents it from reaching the ejaculate. This is the more common and more treatable type.

Common causes:
  • Vasectomy (surgically blocked vas deferens)
  • Epididymal blockage (post-infection — chlamydia, gonorrhoea)
  • Congenital absence of vas deferens (CBAVD)
  • Ejaculatory duct obstruction
  • Post-surgical scarring (hernia repair, prostate surgery)

Treatment: TESA or PESA retrieves sperm directly. Success rate for sperm retrieval: very high (>90%). Sperm used in ICSI.

Non-Obstructive Azoospermia (NOA)

Impaired sperm production

The testes have reduced or absent sperm production. More challenging than OA, but treatment options exist in many cases.

Common causes:
  • Klinefelter's syndrome (47,XXY)
  • Y-chromosome microdeletion (AZFa, AZFb, AZFc)
  • Mumps orchitis (viral damage to testes)
  • Chemotherapy or radiotherapy
  • Undescended testes (cryptorchidism)
  • Hormonal failure (hypogonadotropic hypogonadism — treatable)

Treatment: Micro-TESA may retrieve sperm in selected NOA cases. Hormonal treatment for hypogonadism. Genetic testing guides prognosis.

Investigations for Azoospermia

A systematic workup identifies the type, cause, and best treatment path

🧫
Semen Analysis (×2)
Two separate semen analyses (2–4 weeks apart) confirm azoospermia before proceeding. Post-centrifugation pellet analysis is performed.
⚗️
Hormone Panel
FSH, LH, testosterone, prolactin, inhibin-B. High FSH + low inhibin-B = NOA pattern. Low FSH = possible hypogonadism (treatable).
🔊
Scrotal Ultrasound
Assesses testicular volume, varicocele, epididymal cysts, absent vas deferens. Small testes suggest NOA; normal testes suggest OA.
🧬
Karyotyping
Chromosomal analysis identifies Klinefelter's (47,XXY) and other chromosomal abnormalities causing NOA.
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Y-Chromosome Microdeletion
Tests for AZFa, AZFb, AZFc deletions. AZFc deletion — sperm retrieval may succeed. AZFa/AZFb deletion — retrieval very unlikely.
🧪
CF Gene Mutation (CFTR)
Men with congenital bilateral absence of vas deferens (CBAVD) are tested for CFTR mutation — associated with cystic fibrosis gene.

Sperm Retrieval & Treatment Procedures

Available at Mother Hospitals & IVF Center, Boduppal, Hyderabad

For OA — First Choice

TESA — Testicular Sperm Aspiration

A fine needle is inserted into the testis under local anaesthesia to aspirate sperm-containing tissue. Performed as a 30-minute outpatient procedure. Sperm is retrieved successfully in the vast majority of OA cases. The retrieved sperm is used immediately in ICSI or cryopreserved.

For OA — Alternative

PESA — Percutaneous Epididymal Sperm Aspiration

Sperm is aspirated from the epididymis — the coiled tube attached to the testis where sperm matures. Preferred when sperm quality from the epididymis is better. Used when epididymal blockage is the cause. Combined with ICSI.

With Retrieved Sperm

ICSI — Intracytoplasmic Sperm Injection

Retrieved sperm (from TESA or PESA) is used in ICSI — where a single sperm is injected into each mature egg. Even immature sperm retrieved from the testis can achieve fertilisation with ICSI. This completes the fertility treatment and enables embryo transfer.

For NOA (Selected Cases)

Micro-TESA

For non-obstructive azoospermia, micro-TESA uses an operating microscope to identify and extract small areas of testicular tissue that may contain sperm — improving retrieval rates compared to conventional TESA. Available for carefully selected NOA cases.

For Hypogonadism

Hormonal Stimulation

Men with hypogonadotropic hypogonadism (low FSH + low testosterone) have functional testes but lack hormonal stimulation. Injections of FSH + hCG for 6–12 months can stimulate sperm production, often making TESA unnecessary.

Future Cycles

Sperm Cryopreservation

Sperm retrieved during TESA is cryopreserved (frozen) for future ICSI cycles, avoiding the need for a repeat procedure. Extra embryos created during ICSI are also frozen for subsequent frozen embryo transfer (FET) attempts.

Dr. E. Prashanthi Reddy – Azoospermia & TESA Specialist, Mother Hospitals Hyderabad

Dr. E. Prashanthi Reddy

MBBS · DGO · PG Diploma in ART – Kiel University, Germany · Cosmetic Gynecology Certified (2024)
Founder & Medical Director — Mother Hospitals & IVF Center, Boduppal, Hyderabad
TGMC Reg: 50624 · 19+ Years · 5,000+ IVF & ICSI Cycles
Specialised in TESA, PESA, Azoospermia Management & ICSI for Surgical Sperm

Frequently Asked Questions — Azoospermia

What is azoospermia?
Azoospermia means the complete absence of sperm in the ejaculate. It affects approximately 1 in 100 men and is found in about 10–15% of infertile men. There are two main types: obstructive azoospermia (sperm is produced but cannot exit due to a blockage) and non-obstructive azoospermia (the testes produce very little or no sperm). Both types are investigated at Mother Hospitals Hyderabad.
Can a man with zero sperm count have a biological child?
Yes — in many cases. Men with obstructive azoospermia have normal sperm production but a blockage prevents sperm reaching the ejaculate. TESA or PESA retrieves sperm directly from the testis or epididymis. This sperm is then used in ICSI to fertilise eggs. Many men diagnosed with azoospermia have become biological fathers through TESA+ICSI at Mother Hospitals Hyderabad.
What is the difference between obstructive and non-obstructive azoospermia?
Obstructive azoospermia (OA): Sperm is produced normally but cannot exit due to a blocked vas deferens, epididymis, or ejaculatory duct. Treatment: TESA/PESA + ICSI — sperm retrieval is usually successful. Non-obstructive azoospermia (NOA): Sperm production is impaired (testicular failure, hormonal issue, genetic cause). Sperm retrieval is possible in some NOA cases using micro-TESA. FSH level and testicular volume help predict which type you have.
What is TESA and how does it help azoospermia?
TESA (Testicular Sperm Aspiration) is a minor surgical procedure that retrieves sperm directly from testicular tissue using a fine needle under local anaesthesia. It is the first-line treatment for obstructive azoospermia. The retrieved sperm is used immediately in ICSI to fertilise eggs. TESA is performed as a 30-minute outpatient procedure at Mother Hospitals, Boduppal, Hyderabad with minimal discomfort and recovery within 24 hours.
What causes azoospermia?
Obstructive causes: vasectomy, epididymal blockage (post-infection), absent vas deferens (congenital), ejaculatory duct obstruction, surgical scarring. Non-obstructive causes: Klinefelter's syndrome (47,XXY), Y-chromosome microdeletion, mumps orchitis, chemotherapy/radiotherapy, undescended testes, hormonal failure (treatable with FSH + hCG injections).
Is azoospermia treatment confidential at Mother Hospitals?
Yes. All consultations for azoospermia at Mother Hospitals & IVF Center, Boduppal, Hyderabad are strictly confidential. You can attend alone or with your partner. WhatsApp consultations are available if you prefer. Your results and treatment are discussed in complete privacy.

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