Dealing with Azoospermia


How to Diagnose Azoospermia? How to deal with it?

Patients routinely walk-in to our Andrology Lab for Semen Analysis, some of them have specific questions, but very rarely do you find patients like the one who visited us a few months back. His questions were very specific, he had done his homework, I could hear him ask how many slides would be checked before pronouncing a sample Ázoospermic. ( Azoospermia is lack of sperms in the semen), if we would ‘çentrifuge‘ his sample in case we do not find any sperms on the slides.

By this question, our Lab Technician did not know how to respond, so I walked to the patient and brought him to my office so that I could respond to all his queries before he proceeded with the test.

The gentleman, a man in mid thirties was very polite and had googled the subject in depth, his knowledge on the subject was very impressive. He mentioned that a few months back he underwent a Semen Analysis as a part of routine infertility workup and the sample was declared Azoospermic.

After which he got tested again within a few weeks but at a different lab and  the result was the same. His only question to me was “how can a lab be so sure”? Does the technician check very thoroughly, could it be a case of Cryotozoospermia? Do labs take the pain of checking every part of the sample?

At this point, I explained him the entire process in a very detailed manner and I said that since we were equipped with a way of projecting the microscope images on a screen, I would show him all the slides so that he can see himself. I realized that the gentleman needed Closure.

Imagine being a completely healthy young man who is undergoing a Semen Analysis as a routine Infertility Checkup and imagine being pronounced Ázoospermic just within hours. It hits you like a lightening bolt. You start questioning everything around you, what if the technician did a mistake, what if he did not do his job properly….what if. This is the reason, why your doctor would ask you to repeat your test within a few weeks to come to a conclusion. Azoospermia cannot be and should not be concluded based on one random semen sample.

Azoospermia is diagnosed when sperms cannot be found in the semen on at least two separate occassions.

Acceptance of any medical diagnosis is not easy, from being upset to frustrated to frightened, anyone is bound to feel a plethora of complex emotions. No matter how supportive people near you are, the feeling of being inadequate stays with you for a long time. But accepting the situation and dealing with the “what next” is the best way to deal with it.

What can you do as a Partner ?

It’s true, you don’t know how it feels until you go through it yourself. Be supportive but don’t babysit him, do not overdo things just because you think that your partner is undergoing a tough time. Try to keep things as normal as possible.

Try to be less emotional about it. Whenever it feels comfortable, choose a Doctor that he will be comfortable to discuss his situation, not one that you would be comfortable to deal with. Leave it as his choice. Your strength and support should be directed towards taking one step at a time. Remember, baby steps will still make you reach your destination……just a little slower.

Here’s a quick reference to Azoospermia and what can be done if lab report mentions Azoospermia.

Just as a reference, here’s a video that has been shot at our Andrology lab, showing what a normal semen sample looks like under the microscope. What you see moving are sperms. In case of an Azoospermic sample, the same screen looks like a blank canvas.

Author @ Doel Bose

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