Aspermia Treatment in India

What is Aspermia?

Aspermia refers to a medical condition where a man is not able to ejaculate any semen during orgasm. Simply put, although ejaculation might take place, there will not be any or very little amount of semen being released. It is different from low sperm count or poor sperm quality because, in aspermia, the main issue is the absence of semen itself. The inability to ejaculate semen affects fertility since semen contains sperm that are necessary for conception.

What are the Causes of Aspermia?

Multiple reasons can lead to aspermia and they can vary from person to person. 

Retrograde Ejaculation

This is a very common cause of aspermia where the semen instead of coming out through the penis, flows backwards into the bladder. Men may notice “dry orgasm” with little or no semen release.

Nerve Damage

Some conditions like diabetes, spinal cord injury, multiple sclerosis, or surgeries involving the prostate and bladder, can damage nerves responsible for ejaculation.

Hormonal Imbalance

Low levels of testosterone or issues involving the pituitary gland may interfere with sperm production and ejaculation.

Ejaculatory Duct Obstruction

A blockage in the ejaculatory ducts can prevent semen from being released normally.

Certain Medications

Some medicines used for depression, high blood pressure, or prostate conditions may affect ejaculation.

Past treatments

If anyone has gone through pelvic surgeries, radiation therapy, or chemotherapy, these have a potential impact on reproductive structures that can affect semen release.

Congenital Conditions

These are the conditions that are present at birth. Some men are born with abnormalities that affect the seminal vesicles, vas deferens, or ejaculatory ducts, causing aspermia.

Psychological Factors

Besides physical factors, some psychological factors like stress, anxiety, relationship difficulties, or performance-related concerns, can also contribute to ejaculation issues.

How to Diagnose Aspermia?

Diagnosis of aspermia may involve any of the following: 

Medical History & Physical Examination

Discussion around symptoms, ejaculation pattern, previous surgery (if any), or any medical conditions like diabetes are important to assess medical history and find the root cause of aspermia. Physical examination is done to check for swelling, testicular abnormalities, or signs of a hormonal imbalance.

Semen analysis

Analysis of semen is one of the essential tests in the evaluation of aspermia. This test can help to find out if there is no semen, a very small amount of semen or semen with no sperm. If there is semen available, the sample can also be checked for sperm count, motility and morphology to determine overall fertility health.

Post-ejaculatory urine test

Urine is collected following ejaculation. If retrograde ejaculation is suspected, the sperm will be present in urine and it may be considered that the semen is going backwards inside the bladder instead of coming out.

Hormonal tests

It is a blood test that checks for the level of hormones in the blood i.e. testosterone, FSH, LH and prolactin. These hormones play an important role in sperm production, testicular function, and overall male reproductive health.

Imaging Tests

Scrotal ultrasound or transrectal ultrasound (TRUS) may help identify ejaculatory duct blockage, cysts, or structural abnormalities in the reproductive tract.

Genetic Testing

In some men, genetic testing may be recommended, especially when congenital abnormalities or severe fertility problems are suspected.

Difference Between Aspermia and Azoospermia?

Aspermia is the absence of semen in the ejaculate while azoospermia is the absence of sperm in the semen. A man with azoospermia may ejaculate semen, but there is no sperm present. In aspermia, semen does not come out or is extremely low. Both conditions can contribute to male infertility, but the causes and treatments are different.

What Clinical Treatment Options Are Available for Aspermia?

The treatment of aspermia depends on the cause and the following are some of the key options available.

Medicines

These are usually advised in case of retrograde ejaculation or infection. Medicines help close the neck muscles of the bladder properly during ejaculation. This supports the forward release of semen instead of the backward flow to the bladder. Antibiotics or anti-inflammatory medicines may be prescribed if infection or inflammation is affecting the reproductive tract.

Hormone therapy

If a hormonal disturbance, such as a low level of testosterone, is causing aspermia, your doctor may suggest hormone therapy to improve sperm production and ejaculation function.

Surgery

A minor surgery can be performed to remove the blockage and restore normal flow of semen in case if ejaculatory duct obstruction is the reason behind aspermia.

Assisted Reproductive Techniques (ART)

If pregnancy is desired, advanced procedures like TESA,PESA, or Micro-TESE are used to retrieve sperm directly from the testes. The sperm is then fertilised with the egg through IVF orICSI. Assisted reproductive techniques are advised when natural ejaculation cannot be restored by other treatment methods.

Can I Conceive with 2% Sperm Morphology?

Yes, it is still possible to conceive even when one has only 2% sperm morphology. Sperm morphology describes the structure of the sperm cells. A low percentage means that there are fewer sperm that are normally shaped. Nevertheless, fertilisation depends not only on the shape of the sperm but also on other things, including:

• The total number of sperms
• Motility of the sperm
• Overall sperm health
• Fertility of the female partner

Many couples with low sperm morphology are able to conceive naturally or with fertility treatment. In cases where conception becomes difficult, treatments such as IUI, IVF, or ICSI may improve the chances.