The semen report says 'no sperm seen'. Does that mean my husband can never have a biological child?

Azoospermia means no sperm were found in the ejaculate sample. It is a serious finding, but it does not automatically mean there are no sperm at all. The first step is usually to repeat the test, ideally with the sample spun down (centrifuged) and checked carefully, because one result can be misleading. Doctors then try to work out which of two broad types it is. In obstructive azoospermia, sperm are being made but a blockage or absent tube stops them reaching the semen. In non-obstructive azoospermia, the testes are making very few or no sperm. Evaluation usually includes a physical examination, hormone tests (FSH, LH, testosterone, prolactin), a scrotal ultrasound and often genetic tests such as a karyotype and Y-chromosome microdeletion testing. Depending on the cause, options can include treating a hormonal problem, correcting a blockage, or surgical sperm retrieval from the testis or epididymis, with any sperm found used in IVF with ICSI. Success varies a lot by cause, so it's important not to assume the worst before the full workup. Please see a urologist or andrologist experienced in male infertility, along with your fertility specialist. Also see a doctor if there is a history of undescended testes, mumps affecting the testes, chemotherapy or testosterone use, as these matter for planning.