Gyn Chronicles
Male Infertility With A Focus On Azoospermia
By Dr. Maureen Owiti
Welcome to 2025 and we pray God looks after us this year as he has always done, and make this year more prosperous than 2024. I think for most of us 2024 was harsh and we pray that everything will change for the better. I notice with interest that the boy child has stood up and has been counted as we see majority of our heroes from abduction are young adult males. We salute the young men and pray for peace and sanity to prevail in our nation.
Contrary to public opinion on infertility almost 50 % of cases are due to the male factor. The only difference is that it is very easy to conceal male infertility. I remember growing up we were watching a Ghanaian program on TV. The episode started off as a woman was being castigated by the spouse and his family for not being able to conceive a child. The woman was faithful but the man decided to get a side-chick who fit the bill perfectly as she was the true definition of“ spring chicken!’ As fate would have it the“ mpango wa kando”( girlfriend) conceived and the man was overjoyed but this was the underdoing of the little civility left with the wife.
He confided in his mother about the girlfriend expecting and she took on the role of chief tormentor to the wife. The poor woman in the meantime not being able to handle the abuse both physical and psychological opened up to one of her friends. Her friend laughed at her and told her to stop being silly that the two could play the game and advised her to get another lover. The wife initially resisted but when the torture became unbearable, she gave in to the advice in an attempt to save her marriage.
Back to scene one, remember side-chick is preganant … nine months later the man accompanies the girlfriend in labor to the maternity ward. She gives birth and surprise! Surprise! The child is a half caste. The man is taken aback and the girlfriend laughs and scorns him telling him how useless he is. Overcome with emotion the man bites the bullet and heads to see a doctor, who promptly does a semen check only to discover the man has no sperms, what we in medical terms will call azoospermia.
The man is overcome with shame and is very remorseful and with nowhere else to go heads home. When he opens the door he finds his wife beaming with happiness and she gives him the best news ever …“ Honey, I’ m pregnant!” God only knows how he was able to contain himself( it was a movie!!) but the man is now facing the reality that most probably the wife was having an extra-marital affair as he had just confirmed he cannot sire a child.
Anyway, he reports to the wife his case and she is also distraught but as movies go they are able to forgive each other and the
Contrary to public opinion on infertility almost 50 % of cases are due to the male factor. The only difference is that it is very easy to conceal male infertility. movie ends. Why I have become a movie critic is beyond me but sometimes what happens in real life is more fantastic than the movies. I actually had a client with a similar predicament.
Wycliff and Rose came into my consultation one day and as I had predicted when they walked in, complained that they have been married for 5 years and despite trying all this time they have been unable to conceive. I go through the usual drill establish that Rose has fairly regular menses, does not use any form of contraception and they are intimate with each other fairly regularly( about 3 times per week). No history of previous surgery, or treatment for any sexually transmitted infection and live a relatively healthy lifestyle: don’ t smoke or take alcohol or recreational drugs. Eat a balanced diet but could improve on physical activity.
We requested the couple to do the routine fertility tests. I usually joke that women are complicated and the fertility tests prove it as they have a huge battery of tests from checking the tubes via an ultrasound( sono-hysterogram) or X-ray called the hysterosalpingogram( HSG) for short, a detailed pelvic U / S and several hormones. These are just basic tests.
The man on the other hand has only one test and based on the results is when you can delve into other tests. I don’ t know what many men think when we ask them to do the test or whether it is the women protecting them as you often get answers like“ yeye ako na mtoto!” We get a lot of resistance to get a sperm count yet it is the least invasive test. A normal result is as important as an abnormal result to the fertility specialist or any doctor carrying out a test.
Whatever the case we meet a few weeks
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