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We get a lot of messages from men who are quietly struggling with the stress of not being successful in siring a child. Some of these men have had tests done to confirm infertility on their part, others have simply concluded that they are the problem as their past partners have gone on to conceive with other men.

Amazingly, a lot of these men are stuck with this diagnosis without knowing what to do next. This is mostly out of fear and shame that comes from the stigma associated with infertility in our African culture.

There is also limited resources and information on the topic of Male infertility. This is our motivation at Hannah’s Orison, to shed light on this topic by creating awareness on what Male infertility is and the various treatment options available.

Step 1: Understand what is Infertility

Infertility is normally defined as not conceiving after 12 months (6months if the woman is over 35 years) of regular sexual intercourse without the use of birth control.

There are 2 types of infertility:

  • Primary infertility refers to couples who have not become pregnant after at least 1 year of having sex without using birth control methods.
  • Secondary infertility refers to couples who have been able to get pregnant at least once, but now are unable.

You can read more on infertility and some of the causes here.

Step 2: Get your body healthy to improve chances of conception

As soon as you and your partner decide to start trying to conceive, there are things that can help you get a head start. This will include:

  • Lifestyle changes to ensure optimal health, such as; reducing alcohol intake, reducing smoking and consuming better diet. You can read more on this here.
  • You can also take dietary supplements that will boost your sperm quality.

Step 3 – Fertility test

So after 6months to 1 year of being unsuccessful in conceiving, you should have a Semen Analysis test done. The test will determine if a man is infertile and whether low sperm count or sperm dysfunction is the reason behind infertility. You can read more about this test, where/how it is done, what it costs etc here.

Step 4  – Treatment

Once you have the results of the testing, you can begin to discuss options for improving your fertility.  The most common cause of male infertility will be poor sperm health( Low sperm count, low sperm Motility, poor/abnormal sperm shape).

The treatment option will depend on the problem identified, probabilities of success, risks and cost. Some couples will want to do the least invasive, least expensive option first even if it has the lowest probability of success.

Some of the options could be:

  1. Medication – including dietary supplements to improve sperm parameters (count, motility morphology). You can see here our supplements that improve sperm parameters.
  2. IUI – Artificial insemination, also known as intrauterine insemination (IUI), is a technique that involves placing sperm inside the woman’s uterus with a catheter to achieve fertilization.
  • In vitro fertilization (IVF) is a process in which mature eggs are removed from your body and then fertilized with sperm in a lab dish.

You can read on the types of fertility treatment available in Kenya and their costs here.

You can also read on the benefits of supplements on treatment of Male infertility here.


Knowing the cause of your infertility is very important as it enables you identify options available to address your problem.

Taking action as soon as possible is best as the earlier the problem is identified then the earlier the problem can be addressed.

Also it is important to note that fertility in both men and women decreases with age and therefore more reason to start on possible options early.

Not taking action is only postponing the infertility problem. It is not a solution. Save yourself a lot of time and avoid unnecessary stress by taking action immediately. A lot of men have been surprised by how simple it was to overcome their infertility once they took action.









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Sperm health is the number 1 cause of Male infertility. Improving sperm health improves male fertility and increases chances of getting your partner pregnant.

Diet has been proven to be a factor that affects sperm health. Certain types of food will support your body in the production of healthy sperm while other types of foods will have a negative effect on the production of sperm.

In this article we will discuss on which foods to include in your diet and which ones to remove from your diet in order to improve the quality of your sperm. While there are alternatives to the foods mentioned here, we will focus on the foods that are locally available (Kenya) and affordable, we will also mention some places where you can find these foods.


Before we mention the foods to include in your diet, it is important to understand some of the ingredients we are looking for and which is essentially what will affect the health of the sperm.

Some of the Ingredients:

  • Vitamin C
  • Antioxidants
  • Zinc
  • Selenium
  • Omega 3
  • Carnitine
  • Arginine


  1. Walnuts: These are full of omega-3 fatty acids that help boost sperm volume and production by increasing blood flow to the testicles. It is also full of arginine, known to increase semen volume. It contains twice as much antioxidants than another nuts, helping you fight toxins in your blood stream.
  1. Garlic: is known around the world as a food good for boosting immunity. Among its many properties are vitamin B6 and selenium, both of which play roles in healthy sperm production. Taken by many for its blood cleansing abilities, garlic prevents buildup in arteries and allows for better blood flow to your testicles.
  1. Pumpkin seeds, especially in their raw form, are packed with potassium, zinc, magnesium, calcium, omega 3, and vitamin E. Pumpkin seeds have phytosterol, which improves testosterone levels.High testosterone levels mean high sperm quality. Pumpkin seeds have Omega 3 and fatty acids that improve semen volume.
  1. Zinc rich foods: These will include red meat, beans and other legumes etc Zinc plays a vital role in sperm development. The mineral is found in high concentrations in testicles during the production of healthy, strong semen. So important is zinc, deficiencies of the mineral has been blamed for low sperm motility.
  1. Maca root :The powder from this Peruvian root has a long-standing reputation as a natural libido booster. Some research has shown that maca powder increases sperm concentration and motility.
  1. Vitamin C : This is needed to synthesize collagen, heal wounds, fight against free radicals, and protect your cells including sperm from destruction. Adult men should get at least 90 mg of vitamin C per day. Because vitamin C is soluble to water, it is easily removed from the body. Therefore, you should eat vitamin C-rich foods on daily basis to prevent deficiency.  Foods that contain high amount of vitamin C include: citrus fruits, orange juice. Another excellent source of Vitamin C is Baobab powder.
  1. Antioxidants : Uncontrolled and excessive production of  reactive oxygen species (ROS) overwhelms the limited antioxidant defenses in semen resulting in seminal oxidative stress. Increasing intake of this nutrient will restore balance by removing the ROS. This often results in improvements in the sperm count, motility and shape (morphology) and prevents DNA damage to sperm. The best antioxidants for male fertility include CoQ10, vitamin C, selenium, vitamin E, and lycopene.
  1. Moringa leaves/powder : These are excellent sources of antioxidants, which may help combat oxidative damage that can interfere with sperm production or damage sperm DNA.
  1. Ashwagandha powder: This herb has been shown to boost sexual desire and testosterone levels, some studies have suggested that taking ashwagandha helps to improve sperm count, sperm motility and overall semen quality. A 3-month study analyzed 75 men who experienced infertility and found that a daily dose of 5g of ashwagandha increased both sperm count and motility.

Things to eliminate or limit

These foods may decrease sperm quality and negatively impact male fertility:

Junk food

You already know this stuff isn’t good for the heart or the waistline, but fatty, fried and sugary foods can impair male fertility too.

Sweetened snacks and beverages like soda can hurt sperm quality, research suggests.

Caffeinated drinks and alcohol

Research shows that drinking too much coffee, tea, energy drinks and alcohol may decrease sperm count.


It’s unclear whether a diet rich in soy can actually lead to problems getting pregnant, but some research has linked diets high in soy foods with a lower sperm concentration.

High-fat dairy 

Yes, milk does a body good. But in the case of sperm, men may want to forego the high-fat stuff. Full-fat dairy foods can negatively impact sperm count and motility.

It’s better to reach for low-fat milk, skim milk or milk alternatives like almond milk or coconut milk. The same goes for other dairy products like cheese and yogurt: Pick the low-fat versions, which have been found to benefit sperm quality.

Processed meat 

Diets high in processed red meats are associated with lower sperm count and quality, so cut down on the bacon, hot dogs, sausage, deli meat and similar fare.

Where to get these foods in Kenya (Nairobi)

All of these foods are available in Nairobi.

For the seeds (eg walnut, fenugreek, pumpkin) and the powders eg Maca, Moringa, Baobab and Ashwagandha, you can get this from Healthy U and other spice shops in Ngara or Eastleigh.

In conclusion:

Even when consuming a great diet with all of the food listed above, it can be difficult to get all of the nutrients you need in proper amounts and impossible to get nutrients like CoQ10, Zinc, and Ashwagandha.

Because these hard-to-get nutrients are even better than many of the foods in this article, experts recommend that men take a high-quality male fertility supplement like Fertilaid, Countboost and Motilityboost to ensure they are achieving appropriate levels of the nutrients mentioned in this article and the many others vitamins, minerals, biomolecules, and herbs that have been shown to provide the ultimate increase in sperm health and fertility.


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Don’t let your doctor talk you into IUI (intrauterine insemination) or IVF (in vitro fertilization) too soon. These aren’t the only hope for conceiving.

Getting pregnant is one of those things in life that’s difficult to balance. Most of us don’t want to have a baby until suddenly we do, and then we’re anxious to get pregnant as fast as possible. For couples who wait until later in life (after age 35 and over) to expand their families, the process can seem even slower and more stressful. Each month of trying to conceive can feel like a lifetime.

Most couples will seek a doctor’s help after failing to conceive for a period of time. However, a lot of these couples are not properly informed on all of the natural ways/options to achieve pregnancy. They are instead quickly pushed toward conventional and costly fertility treatments like IVF or IUI without being educated on all their options.

At the end of the day, we should all choose what’s right for us, but there’s a lot to learn about fertility treatments and natural alternatives that can make the conception process safe, beautiful, less stressful and less stressful.

There are many cons to conventional fertility treatments that couples must be aware of: 

  1. Cost. 

Most fertility treatments are extremely expensive. The average cost of an IVF cycle in Kenya is around Kshs.400,000/-.

  1. Success rate. 

The Society for Assisted Reproductive Technologies reports that, as of 2011, the best chance that an IVF cycle will result in a live birth is 40 percent, and it can be as low as ten percent.

  1. Stress. 

Fertility treatments have been shown to be very taxing both on a woman’s body and on the couple. Some patients have rated the stress of undergoing IVF as more stressful than or almost as stressful as any other major life event, such as the death of a family member or separation or divorce.”

  1. Side effects. 

Most fertility treatments come with side effects, including mood swings, hot flashes, headaches, dizziness, nausea and fatigue.

  1. Moral considerations.  

Many couples don’t take the time to discuss how many embryos to transfer, what to do with the extra eggs and/or embryos, or what to do if they need a donor egg or donor sperm.

So what are the Natural Alternatives to Conventional Fertility Treatments?

Before going down the expensive and difficult road of fertility treatments, there are a number of natural ways to boost fertility that couples can explore.

Natural alternatives are significantly less expensive. They’re also safe, easy, and incredibly effective.

  1. Track ovulation. 

Lack of fertility awareness is a major factor in some couples’ inability to conceive. By learning to track fertility signs, couples can accurately predict when ovulation is going to occur and time intercourse appropriately. There are a number of fertility tracking tools available online.

  1. Improve overall health.

There are often general health issues that can prevent pregnancy that many couples aren’t aware of. Improving each partner’s overall health by maintaining a healthy weight, improving nutrition, and getting moderate exercise will enhance fertility.

  1. Supplement. 

Many natural products such as herbs, minerals, and vitamins have been scientifically proven to help promote sperm health in men and hormonal balance in women.

  1. De-stress. 

Stress is a fertility killer. Couples who have trouble getting pregnant should reevaluate all the activities and relationships in their lives that might be triggering stress. Exercise, meditation, and acupuncture are all effective ways to unwind.

When we’re ready to start our families but can’t seem to get pregnant, continuing the old-fashioned way can seem hopeless. It’s easy to get impatient, and it’s natural to turn to a doctor for help. But no couple should let a physician pressure them into fertility treatments or conventional medicine. We always have options, and there’s no right or wrong way to make a baby.

Even as you seek help from your doctor, be your own advocate, do your own research. Make an informed decision.


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What is Infertility

This is when a couple is unable to conceive after having frequent and unprotected sex for a year. Half the time, the cause for an infertile couple’s difficulty in conceiving will be the male factor.

With infertility in men in Kenya being on the rise, today we look at some of the treatment options available locally thanks to the Fertility clinics and Fertility Doctors located in the country.

Common Causes of Male infertility include:-

  • Obstructive Azoospermia

    in this case, sperm are being produced normally in the testes, but there is a blockage or obstruction in the male reproductive tract that prevents the normal transport of sperm through the post-testicular ductal system. Azoospermia can be caused due to several conditions including sexually transmitted disease, retrograde ejaculation, scrotal trauma/injury, scar tissue, cystic fibrosis, hernia surgery and vasectomy.

Treatment options for obstructive azoospermia include:

  1. surgical correction of the obstruction, or
  2. IVF/ICSI with sperm retrieval from the epididymis or testes through testicular sperm extraction (TESA)
  • Poor Sperm Health 

This is the leading cause of male infertility. A semen analysis is the test done to evaluate the quality of sperm.

  1. Oligospermia – Low sperm count. This is defined as low sperm concentration in the ejaculate. As per WHO the sperm count in a semen sample should be above 15 million sperm per milliliter, anything below can be diagnosed as oligospermia.
  2. Asthenospermia – Poor sperm motility. Motility is the forward swimming motion of sperm. When sperm motility is poor, fewer sperm are able to reach the egg, making conception less likely to occur.
  3. Poor sperm morphology refers to the size and shape of sperm. Abnormally shaped sperm may have difficulty fusing with the egg, thereby decreasing the chances of successful fertilization.

Treatment options for poor sperm health:

  1. Dietary supplements designed to improve sperm count, motility and morphology such as Fertilaid, Motilityboost, Countboost.
  3. IUI
  • Retrograde Ejaculation

Retrograde ejaculation occurs when the semen is redirected to the urinary bladder instead of ejaculating via the urethra. This happens when the bladder sphincter does not function properly, forcing semen to enter the bladder.

Even though retrograde ejaculation is harmless, it can cause male infertility. Retrograde ejaculation may be also caused due to usage of certain medications, congenital conditions, injury or surgery.

Treatment option

  1. IVF/ICSI with sperm retrieval from the epididymis or testes through testicular sperm extraction (TESA)
  • Varicocele

Varicocele is a condition occurs when the veins enlarge within the scrotum. It might cause male infertility. Pooled blood in the enlarged veins affects the temperature in the scrotum to increase than normal, it affects the ability of the testes to produce sperm resulting in decreased sperm count, decreased motility and poor morphology.

Treatment option

Varicocelectomy is a treatment option available to treat varicocele. It is a small microsurgical procedure in which all the swollen veins are tied off while preserving the normal blood vessels. In many patients this can result in a dramatic increase in sperm counts and motility.

Approximate costs for the different treatment options

IVF Type in Nairobi, Kenya City Approximate Cost (Kenya Shilling – KES)
Normal IVF Cycle Nairobi 400,000 KES
Advanced IVF Cycle/ ICSI Nairobi 500,000 KES
IUI Nairobi 60,000 KES
Dietary supplements Nairobi 10,000 KES

I hope this helps you in understanding the treatment options available and deciding on the best option for you on your fertility journey.

Some other topics that could interest you are:

Steps to take when struggling with infertility

Heat and Male infertility

What is a Semen Analysis/sperm test

Why dietary supplements are a great treatment option for infertility




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Damaged Sperm Plays a Role in Repeated Miscarriages

Recurrent or repeated miscarriage is defined as the loss of three or more pregnancies before 20 weeks of gestation.

For decades, miscarriage was believed to relate to the woman’s ability to carry a pregnancy to term. However, recent studies have revealed that frequent miscarriages can be associated with poor quality of sperm. Recent studies have shown that, compared to healthy couples, women with recurrent miscarriages have male partners whose sperm shows increased levels of DNA damage.

In addition to having a reduction in serum testosterone and estrogen levels, these men have reduced total and progressive sperm motility and atypical sperm morphology. Furthermore, the levels of reactive oxygen species (ROS) in the semen samples of these men are significantly higher than those in healthy counterparts.

Sperm DNA plays an important role in placenta formation. A healthy placenta is necessary for fetal survival. Thus, it is obvious that increased sperm DNA damage can impact pregnancy outcomes by negatively affecting placental health.

Also, a low level of testosterone can negatively impact sperm health by altering spermatogenesis (the process of sperm cell production and development). This can lead to structural and functional abnormalities in sperm, which then can increase the chance of recurrent miscarriages.

What are the frequent sources of ROS in semen?

Production of ROS in sperm cells can be induced by several factors, including:

  1. excessive consumption of alcohol can increase the level of certain metabolites that are responsible for increased ROS production.
  2. smoking can induce ROS production by increasing lipid peroxidation and reducing cellular antioxidant levels.
  3. Varicocele, which is defined as an enlargement of the veins in the scrotum. Men with varicocele have higher numbers of sperms with chromatin-related abnormalities, which can be due to increased ROS-induced oxidative stress.
  4. Bacterial or viral infections in the male reproductive tract can increase the production of ROS.
  5. Obesity is considered an important trigger of ROS production in sperm cells, which is most probably due to an increased rate of metabolism. The high level of ROS in obese men can impair spermatogenesis, leading to deterioration in sperm quality.
  6. Aging is another important factor associated with increased ROS production and reduced antioxidant capacity. The resultant oxidative stress can impair sperm DNA integrity, leading to the production of poor-quality sperm.
  7. Certain environmental factors, such as air pollutants, can increase ROS production in sperm cells, which can subsequently reduce sperm quality and quantity.

Can Antioxidant Male Fertility Supplements Protect Sperm?

Studies have shown that taking dietary supplements with antioxidants, such as Fertilaid, Countboost, Motilityboost , can reduce ROS damage to sperm. Antioxidants protect against ROS-caused oxidative stress and can keep DNA in sperm healthy.

In conclusion

Damaged sperm are far more involved in recurrent pregnancy loss than previously thought. Protecting them from too many reactive oxygen species can not only help you get pregnant in the first place—it may help you carry your baby to term.


  • Jayasena CN, Radia UK, Figueiredo M, et al. Reduced Testicular Steroidogenesis and Increased Semen Oxidative Stress in Male Partners as Novel Markers of Recurrent Miscarriage. Clinical Chemistry. Published Online January 2019.
  • Science Daily. 2019. Recurrent miscarriage linked to faulty sperm.
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Finding your fertile window

As you might already know, in order for conception to take place, sperm must be waiting in the Fallopian tube at the moment that ovulation occurs so it can fertilize the egg within 12-24 hours of the egg being released from the ovary.

Because sperm can only live for up to 7 days in the female body, and only a small number of sperm will even survive the long journey to the egg, you and your partner need to have sex at the right time to maximize the chance that you will conceive.

This means you need to know when you will ovulate, which is more difficult to determine than you might think. One reason for this is that due to normal fluctuations in your body, you won’t always ovulate on the same cycle day from one cycle to the next. Fortunately, there are other reliable ways to measure what’s going on in your body and predict when your most fertile days in each cycle will fall. The most important thing is to find a method for pinpointing your fertile window that works well for you!

Some of the ways to predicting your fertile window include:

  1. Using a period tracking APP. This is good enough especially for those with regular periods. There are also many free options of these apps.
  2. Ovulation Predictor Kits(OPKs) are a popular method for predicting ovulation. OPKs detect the presence of luteinizing hormone (LH) in your urine. Approximately 12-36 hours before ovulation occurs, the amount of LH in your body “surges”. By testing with OPKs, you can identify this LH surge, which allows you to know that ovulation is just around the corner and that you are in your fertile window. These can be used alongside your period tracking app to be extra sure of when you are ovulating.
  3. Electronic fertility monitors, like the OvaCue Wireless Fertility Monitor, can give you the most advanced notice of ovulation, up to 7 days. They use the Electrolyte Method to track changes in the electrolytes in your saliva and cervical mucus that correspond to the fluctuating levels of estrogen and progesterone throughout your cycle. These devices even work well for women with irregular cycles as they work by watching for trends in the readings rather than looking for set reading levels. The main con for these is price with most of them starting at about 250USD or Ksh.30,000/-.

For those with irregular cycles, it would be best to first regulate their cycle so that they can be better able to track their fertile window. Fertilaid for women is a supplement that is designed just for this.

Have you been tracking your ovulation? Which method have you been using? What challenge have you faced?

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What next after not conceiving?

So you’ve been trying to conceive for some time….now what?

First of all, relax, don’t panic!

You’re doing great. The fact is that it sometimes it just takes time. If you’ve been trying for more than a few months and are feeling a little impatient, know that it’s common to take a year or more to conceive and that sometimes it just takes time. Usually there’s no need to seek help just yet. Still there are some things you can do to get the most out of your efforts and improve your chances of getting pregnant.

Find YOUR fertile window

As you may already know, in order for conception to take place, sperm must be waiting in the Fallopian tube at the moment that ovulation occurs so it can fertilize the egg within 12-24 hours of the egg being released from the ovary. Because sperm can only live for up to 7 days in the female body, and only a small number of sperm will even survive the long journey to the egg, you and your partner need to have sex at the right time to maximize the chance that you will conceive. This means you need to know when you will ovulate, which is more difficult to determine than you might think. One reason for this is that due to normal fluctuations in your body, you won’t always ovulate on the same cycle day from one cycle to the next.

This will even be harder for those with irregular cycles. Fortunately, there are reliable ways to measure what’s going on in your body and predict when your most fertile days in each cycle will fall. The most important thing is to find a method for pinpointing your fertile window that works well for you! Aside from using a basic period calculator, you can also use Ovulation Predictor Kits (OPKs). These are a popular method for predicting ovulation. OPKs detect the presence of luteinizing hormone (LH) in your urine. Approximately 12-36 hours before ovulation occurs, the amount of LH in your body “surges”. By testing with OPKs, you can identify this LH surge, which allows you to know that ovulation is just around the corner and that you are in your fertile window.

Create a sperm-friendly environment

Many major lube brands harm sperm motility (ability to swim) and viability (ability to survive).  When you are trying to get pregnant, it is important to understand that all lubricants are NOT created equal, and you need to be careful when selecting the best lube to use when trying to conceive.

Most everyday lubricants have a low pH and very high salt concentrations, creating a harmful environment for sperm. Another way to help sperm survive is to support your body’s production of fertile-quality cervical mucus. Each cycle during your fertile window, your cervical mucus changes consistency to be very slippery and pH matched to semen. To help increase production of this natural lube, drink LOTS of water. Water is a key ingredient in the creation of this body fluid.

Regulate your cycle and support egg health

An irregular period is defined as a menstrual cycle that is consistently shorter than 21 days or consistently longer than 36 days. Your cycle can also be considered irregular if the length varies significantly from cycle to cycle, for example sometimes lasting 28 days, then 40 days, then 32 days. What does this have to do with fertility? Irregular cycles make it more difficult to predict your fertile window and ovulation, however, you may be able to improve your cycle regularity. For women with chronic irregularity, the cause is likely that there is an underlying hormonal imbalance. The herb commonly known as Chasteberry (Vitex agnus-castus), included in the dietary supplement FertilAid for Women, is frequently used to help women restore hormonal balance and cycle regularity. FertilAid for Women also contains a comprehensive prenatal vitamin, which helps to ensure that trying-to-conceive women take in all of the nutrients (think iron and folate) they need to sustain a healthy pregnancy.

Egg health is another factor you should consider, especially if you are over the age of 35. Each woman has a limited supply of eggs and you want to make the most of yours. Natural products like the dietary supplement OvaBoost protect your eggs from toxins and stress through a specialized formulation of antioxidants and vitamins, supporting egg quality and healthy ovulation.

Trying to conceive is a team sport

If things are taking a while, both partners have an opportunity to up their game. While you are keeping your cycles on track, your partner can help move things along, too. A non-invasive and first step is testing his sperm health through a semen analysis to determine what his actual sperm count is and whether or not his sperm motility and morphology are normal. The good news is that a growing body of scientific research indicates that supplementing with antioxidant nutrients, like those found in Fertilaid for Men, Countboost and Motilityboost can improve overall sperm health.

Acknowledge that life is stressful

If you’re reading this, you may be stressed out about how long it’s taking to conceive. According to many fertility experts, chronic stress can be a fertility-buster, as it causes the body to be in “fight or flight” mode constantly, which suppresses reproductive hormones. While it’s probably not realistic to think you’ll be able to eliminate stress all together, now is the time to lean in to your most effective stress-reducing tactics and self-care favorites. Take a careful look at the relationships and other activities in your life that might be impacting your stress levels and consider what options you have for changing those dynamics. It could make all the difference!


Fairhaven health

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Every day we have at least one man reach out to us indicating that they have azoospermia and they need help. They are usually feeling completely defeated. Almost always they do not even understand what the condition is and what options they have in their desire to father children. Hopefully this blog will shed light on the matter and restore hope to the many men/couples here in Kenya who have azoospermia as the cause of their infertility.

What is azoospermia?

Azoospermia is the medical term used when there are no sperm in the ejaculate.

It can either be:

  1. “obstructive,” where there is a blockage preventing sperm from entering the ejaculate,
  2. “non-obstructive” when it is due to decreased sperm production by the testis.

Obstructive Azoospermia

Here, testicles make normal sperm, but something keeps them from getting out.

Obstructions mostly occur in the vas deferens, the epididymus or ejaculatory ducts.

Problems that can cause blockages in these areas include:

  • Trauma or injury to these areas.
  • An infection in your reproductive tract, such as epididymitis and urethritis
  • Inflammation.
  • Previous surgeries in the pelvic area.
  • Development of a cyst.
  • Vasectomy (planned permanent contraceptive procedure in which the vas deferens are cut or clamped to prevent the flow of sperm).
  • Cystic fibrosis gene mutation, which causes either the vas deferens not to form or causes abnormal development such that semen gets blocked by a buildup of thick secretions in the vas deferens.

Non-obstructive  Azoospermia

Here the testis are not producing sperm as they should be. Causes of these include:

  • Genetic causes. Certain genetic mutations can result in infertility.
  • Hormone imbalances/endocrine disorders, including hypogonadotropic hypogonadism. hyperprolactinemia and androgen resistance.
  • Ejaculation problems such as retrograde ejaculation where the semen goes in to the bladder
  • Testicular causes include:
    • Anorchia (absence of the testicles).
    • Cyptorchidism (testicles have not dropped into the scrotum).
    • Sertoli cell-only syndrome (testicles fail to produce living sperm cells).
    • Spermatogenic arrest (testicles fail to produce fully mature sperm cells).
    • Mumps orchitis (inflamed testicles caused by mumps in late puberty).
    • Testicular torsion.
    • Tumors.
    • Reactions to certain medications that harm sperm production.
    • Radiation treatments.
    • Diseases such as diabetes, cirrhosis, or kidney failure.
    • Varicocele (veins coming from the testicle are dilated or widened impeding sperm production).

How will Azoospermia be treated?

Treatment will definitely depend on the cause, but for any given patient, the best treatment is a customized approach based on many factors, such as partner’s age and reproductive function, physical exam findings, blood test results, long- and short-term family goals and even finances. Depending on the suspected causes, many treatments may be available. If there is a blockage (or history of vasectomy), reconstruction might be the best treatment for some men. In others, removing offending agents such as medications or recreational drugs might be the first step. Sometimes there may be hormonal abnormalities that need to be addressed, and in some men, treatment could increase sperm production. In some men, surgery to fix anatomical abnormalities or varicoceles can be pursued, and in others the best option is to go directly into the testicle to attempt retrieval of sperm that could be used for ART(assisted reproductive technology).

I had a semen analysis showing azoospermia — what should I do?

  • the first step would be to get a repeat semen analysis at a lab that has a lot of experience doing semen and sperm tests, because results can vary a lot from test to test and lab to lab. Also, having small numbers of sperm can change the management/treatment options drastically, so the first step should be getting proper confirmation of the finding.
  • After confirmation of the diagnosis, step 2 should be seeing a fertility doctor specializing in male infertility.


John Hopkins Medicine “The Evaluation of the Azoospermic Male: American Family Physician: “Epididymitis and Orchitis: An Overview.”

UCSF: “In Vitro Fertilization,” “Intracytoplasmic Sperm Injection.”

Reproduction, Fertility and Development: “Causes of azoospermia and their management.”

The Urology Clinics of North America: “Obstructive Azoospermia.”

Clinics: “Obstructive azoospermia: reconstructive techniques and results.”

Indian Journal of Urology: “Surgical Sperm Retrieval: Techniques and Their Indications.”






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VARICOCELE – What it is and how it affects male fertility

What are Varicoceles?

A varicocele is when veins become enlarged inside your scrotum (the pouch of skin that holds your testicles). It is like getting a varicose vein in your leg.  It might cause male infertility. Pooled blood in the enlarged veins affects the temperature in the scrotum to increase than normal, it affects the ability of the testes to produce sperm resulting in poor sperm health i.e decreased sperm count, decreased motility and poor morphology.

Most of the time, varicoceles cause no problems and are harmless. Less often varicoceles can cause pain, problems fathering a child/infertility, or one testicle to grow slower or shrink.


Most males with a varicocele have no symptoms. Varicoceles may be the cause of fertility problems in about 4 out of 10 men who have problems fathering their first child. They may also be the cause of fertility problems in about 8 out of 10 men who have problems fathering a child after their first.


Many causes of varicoceles have been offered. The valves in the veins may not work well (or may be missing). If blood flow is sluggish, blood may pool in the veins. Also, the larger veins moving from the testicles towards the heart are connected differently on the left and right side. So more pressure is needed on the left side to keep blood flowing through the veins towards the heart. If blood flows backwards or pools in the veins, that can cause them to swell.


Urologists often check for varicoceles with the patient standing. You may be asked to take a deep breath, hold it, and bear down while your urologist feels the scrotum above the testicle. This technique is known as the “Valsalva maneuver.” It lets your urologist find any enlarged veins.

Your urologist may order a scrotal ultrasound test. The ultrasound can also show the size of the testicles.


Often, varicoceles are not treated. Treatment is offered for males who have:

  • fertility problems (problems fathering a child)
  • pain
  • the left testicle growing more slowly than the right
  • Abnormal semen analysis

There are no drugs to treat or prevent varicoceles. But pain killers (such as acetaminophen or ibuprofen) may help with pain.

When needed, surgery is the main form of treatment. Embolization (briefly blocking the veins) is a non-surgical treatment option.


Varicocelectomy is a treatment option available to treat varicocele. It is a small microsurgical procedure in which all the swollen veins are tied off while preserving the normal blood vessels.  There are many urologist in Kenya who do these surgery.

Surgery Results

In many patients this can result in a dramatic increase in sperm counts and motility.

Most of the time, patients return to normal activities after 1 week with little pain.

This treatment should be thought about along with other fertility treatment choices.


more topics:

Heat and male fertility

Understanding male infertility


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Sperm are sensitive to high temperatures. Sperm cells tend to die when exposed to too much heat. Continuous exposure to higher temperatures can cause sperm production to be lower, or cause the production of abnormally shaped sperm cells resulting in male infertility. Testicles are located outside of the human body because the ideal temperature for sperm production, and thus for male fertility, is about three to four degrees below the ideal human body temperature.

Overheating can be due to reasons that are internal such as in the case of a high fever. It can be also due to factors that are environmental or physiological. Activities such as cooking, grilling, motorcycling, sauna, and cycling can cause heat production. Using laptops and cellphones for long durations can also result in overheating. Physiological factors include Varicocele (enlargement of the veins within the loose bag of skin that holds your testicles), late descended testicles and obesity.

To promote male fertility and healthy sperm, avoid these 5 hot situations;

  1. Avoid spending prolonged periods of time in hot tubs and/or Jacuzzis.

Sitting and soaking in hot water will raise the body temperature, which can have a negative effect on male fertility.

  1. Don’t wear tight-fitting pants or underwear.

When you wear tight jeans, pants or briefs, you’re putting your scrotum in a tight environment that can trap heat in the testicles, and especially during the hot months when you may already be overheated. Wear boxers or loose pants made from natural fiber like cotton.

  1. Do not sit for long periods of time without getting up.

Sitting, whether for work, for long driving trips, or just to watch television, can also trap heat around the scrotum, which is not beneficial for male fertility. Take breaks to stand and walk around.

  1. Avoid prolonged bike rides, especially in the heat.

Tight biking shorts, combined with long periods of sitting on a bike seat, may cause friction and pressure on the testicles. This can cause the testicles to become overheated, too. Men should wear loose shorts and take shorter bike rides or take breaks during longer rides.

  1. Don’t put a laptop computer directly on your lap for long periods of time.

The battery on laptop computers can produce quite a bit of heat. It’s best to place your laptop on a desk or table instead of on your lap.