Azoospermia, which accounts for 10 to 15 percent of all male infertility, refers to a complete absence of sperm in your ejaculate. Azoospermia can be due to a sperm production defect that can be triggered by various hormonal or genetic defects. Azoospermia can also be due to obstruction of sperm transport through blockage in any part of a sperm’s route of transport from the testicle, to the outside. In a majority of men, physical exam of the testes and blood tests (FSH) can help diagnose whether zero sperm count is due to a production or a transport problem. Genetic testing can also elucidate conditions such as Klinefelter’s syndrome. In some men, a surgery to obtain a testicular biopsy is necessary to confirm the diagnosis. Along with performing surgeries to unblock those who have “obstructive” azoospermia, Dr. Clavijo has special expertise in treating men with non-obstructive azoospermia – men who do not have sperm in the ejaculate due to testicular failure (poor or no production of sperm). He is trained to perform microdissection testicular sperm extraction (micro-TESE), a surgery which uses an operating microscope to identify areas of sperm production within the testicle. Luckily, there are situations where a man cannot produce enough sperm to be detected in semen, but can have pockets of small amounts of sperm production in the testicle. This is where a surgery like micro-TESE would be helpful.

Dr. Clavijo has published both on treatments for obstruction of sperm transport and genetic lesions that can cause poor sperm production (references listed below).

  1. Clavijo RI, Arora H, Gibbs E, Cohen S, Griswold A, Bakircioglu E, Bademci G, Tekin M, Ramasamy R (2018) Whole Exome Sequencing of a Consanguineous Turkish Family Identifies a Mutation in GTF2H3 in Brothers with Spermatogenic Failure. Urology. doi: 10.1016/j.urology.2018.06.031
  2. Sávio LF, Palmer J, Prakash NS, Clavijo R, Adamu D, Ramasamy R (2017) Transurethral resection of ejaculatory ducts: a step-by-step guide. Fertil Steril 107:e20