Azoospermia is a common cause of male infertility which demonstrates zero sperm count or nil sperm count. Out of all causes of azoospermia, Non-obstructive azoospermia (NOA) is the common one. Before understanding what is Non-obstructive azoospermia (NOA) let us understand male reproductive system functioning

Male Reproductive System

Before understanding what causes this obstruction let’s understand the male reproductive system

  • Testes, commonly known as testicles, are the part of the male reproductive organ where sperms are produced.
  • Later these sperms travel via a duct or a pipeline called the vas deference and are temporarily stored in seminal vesicles.
  • In the seminal vesicles, certain nutrition and fluids are added to these sperms.
  • At the time of intercourse, the sperms are ejaculated through ejaculatory ducts from the penis and it gets out as the seminal fluid.

In the case of Non-obstructive azoospermia (NOA), there is no blockage in the reproductive tract but there is some abnormality in the testes which causes a reduction in sperm production.

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Causes of Non-obstructive azoospermia (NOA)

  1. Congenital Issues with tests. i.e. Chryptorchidism, Retractile Testes.
  2. Injury to the testes.
  3. Viral Infections in Childhood.
  4. Endocrinological problems related to the brain and secretion of hormones in the body.
  5. Gonadotoxic therapy. i.e, therapies that affect the gonadotropin hormones in the body.

In Non-obstructive azoospermia (NOA), it’s very common to have an elevated level of FSH, mildly elevated levels of Estradiol, and low to the normal level of testosterone.

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Difference between Obstructive and Non-obstructive azoospermia

Obstructive azoospermia: The testes are going to be normal size.

Non-obstructive azoospermia: The testes could be slightly smaller in size and slightly softer in consistency and could be slightly variable in location.

Treatment for Non-obstructive azoospermia (NOA)

How to retrieve sperms in Non-obstructive azoospermia (NOA) The testes could be defective but there are some areas in testes that might be producing healthy sperms that are retrieved with the help of a procedure called Microdissection.

MicroDissection Surgery in Non-obstructive azoospermia

Microdissection TESE is a highly specialized surgical technique Its a 2 1/2 hour procedure wherein a testis is opened up to screen and examine to retrieve healthy sperms. The average sperm retrieval rate varies between 55-70. Prior to MicroDissection, a patient should undergo clinical and hormonal examination regarding the expected success rate of the procedure. But due to MicroTESE, it’s possible for Non-obstructive azoospermia patients to have conceived pregnancy with their own sperm.

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Dr. Jay Mehta Fertility and IVF Specialist In Mumbai

Dr. Jay Mehta

Fertility and IVF Specialist


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Dr. Jay Mehta is the Scientific Director of Shree IVF Clinic. He is a well-known Fertility and IVF Specialist and also among few doctors in the country who specializes in Embryology and Andrology.

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