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Severe male infertility can look simple on the surface: a semen analysis shows very few sperm, or none at all. Beneath that result, the cause may sit in a tiny missing segment of DNA on the Y chromosome.

In non-obstructive azoospermia, semen analysis shows no sperm because the testes are producing very little sperm, or sometimes none at all. This is different from obstructive azoospermia, where sperm production may be normal but a blockage prevents sperm from reaching the semen.

A lump in the groin or scrotum can cause immediate worry, especially when the diagnosis involves a term few people have ever heard. Spermatic cord masses are rare, and some types, including paragangliomas, are so uncommon that many clinicians may see very few in practice.