Diagnosis of azoospermia The diagnosis is confirmed when the semen is centrifuged without sperm on three or more high-powered microscopic examinations. The World Health Organization semen analysis manual recommends centrifugation of semen at 3000 rpm for more than 15 min. Azoospermia diagnosis requires at least three centrifugations of semen without spermatozoa to be diagnosed. Different causes of azoospermia: Patients with azoospermia should further determine the cause. There are three categories of causes:pre-testicular, testicular, and post-testicular. Pre-testicularity is endocrine abnormalities affecting spermatogenesis or secondary testicular failure; testicularity includes primary testicular failure with problems in sperm production itself; post-testicularity is mainly sperm discharge disorder or obstruction of the seminal tract or urethra, accounting for about 40% of cases. 2:Patients with azoospermia should undergo a detailed medical history, physical examination and sex hormone tests including testosterone and follicle stimulating hormone. Evaluation of specific causes of azoospermia In order to determine the cause of azoospermia, it is important to review the basic test results.