Sperm produced in a low amount


Sperm is produced in a very low amount making it seem as if there is none at all in the ejaculate


Sperm has reduced motility


Sperm is abnormally shaped.

Varicocele is swelling of the veins within the scrotum due to a defective valve. The valve normally moves only in one direction, allowing blood to flow away from the testes. Blood can move back into the veins of the testicle with a defected valve, causing the veins to swell. Varicoceles normally occur in the left testicle and it is rarely present in both. A varicocele in one testicle can also affect sperm production of the other testicle.


Men normally do not have symptoms and pain is uncommon because varicoceles develop slowly. Men with the condition may experience:

  • Dull pain
  • Pressure or heaviness of scrotum
  • Veins of scrotum feel like worms
  • One testicle is larger than the other
  • Relief when lying on his back


Varicocele usually does not require treatment. However, pain and swelling of the scrotum are signs that it is time to seek medical attention.

  • Physical Exam
  • Ultrasound of scrotum

Medical Therapy

Varicocele repair is a surgery that seals off the defected vein, which in return, redirects the blood flow into other veins.
Methods used:

  • Surgery through the groin or an incision in the abdomen or below the groin
  • Laparoscopic surgery

Retrograde ejaculation occurs when semen goes into the bladder rather than exiting out of the urethra after an orgasm. The semen does not harm the bladder and exits the body during urination.


  • Orgasm with little or no semen emerging from the penis
  • Cloudy urine after orgasm


  • Physical exam
  • Urine sample
  • The bladder will need to be emptied first
  • Then masturbation until climax
  • Urine sample provided for analysis after orgasm

Medical Therapy

  • Intracytoplasmic sperm insemination (ICSI)
  • Intrauterine insemination (IUI)

Congenital bilateral absence of the vas deferens (CBAVD) is a genetic abnormality that prevents the development of the vas deferens. The vas deferens is the tube that carries sperm from the testes. CBAVD keeps sperm from exiting the body. CBAVD can also lead to azoospermia, an extremely low sperm count.

Possible Cause

  • Cystic fibrosis


  • Lack of sperm during ejaculation


  • Semen analysis
  • Genetic testing- to check for cystic fibrosis

Medical Therapy

  • Intracytoplasmic sperm insemination (ICSI)
  • Intrauterine insemination (IUI)
  • In vitro fertilization (IVF)

Hypogonadism refers to a condition in men who do not produce enough testosterone. Hypogonadism can occur in utero, puberty or adulthood. Testicular failure and dysfunctions of the pituitary gland or hypothalamus can cause hypogonadism.

Other Causes

  • Klinefelter syndrome
  • Undescended testicles
  • Mumps orchitis
  • Hemochromatosis
  • Testicle injury
  • Cancer treatment
  • Kallmann syndrome
  • Pituitary disorders
  • Inflammatory disease
  • Medications
  • Excess weight
  • Advanced age


  • Erectile dysfunction
  • Infertility
  • Decrease in facial and body hair
  • Development of breast tissue
  • Osteoporosis (loss in bone mass)
  • Lack of energy
  • Low sex drive
  • Difficulty concentrating


  • Physical exam
  • Blood Test
  • Hormones
  • Genetics
  • Semen analysis

Medical Therapy

  • Pituitary hormones- to stimulate sperm production
  • Intracytoplasmic sperm insemination (ICSI)
  • Intrauterine insemination (IUI)