{"id":12634,"date":"2025-07-08T10:09:33","date_gmt":"2025-07-08T14:09:33","guid":{"rendered":"https:\/\/www.rigicon.com\/glossary-term\/azoospermia\/"},"modified":"2026-10-06T18:19:32","modified_gmt":"2026-10-06T22:19:32","slug":"azoospermia","status":"publish","type":"glossary-term","link":"https:\/\/www.rigicon.com\/pt-br\/glossary-term\/azoospermia\/","title":{"rendered":"Azoospermia"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"","protected":false},"featured_media":0,"template":"","glossary-category":[131],"glossary-product":[116],"class_list":["post-12634","glossary-term","type-glossary-term","status-publish","hentry","glossary-category-male-infertility-treatments","glossary-product-testi10-testicular-prosthesis"],"acf":{"gt-definition":"A azoospermia \u00e9 uma condi\u00e7\u00e3o m\u00e9dica caracterizada pela aus\u00eancia completa de espermatozoides no ejaculado (s\u00eamen) de um homem ap\u00f3s a centrifuga\u00e7\u00e3o de uma amostra de s\u00eamen, confirmada em pelo menos duas ocasi\u00f5es distintas.\u00b9 \u00c9 uma causa significativa de infertilidade masculina, afetando aproximadamente 1% da popula\u00e7\u00e3o masculina geral e 10-15% dos homens inf\u00e9rteis.\u00b9\u02d2\u00b2 A azoospermia pode decorrer de diversas causas subjacentes, que s\u00e3o amplamente classificadas em etiologias pr\u00e9-testiculares, testiculares e p\u00f3s-testiculares (obstrutivas).\u00b9 As causas pr\u00e9-testiculares envolvem desequil\u00edbrios hormonais ou doen\u00e7as sist\u00eamicas que afetam a produ\u00e7\u00e3o de espermatozoides. As causas testiculares, frequentemente denominadas azoospermia n\u00e3o obstrutiva (ANO), est\u00e3o relacionadas ao comprometimento da produ\u00e7\u00e3o de espermatozoides nos pr\u00f3prios test\u00edculos devido a fatores gen\u00e9ticos, problemas de desenvolvimento, infec\u00e7\u00f5es ou outras les\u00f5es testiculares. As causas p\u00f3s-testiculares, conhecidas como azoospermia obstrutiva (AO), ocorrem quando a produ\u00e7\u00e3o de espermatozoides \u00e9 normal, mas h\u00e1 um bloqueio no trato reprodutivo (por exemplo, ducto deferente, epid\u00eddimo ou ductos ejaculat\u00f3rios) que impede a ejacula\u00e7\u00e3o dos espermatozoides.\u00b9\u02d2\u00b3 O diagn\u00f3stico envolve uma avalia\u00e7\u00e3o abrangente, incluindo hist\u00f3ria cl\u00ednica, exame f\u00edsico, an\u00e1lises seminais, perfil hormonal, testes gen\u00e9ticos e, possivelmente, exames de imagem ou bi\u00f3psia testicular para determinar o tipo e a causa espec\u00edficos da azoospermia, o que \u00e9 crucial para orientar estrat\u00e9gias adequadas de manejo e tratamento.\u00b9\u02d2\u2074","gt-synonyms":"Esperma ausente no s\u00eamen, Azoospermatismo, Esperma ausente, Sem contagem de espermatozoides, Contagem zero de espermatoz\u00f3ides","gt-citation":"[1] Sharma M, Leslie SW. Azoospermia. [Updated 2023 Nov 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK578191\/\n\n[2] Cocuzza M, Alvarenga C, Pagani R. The epidemiology and etiology of azoospermia. Clinics (Sao Paulo). 2013;68(Suppl 1):15-26. doi:10.6061\/clinics\/2013(sup01)03. PMID: 23503951\n\n[3] Jarow JP, Sigman M, Kolettis PN, Lipshultz LI, McClure RD, Naughton CK, et al. The optimal evaluation of the infertile male: AUA best practice statement. Linthicum (MD): American Urological Association Education and Research, Inc.; 2010.\n\n[4] Practice Committee of the American Society for Reproductive Medicine. Diagnostic evaluation of the infertile male: a committee opinion. Fertil Steril. 2015 Mar;103(3):e18-25. doi: 10.1016\/j.fertnstert.2014.12.103. Epub 2015 Jan 15.\n\n[5] Wosnitzer M, Goldstein M, Hardy MP. Review of Azoospermia. Spermatogenesis. 2014 Jan 1;4(1):e28218. doi: 10.4161\/spmg.28218. eCollection 2014.\n\n[6] Esteves SC, Miyaoka R, Agarwal A. An update on the clinical assessment of the infertile male. [Updated 2021 Jul 16]. In: Feingold KR, Anawalt B, Blackman MR, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK279149\/\n\n[7] Gudeloglu A, Parekattil SJ. Update in the evaluation of the azoospermic male. Clinics (Sao Paulo). 2013;68 Suppl 1(Suppl 1):27-34. doi: 10.6061\/clinics\/2013(sup01)04. PMID: 23503952.\n\n[8] Goss DM, Vasilescu SA, Vasilescu PA, et al. Evaluation of an artificial intelligence-facilitated sperm detection tool in azoospermic samples for use in ICSI. Reprod Biomed Online. 2024 Jul;49(1):103910. doi: 10.1016\/j.rbmo.2024.103910. Epub 2024 Feb 22. PMID: 38652944.\n\n[9] Jamalirad H, Jajroudi M, Khajehpour B, et al. AI predictive models and advancements in microdissection testicular sperm extraction for non-obstructive azoospermia: a systematic scoping review. Hum Reprod Open. 2025;2025(1):hoae070. doi: 10.1093\/hropen\/hoae070. Epub 2024 Nov 21. PMID: 39764557.\n\n[10] Ito Y, Unagami M, Yamabe F, et al. A method for utilizing automated machine learning for histopathological classification of testis based on Johnsen scores. Sci Rep. 2021 May 10;11(1):9962. doi: 10.1038\/s41598-021-89369-z. PMID: 33967273; PMCID: PMC8107178.","gt-clinical-context":"A azoospermia \u00e9 identificada clinicamente quando um homem est\u00e1 sendo avaliado por infertilidade, pois \u00e9 uma causa prim\u00e1ria de infertilidade por fator masculino, afetando 10-15% dos homens inf\u00e9rteis.<sup>1<\/sup>\u02d2<sup>5<\/sup> A avalia\u00e7\u00e3o cl\u00ednica visa diferenciar a azoospermia obstrutiva (AO), na qual a produ\u00e7\u00e3o de espermatozoides \u00e9 normal, mas bloqueada, da azoospermia n\u00e3o obstrutiva (ANO), na qual a produ\u00e7\u00e3o de espermatozoides est\u00e1 comprometida.<sup>1<\/sup>\u02d2<sup>5<\/sup>\n<p>As condi\u00e7\u00f5es m\u00e9dicas relevantes associadas \u00e0 ANO incluem dist\u00farbios gen\u00e9ticos como a s\u00edndrome de Klinefelter (cari\u00f3tipo XXY), microdele\u00e7\u00f5es do cromossomo Y (por exemplo, regi\u00f5es AZFa, AZFb, AZFc), a s\u00edndrome de Kallmann e outras formas de hipogonadismo hipogonadotr\u00f3fico.<sup>1<\/sup>\u02d2<sup>5<\/sup> Outras causas podem ser les\u00e3o testicular decorrente de infec\u00e7\u00f5es (por exemplo, orquite por caxumba), quimioterapia, radioterapia, varicocele ou exposi\u00e7\u00e3o a gonadotoxinas.<sup>1<\/sup> Na AO, as condi\u00e7\u00f5es incluem a agenesia bilateral cong\u00eanita dos ductos deferentes (CBAVD), frequentemente associada a muta\u00e7\u00f5es no gene regulador da condut\u00e2ncia transmembrana da fibrose c\u00edstica (CFTR), ou obstru\u00e7\u00f5es adquiridas decorrentes de infec\u00e7\u00f5es (por exemplo, epididimite), traumas ou cirurgias pr\u00e9vias, como vasectomia ou corre\u00e7\u00e3o de h\u00e9rnia.<sup>1<\/sup>\u02d2<sup>5<\/sup><\/p>\n<p>A sele\u00e7\u00e3o de pacientes para tratamentos espec\u00edficos depende muito do tipo de azoospermia. Para homens com AO, a reconstru\u00e7\u00e3o cir\u00fargica (por exemplo, vasovasostomia ou vasoepididimostomia) pode ser uma op\u00e7\u00e3o se for identificado um bloqueio corrig\u00edvel e a parceira tiver um bom potencial de fertilidade.<sup>5<\/sup> Alternativamente, s\u00e3o comuns t\u00e9cnicas de recupera\u00e7\u00e3o de espermatozoides, como a aspira\u00e7\u00e3o microcir\u00fargica de espermatozoides do epid\u00eddimo (MESA) ou a aspira\u00e7\u00e3o percut\u00e2nea de espermatozoides do epid\u00eddimo (PESA), seguidas de inje\u00e7\u00e3o intracitoplasm\u00e1tica de espermatozoide (ICSI) com fertiliza\u00e7\u00e3o in vitro (FIV).<sup>5<\/sup> Para homens com ANO, as op\u00e7\u00f5es de tratamento s\u00e3o mais limitadas. Se a causa for hipogonadismo hipogonadotr\u00f3fico, a terapia hormonal \u00e0s vezes pode restaurar a espermatog\u00eanese.<sup>1<\/sup>\u02d2<sup>5<\/sup> Nos demais casos de ANO, pode-se tentar a extra\u00e7\u00e3o de espermatozoides testiculares (TESE) ou a TESE por microdissec\u00e7\u00e3o (micro-TESE) para encontrar espermatozoides para ICSI.<sup>5<\/sup>\u02d2<sup>7<\/sup> O sucesso da recupera\u00e7\u00e3o de espermatozoides na ANO varia conforme a patologia subjacente; por exemplo, a micro-TESE pode recuperar espermatozoides em at\u00e9 50% dos homens com s\u00edndrome de Klinefelter.<sup>1<\/sup><\/p>\n<p>Os procedimentos cir\u00fargicos relacionados ao manejo da azoospermia destinam-se principalmente \u00e0 recupera\u00e7\u00e3o de espermatozoides ou \u00e0 reconstru\u00e7\u00e3o do trato reprodutivo. Entre eles: <strong>Vasovasostomia\/Vasoepididimostomia:<\/strong> Procedimentos microcir\u00fargicos para reverter a vasectomia ou contornar outras obstru\u00e7\u00f5es do ducto deferente\/epid\u00eddimo.<sup>5<\/sup> <strong>MESA\/PESA\/TESA\/micro-TESE:<\/strong> T\u00e9cnicas para obter espermatozoides diretamente do epid\u00eddimo ou dos test\u00edculos para uso em TRA.<sup>5<\/sup>\u02d2<sup>7<\/sup><\/p>\n<p>Os resultados esperados variam significativamente. Na AO, a reconstru\u00e7\u00e3o cir\u00fargica pode levar \u00e0 concep\u00e7\u00e3o natural em uma parcela dos casais, com taxas de sucesso que dependem de fatores como a dura\u00e7\u00e3o da obstru\u00e7\u00e3o e a idade da parceira.<sup>5<\/sup> A recupera\u00e7\u00e3o de espermatozoides com ICSI na AO geralmente apresenta boas taxas de sucesso, pois a qualidade dos espermatozoides costuma ser normal.<sup>5<\/sup> Na ANO, as chances de encontrar espermatozoides com TESE\/micro-TESE chegam a cerca de 50% no geral (m\u00e9dia meta-anal\u00edtica de aproximadamente 47%), mas podem ser menores dependendo da causa espec\u00edfica e da histologia testicular.<sup>5<\/sup>\u02d2<sup>7<\/sup> Se forem recuperados espermatozoides, as taxas de sucesso da ICSI passam a ser influenciadas pela qualidade dos o\u00f3citos e por outros fatores femininos. O aconselhamento gen\u00e9tico \u00e9 crucial, especialmente se forem identificadas anormalidades gen\u00e9ticas, pois estas podem ser transmitidas aos descendentes.<sup>1<\/sup>\u02d2<sup>5<\/sup> Nos casos em que n\u00e3o \u00e9 poss\u00edvel recuperar espermatozoides, as op\u00e7\u00f5es incluem o uso de s\u00eamen de doador ou a ado\u00e7\u00e3o.<sup>1<\/sup>","gt-related-evidence":null,"gt-featured":true,"gt-ai-referenced":false,"gt-view-count":108},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.7 (Yoast SEO v28.7) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Azoospermia: Causas, Diagn\u00f3stico e Tratamento | Rigicon<\/title>\n<meta name=\"description\" content=\"Entenda a azoospermia, condi\u00e7\u00e3o caracterizada pela aus\u00eancia de espermatozoides no s\u00eamen. 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