Is your husband shooting blanks?

Learn the seven common causes of azoospermia — no sperm count — and how to deal with it…

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You’ve probably heard of the term low sperm count, but some men actually face an even more severe form of male infertility called azoospermia. Also known as no sperm count, the guy’s ejaculate actually has no traces of sperm.

Dr Lewis Liew, a Gleneagles Hospital urologist, notes that about 10 per cent of male infertility issues is related to this condition. The average Singaporean man in his mid to late 30s has a higher risk of suffering from azoospermia. Although this problem can also happen when one’s pre-existing low sperm deteriorates, Dr Liew stresses that the probability is “not high”.

Two tests will determine if a man suffers from azoospermia. First, a semen analysis will confirm if he has the condition. He may then undergo a series of blood tests to check if he has male fertility hormones such as testosterone, luteinising hormone and follicular stimulating hormones.

If the cause is obstructive, the testicles produce sperm that is unable to flow out of the testes because of blockages.

The pituitary gland produces the luteinising hormone (LH) — also known as lutropin — which is responsible for the production of testosterone and plays a critical role in sperm production. The follicle-stimulating hormone (FSH), on the other hand, helps to control the production of sperm.

Azoospermia can be obstructive or non-obstructive in nature. If the cause is obstructive, the testicles produce sperm that is unable to flow out of the testes because of blockages. When the cause is non-obstructive, hormonal or genetic issues give rise to a problem with sperm production. Dr Liew explains what the different causes of azoospermia are and how he can resolve them…

Non-obstructive causes

1. LH and FSH deficiency
WHAT As both luteinising and follicle-stimulating hormones are crucial in influencing the levels of sperm production, a drop in their levels can spell trouble for your spouse’s sperm count.
EXPERT SAYS Excessive alcohol consumption may mess with his LH and FSH levels — a very good reason to stop drinking. Dr Liew says that certain drugs, like anabolic steroids and testosterone supplements, can also suppress a man’s pituitary gland functions. Treatment for pre-existing conditions like Kallman Syndrome — a failure to start or complete puberty ― can also cause his LH and FSH levels to drop. However, Dr Liew assures, “Treatment with synthetic LH and FSH can restart the testicular function and sperm-producing functions of the testes.”

Six more causes of azoospermia… Coming right up!