Brief Answer:
You need to be investigated.

Detailed Answer:

Hi
Thanks for posting your query on HCM.
I really appreciate your concern for the semen analysis report.
I can understand your problem.
You need to be investigated to find out the causes.

Complete lack of sperm ("no sperm count) in the ejaculate is referred to as Azoospermia. It occurs in 5% of infertile men.

It could be due to a problem with sperm production or a blockage in which the sperms cannot reach the ejaculate.

Production Problems:

1. Hormonal Problems: The testicles need pituitary hormones to be stimulated to make sperm. If these are absent or severely decreased, the testes will not maximally produce sperm. Importantly, men who take androgens (steroids) either by mouth or injection for body building shut down the production of hormones for sperm production.

2. Testicular Failure: Inability of the sperm producing part of the testicle (the seminiferous epithelium) to make adequate numbers of mature sperm. This situation may be caused by genetic abnormalities, which must be screened for.

3. Varicocele: A varicocele is dilated veins in the scrotum, (just as an individual may have vericose veins in their legs.) These veins are dilated because the blood does not drain properly from them. These dilated veins allow extra blood to pool in the scrotum, which has a negative effect on sperm production.
This condition may be corrected by minor out-patient surgery.

Sperm Delivery Problems - Ductal Absence or Blockage

The sperm carrying ducts may be missing or blocked. Thus the patient may have both sides congenital absence of the vas deferens. s. He may have become mechanically blocked during hernia or hydrocele repairs.

Sperm are stored in sacs called the seminal vesicles, and then are deposited in the urethra, which is the tube through which men urinate and ejaculate. The sperm must pass through the ejaculatory ducts to get from the seminal vesicles to the urethra. If these are blocked on both sides no sperm will come through.

Finally, There may be neurological damage from surgery, diabetes, or spinal cord injury, which prevents the ejaculation from happening.

You need to be examined by a doctor for the following:


Physical Examination:

If the size of the testicles is severely diminished, this is an indication that the seminiferous epithelium is affected.
Follow up hormonal profiles can determine whether this is a primary problem or caused by inadequate hormonal stimulation.

The scrotum is examined for the presence of dilated veins (varicocele). Their presence can be confirmed by an ultrasound probe placed on the skin at the scrotum.

During a physical exam, the ductal systems can be felt. If they are absent, the patient has what is called congenital bilateral absence of the vas deferens;

Finally, during examination of the ductal structures, the epididymis may feel as though it is dilated. Generally, it is flat and the middle cannot be felt. Thus, a dilated epididymis may be indicative of a blockage.

Hormonal Evaluation:

Follicle stimulating hormone (FSH) is the hormone responsible for stimulating the testes to make sperm. If significantly elevated there is a strong indication that the testicles are not producing sperm optimally.
Other hormones estimated are testosterone, prolactin, leutenizing hormone and thyroid stimulating hormone.

Transrectal Ultrasound
Urinalysis
Testicular Biopsy

Hope these suggestions could be useful to you in detecting the causes of azoospermia and effective treatment.

Best regards.

---