Table 1.
Obstructive Azoospermia | Non-obstructive Azoospermia (Testicular Failure) |
Congenital Ductal Obstructions: | Congenital Testicular Failure: |
Congenital bilateral absence of the vas deferens | Testicular dysgenesis/cryptorchidism |
Young's syndrome (clinical triad of chronic sinusitis, bronchiectasis, and obstructive azoospermia) | Genetic abnormalities (Klinefelter syndrome, Y chromosome microdeletions*) |
Stenosis or atresia of the ejaculatory ducts | Germ cell aplasia (Sertoli cell-only syndrome) |
Midline prostatic cysts (utricular and Müllerian cysts) | Spermatogenic (maturation) arrest |
Ejaculatory duct cysts | |
Seminal vesicle cysts | |
Acquired Ductal Obstructions: | Acquired Testicular Failure: |
Post-infection (epididymitis, prostatitis, seminal vesiculitis) | Testicular trauma |
Testicular torsion | |
Post-vasectomy | Post-inflammatory (e.g., mumps orchitis) |
Post-surgical (epididymal cysts, hernia repair, scrotal surgery, bladder neck surgery, prostatectomy) | Exogenous factors (steroid medications, cytotoxic drugs, irradiation, heat) |
Iatrogenic (urologic endoscopic instrumentation) | Systemic diseases (liver cirrhosis, renal failure) |
Testicular tumor | |
Varicocele | |
Post-surgical (surgeries that may compromise testicular vascularization, resulting in testicular atrophy) | |
Idiopathic: | Idiopathic (unknown etiology) |
Idiopathic epididymal obstruction |
The likelihood of obtaining sperm at sperm retrieval is virtually zero when complete AZFa and/or AZFb Yq microdeletions are found.