If you’ve been trying to conceive for 12 months (or 6 months if the female partner is over 35), it’s reasonable to seek assessment. Earlier review is advised if there’s known male factor risk (prior chemotherapy, undescended testis, very small testes, history of azoospermia, or prior vasectomy).

Causes include low sperm count/motility/morphology, varicocele, hormonal disorders, genetic factors, obstruction (including post-vasectomy), infections, lifestyle factors (smoking, obesity, heat exposure), and prior surgery or medical treatments.

A semen analysis measures sperm concentration, movement, and form, plus semen volume and other markers. Typical preparation includes 2–7 days of abstinence, avoiding fever/illness where possible, and following the lab’s collection instructions to improve accuracy.

Often, yes. Because sperm parameters naturally fluctuate, repeating the test can confirm whether a result is persistent or temporary (e.g., after illness, stress, or recent heat exposure).

Hormonal testing may include FSH, LH, testosterone, prolactin (and others depending on context). These results help distinguish production issues from other causes and guide next steps.

Azoospermia means no sperm is seen in the ejaculate on semen analysis. It can be due to obstruction (sperm produced but blocked) or non-obstructive causes (reduced sperm production). The distinction matters because treatment pathways differ.

Obstructive azoospermia occurs when sperm production is present but blocked (for example after vasectomy, congenital absence of the vas deferens, or ejaculatory duct obstruction). Non-obstructive azoospermia means the testicles are making very few or no sperm, often requiring advanced retrieval techniques if possible.

Scrotal ultrasound may assess testicular size, varicocele, and other findings. Other imaging can be considered if obstruction is suspected (based on history, semen volume, or exam).

Varicoceles can be associated with impaired sperm production and sometimes testicular discomfort. Treatment may be considered when a clinically significant varicocele is present alongside abnormal semen analysis or symptoms, but it’s individualised.

MicroTESE (microsurgical testicular sperm extraction) is a technique used mainly for non-obstructive azoospermia, where sperm may be found in small “islands” of the testicle. An operating microscope helps identify areas more likely to contain sperm, potentially improving retrieval while minimising tissue disruption.

Men with non-obstructive azoospermia may be candidates after thorough evaluation (hormones, genetics when indicated, ultrasound, medical history). Your specialist will discuss your estimated likelihood of retrieval and whether other options should be considered.

Risks include pain, bruising/haematoma, infection, swelling, and (in some men) a temporary reduction in testosterone levels. Your surgeon will outline risk reduction strategies and follow-up.

Yes. If sperm are retrieved, they can often be frozen for future use with IVF/ICSI. Coordination with the IVF laboratory is important for timing, processing, and storage.

If no sperm are found, your specialist will discuss next steps, which may include reviewing pathology findings, considering repeat attempts in select cases, or exploring alternative family-building options. The right plan depends on your diagnosis and goals.

It depends on factors like time since vasectomy, female partner age/fertility, desired number of children, timelines, and costs. Many couples benefit from a consultation that compares expected success rates and practical considerations for both pathways.