Azoospermia Treatment
When a semen analysis shows no sperm count (azoospermia) or very low levels of sperm (cryptospermia), it does not necessarily eliminate the possibility of a couple conceiving. Our team of experts offer innovative treatments that may either help the man produce sperm or locate small numbers of sperm, not found on a regular semen analysis. Maze specializes in No Sperm/Azoospermia for patients in Westchester, New York City NYC, Connecticut, and New Jersey.
Maze’s Unique Approach
At Maze Men’s Health, we specialize in diagnosing and treating azoospermia (no sperm) and cryptospermia (very low sperm count) — complex conditions that require expertise in male infertility. A semen analysis showing no sperm does not mean you can’t have a biological child. With advanced evaluation and treatment, many men go on to successfully conceive. Serving patients across Westchester, New York City, Connecticut, and New Jersey, our team, led by Michael A. Werner, MD, board-certified urologist and male reproductive specialist, provides the most comprehensive and personalized care available.
Our process begins with identifying the root cause — whether it’s non-obstructive azoospermia (a sperm production issue) or obstructive azoospermia (a blockage preventing sperm release). Using detailed hormone testing, imaging, and genetic evaluation, we create a customized plan to either stimulate sperm production or locate sperm not detected on routine semen analysis. Treatments may include hormonal therapy, varicocele repair, or microsurgical sperm retrieval techniques such as TESE or micro-TESE. Once sperm are found, they can often be used with IVF or ICSI to achieve pregnancy — remember, it only takes one healthy sperm per egg.
At Maze, we understand that a diagnosis of azoospermia can be overwhelming, but it is not the end of your fertility journey. Our compassionate, science-driven approach has helped countless men overcome even the most challenging cases and achieve their dream of fatherhood.
Diagnosis
Accurate diagnosis is the foundation of effective treatment for azoospermia (no sperm count). At Maze Men’s Health, we recommend performing at least two semen analyses in a highly specialized laboratory before confirming total azoospermia. Because sperm production naturally fluctuates, some men with very low sperm counts may appear azoospermic on one test but not another. Our advanced testing methods often detect small numbers of sperm that standard labs miss, giving many men renewed hope for biological conception.
Following a confirmed diagnosis, a thorough evaluation by Michael A. Werner, MD, board-certified urologist and male infertility specialist, is essential to determine the cause. The key question is whether the issue is with sperm production (non-obstructive azoospermia) or sperm delivery (obstructive azoospermia). If the testes are producing sperm but a blockage prevents it from entering the ejaculate, we focus on retrieving and preserving sperm for use in assisted reproductive techniques. If production is impaired, we work to stimulate and maximize sperm creation through targeted hormonal, medical, or surgical treatment.
At Maze, we bring deep expertise, precision diagnostics, and a compassionate, personalized approach to every azoospermia evaluation, helping men across Westchester, NYC, Connecticut, and New Jersey take the first step toward achieving fatherhood.
Your Story: When the Testes Make Sperm, But It Can’t Get Out
For some men diagnosed with azoospermia, the problem isn’t that the testes fail to produce sperm — it’s that the sperm can’t reach the ejaculate. This is known as obstructive azoospermia, and it’s far more common — and more treatable — than many realize. At Maze Men’s Health, led by Michael A. Werner, MD, we specialize in identifying and correcting these “delivery” issues so men across Westchester, New York City, Connecticut, and New Jersey can achieve biological fatherhood.
Obstructive azoospermia can result from a variety of causes. Some men are born without the vas deferens, the tubes that carry sperm from the testes — a condition called Congenital Bilateral Absence of the Vas Deferens (CBAVD), often linked to genetic mutations in the cystic fibrosis gene. Others may have blockages in the epididymis or vas deferens caused by infection, prior surgeries, or even a past vasectomy. In some cases, the ejaculatory ducts or seminal vesicles become blocked, preventing sperm from reaching the urethra, or nerve damage causes ejaculatory dysfunction, where sperm flows backward into the bladder instead of outward.
Fortunately, advanced treatments can often restore or bypass these blockages. Depending on the cause, Maze offers microsurgical reconstruction to reconnect the ducts, Transurethral Resection of the Ejaculatory Ducts (TURED) to clear obstructions, or precise sperm retrieval techniques such as MESA (Microsurgical Epididymal Sperm Aspiration) and testicular biopsy to collect sperm directly from the source. Retrieved sperm can then be used in IVF/ICSI procedures, allowing couples to conceive using the man’s own sperm. In cases of ejaculatory dysfunction, specialized medications or urine sperm recovery methods can also help.
Every case of obstructive azoospermia tells a different story — and at Maze, we take the time to uncover yours. With compassionate, expert care and the latest reproductive technology, we help men transform a diagnosis that once felt hopeless into a new beginning.
Your Story: When the Testes Aren’t Making Enough Sperm
For some men, azoospermia isn’t caused by a blockage — it’s due to the testes not producing enough sperm. This is called non-obstructive azoospermia (NOA), and while the diagnosis can sound discouraging, it doesn’t mean you can’t have a biological child. At Maze Men’s Health, led by Michael A. Werner, MD, we specialize in uncovering why sperm production is impaired and using advanced treatments to give men across Westchester, NYC, Connecticut, and New Jersey real hope for conception.
The first step is understanding the cause. Sperm production can be suppressed by hormonal imbalances, varicoceles (dilated scrotal veins), thyroid or pituitary issues, past testosterone or steroid use, or genetic factors such as Y-chromosome microdeletions. After a detailed physical exam, hormone panel, and genetic testing, we work to maximize natural sperm production through targeted therapies. This may include Clomiphene Citrate (Clomid) or other hormonal treatments to stimulate the testes, or microsurgical varicocelectomy to repair varicoceles — a procedure that restores sperm in up to 44% of azoospermic men.
When sperm aren’t visible in a standard semen analysis, Maze uses groundbreaking diagnostic and retrieval methods, including our exclusive Extended Sperm Search & Microfreeze (ESSM) — the only program of its kind in the US ESSM involves an exhaustive, hour-long microscopic search of the entire semen sample to find and freeze even a single viable sperm for IVF with ICSI. If ESSM doesn’t uncover sperm, we may recommend Sperm Mapping or our innovative Grid Needle Sperm Extraction & Microfreeze (GN-SEM) procedure, which can both locate and collect sperm directly from the testicle in one minimally invasive step.
Even when sperm production is extremely low, we often find enough for successful fertilization. Every sperm represents potential — and at Maze, we use every tool of modern reproductive science to help men turn that potential into parenthood.
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Our deepest thanks for your support in our fertility journey
We want to express our deepest thanks for your support in our fertility journey.
We are still very much in the throes of our family building story, but as we reflect back on the last year, the moment we stepped into your office is one of our biggest turning points. We were terrified, and your guidance, reassurance, and compassion during a time of extreme uncertainty for us meant more than words can express. That moment when you let us know that having biological children would be a possibility for us will hold a special place in our hearts for the rest of our lives.
Your ability to create an atmosphere of comfort and understanding sets a benchmark in patient care that is truly unparalleled.
L, NY
I deeply appreciate the efforts you and your staff have made...
Maze has created an experience of gaining insight and comfort with and acceptance of, my post surgical sexual self.
Based on my experience with Maze, I would highly recommend you, your clinicians and staff, to others — your approach and quality of concern and support (and determination!) have been hugely valuable.
A, NJ
I have been a patient for almost 10 years...
If you want to go to an office where everyone there is encouraging, helpful, and sincere then Dr. Werner and staff is the place for you. I have been a patient for almost 10 years and never did I think it was about money for his operation.
They have always gave me clear information and guided me through any procedure or process I was working through. I would recommend this office to anyone that needs help!
SR, NY, 49
I could not recommend Dr. Werner and his great team more highly!
I have been seeing Dr. Werner and his fine staff for a few years now and simply put-its the best medical care I’ve ever experienced. Due in large part to the guidance and healthcare I’ve experienced here I feel like the best version of myself at age 41. I could not recommend this Dr. Werner and his great team more highly! Thank you all for what you do!!
JC, NY, Age 41
I Wish I Could Give Them More Stars!!
This is an amazing place!!!! Not only is Dr. Werner great, but the entire staff is incredible. They have completely changed my life for the better. Only wish I had known about them sooner. I wish I could give more stars!!!
David, NY, Age 39
I am in great, knowledgeable, and experienced hands.
Excellent care and follow up by Dr. Werner and Nick. As a doctor myself, I feel I am in great, knowledgeable, and experienced hands. A+
A, NY, Age 44
To state that Dr. Werner saved my life, would be an understatement!
I have been under his care for almost a decade during which he guided me through successful Peyronies treatment, a penile fracture, erectile dysfunction, and in the end, a life beyond my wildest dreams. Dr. Werner, Nick, Paul, Rima, and his entire staff, have spent so much time investing in my physical health, in an effort to not only solve medical problems, but to maximize my overall quality of life.
Dr. Werner is beyond a great practitioner. He’s a great man. His balance of exemplary knowledge, comprehensive treatment, humor, and individualized patient care, has far exceeded any expectation that I have ever had for a doctor. This is to say that Dr. Werner has always treated me as a human being, first. Therefore, his understanding of the person whom he treats, in addition to only the most sound scientific research, makes his work life-altering.
Over the past 10 years, I have continually peppered his staff with questions and concerns, as I have always felt the need to stay educated. Backed by tremendous patience and humility, Dr. Werner has never made me feel like a number. I feel grateful that I found his office, years ago. To that end, I no longer consider him, Nick, or Paul, mere practitioners, but dear friends. I owe much, if not all of my progress over the last few years, to MAZE MENS HEALTH.
Alix B, NJ, Age 51
Dr. Werner and team are knowledgeable, confident and really care about you as an individual!
My first impressions of Dr. Werner: smart, caring, confident, warm. He really listened to me and demonstrated a high level of confidence that he could help me. He understood the impact my symptoms were having on my life and didn’t minimize them. Paul (therapist) and Kristy (exercise physiologist) were also professional and inspired both calm and confidence.
I was initially referred to Dr. Werner for ED and began using a combination of medication and penile injections. Once Dr. Werner found the right dose for me, I was able to get the best erection I had had in over six months. I later developed Peyronie’s Disease as well. I was fortunate that Dr. Werner had significant experience treating Peyronie’s Disease, as he was able to assess me and recommend Xiaflex injections. While treating my Peyronie’s, Dr. Werner also suggested I begin Shockwave Therapy to further help my ED. Since completing both treatments, not only has my Peyronie’s seen dramatic improvement, but my ability to get an erection has improved 95%!
I feel very positive about my experience with Dr. Werner and Maze. These are good people and they are good at what they do. They understand the problem, treat you with respect and take your concerns seriously. I can’t imagine there’s any sexual health issue Dr. Werner would not be able to help you with! If you do consider coming to Maze, it’s important to stick with it and remember that these are medical issues and results do not happen overnight. I was incredibly nervous when I came in for my first appointment, but Dr. Werner has created an environment and a team at Maze that will immediately put you at ease.
Additionally, you and your partner must be on the same page since treatment is a process and requires both patience and good communication. I’m happy to say my wife and I have seen tremendous benefits, becoming even more communicative and closer as a couple throughout this process. Two years ago, I never would have believed coming in for treatment would have changed our relationship so positively.
D, PA, Age 69
Bottom line is that Dr. Werner and all the staff were wonderful!
Very impressive and professional medical practice. Top staff, rigorous process, timely service and excellent follow-up. There is also a positive and vibrant demeanor projected by everyone in the office that I have not seen in other places. There is extensive testing that can get pricey for out of network patients, but cannot argue with the treatment process, quality and results. Bottom line is that Dr. Werner and all the staff are wonderful!
AP, NY, Age 63
The word I would use for Dr. Werner is “thorough."
In 2009, I came to see Dr. Werner for erectile dysfunction, but I was having symptoms for ten years before I got here! I had seen many other urologists, but they just couldn’t figure it out. When I found Dr. Werner, all that changed.
I was very impressed with the caring and knowledge he possesses. He really went out of his way to find out everything that was a piece of my issues. The word I would use for Dr. Werner is “thorough.”
He discovered that I had low testosterone as well as erectile dysfunction. Once I started treatment he had me come in every 4-6 months to check my numbers and regulate me. Together, we found the right treatment cocktail, and my issues were resolved within 4-6 weeks!*
If you ever feel, at any point in your life, that there is a problem, seek help immediately!
A, NY, Age 47
Dr. Werner combines thoroughness with panache.
Dr. Werner combines thoroughness with panache. I feel like his care is totally comprehensive and I feel total confidence that no details will be missed. I have very high standards and he more than surpassed them all.
R, NY, Age 59
Dr. Werner helped us start a family. We will always be extremely thankful.
How are you, Bat Sheva, and Dr. Werner? We hope all of you are doing well and I’m sure helping people move towards sexual wholeness.
We’re doing really well. Our little miracle from God, Anna Joy, is almost 5 months old now!! She is rolling over, babbles a lot, and has the cutest toothless smile. Stan and I absolutely adore her and marvel every day that God gave us this amazing little girl to take care of. We’re so blessed.
We will never forget how Dr. Bat Sheva, and Dr. Werner played such a vital role in our journey towards parenthood. We will always be extremely thankful to God for you.
Please send our love to them.
S & J, NJ
Most compassionate, friendly doctor.
I have been a patient of Dr. Werner’s for over 21 years and he is the most compassionate, friendly doctor I have ever met.
I look for his advice even outside of his specialty. The same can be said for Nick and all of the staff at Maze.
A, NY, Age 59
How to Become a New Patient
Schedule a Free Phone Consultation
Your journey begins with a quick, confidential phone call with one of our Patient Care Coordinators. We’ll discuss your symptoms, explain what to expect, and schedule your first appointment at a convenient location.
Complete Your Intake Forms
Before your visit, you’ll receive secure online forms to share your medical history, medications, and goals. This helps our providers prepare for your evaluation and design a tailored plan from day one.
Comprehensive First Appointment
Your initial consultation lasts 45–60 minutes and includes a detailed review of your medical, sexual, and lifestyle history, lab testing (including hormones), and discussion of both physical and psychological factors that may be contributing to delayed ejaculation.
Begin Your Personalized Treatment Plan
Based on your evaluation, we’ll create a customized plan that may include medications, hormone therapy, behavioral techniques, or desensitization exercises—all designed to improve function, pleasure, and confidence.