1. Varicocele

Dilatation of veins of the scrotum resulting in pooling of venous blood around the testes. This condition can be corrected by surgery.

Varicoceles are known to occur in adolescent boys. To prevent damage to the testes they require early diagnosis and surgical correction.

2. Undescended Testes

The testes develop within the abdomen and fail to reach the scrotum. If they remain higher, the scrotum feels empty. The testes which remain in the abdomen lacks sperm producing capabilities and these men with undescended testes on both sides of scrotum have absence of sperms due to testicular atrophy. Any surgery to place the testes in the scrotum should be done during childhood itself.

3. Torsion Testes

During adolescent age some boys develop sudden cramps in the scrotum, which may indicate twisting of cord structures.
If not corrected in time the testes may loose its blood supply and result in atrophy.

4. Post Chemotherapy / Radiotherapy

A 23 years old male had 30 million sperms with 40% motility. Subsequently he developed testicular tumour for which that testes was removed by surgery followed by Radiotherapy, within 3 months the other testis became small (atrophic) and the semen analysis showed no sperms(azoospermia).

Cryopreservation(freezing) of sperms prior to radiotherapy could have helped him to get a child through his own sperms when he gets married later in his life.

5. Kleinfelters Syndrome

A condition due to chromosomal (Genetic) abnormality which results in atrophy of testes, enlargement of breasts and absence of sperms.

Case Report : Mr.J 33 years married since 4 years. Obese – Lack of Facial hair - gross enlargement of both breasts (GYNAECOMASTIA) – Penis normal- Both testis very small – Semen Analysis – No Sperm.
FSH – 13.45 mIu, LH – 12.62 mIu, PRL – 8.75 mIu, Test – 0.10 ng/dl CYTOGENIC REPORT : KARYOTYPE 47 XXY.
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6. Post Mumps Orchitis

Mumps is viral infection of salivary glands, which may also affect both the testes leading to atrophy and absence of sperms.

7. Germ Cells Aplasia, Maturation Arrest &
     Hypospermatogenesis

These are histological terms, which are used to indicate the extent of damage to the testes. In most of these conditions any form of hormonal therapy will not be helpful.

In some cases there may be few islands of sperms present in some tubules, which could be extracted and used for ICSI.

8. Post Surgical Obstructions (Delivery Problem)

Surgical procedures on the scrotum (Hydrocelce) or Inguinal hernia repair there is a possibility of damage to sperm conducting tubes (VAS), which may result in absence of sperm.

9. Post Infective Causes

Due to infections some portion of the epididymis may be blocked resulting in absence of sperms; these conditions could be corrected by Microsurgical Reconstructive procedures, by-passing the site of obstruction (Microsurgical Vaso epididymel Anestomosis - Micro VEA).

10. Post Vasectomy

Vasectomy procedures some men may like to restore their fertility to get another child; Micro surgical Vaso-Vasal Anestomosis (Micro VVA) gives excellent results.

11. Congenital Bilateral Absence of VAS - (CBAVD):

This is one of the common causes of obstructive azoospermia resulting in Male Infertility. In spite of the presence of normal sperm production these sperms get trapped within the epididymal tubules with no way out to get into the semen.

This is a birth defect, perhaps due to chromosomal abnormality. These men are not suitable for Microsurgery. However the sperms could be retrieved from them and used for Intracytoplasmic Injection (ICSI) to produce biologically their own child.

12. Ejaculatory Duct Obstructions

The sperms which are produced in the testes gets mixed with the seminal fluid and escape into urethra at the time of ejaculation.
Some men have block into these delicate, tiny passages which results in absence of sperm in their ejaculate.