Male Infertility Treatment in Singapore

Male infertility affects approximately 1 in 7 couples trying to conceive in Singapore, yet many men delay seeking help due to misconceptions or embarrassment. Male factors contribute to about 40-50% of all infertility cases. Addressing these concerns early can improve your chances of starting a family. Our MOH-accredited urologist specialises in male infertility treatment in Singapore, offering comprehensive evaluation and evidence-based treatment options. Modern medicine provides numerous solutions for male fertility challenges, from simple lifestyle modifications to reproductive techniques.

Primary Infertility

Primary infertility occurs when a man has never fathered a child despite regular attempts at conception. This type accounts for approximately 60% of male infertility cases and often involves congenital or genetic factors affecting sperm production from the onset of puberty.

Secondary Infertility

Secondary infertility affects men who have previously fathered children but cannot conceive again. This condition may develop due to new health issues, infections, injuries, or age-related changes in sperm quality. Secondary infertility often responds well to treatment once the underlying cause is identified.

Obstructive Infertility

Obstructive infertility results from blockages in the reproductive tract preventing sperm from reaching the ejaculate. These blockages can occur at various points including the epididymis, vas deferens, or ejaculatory ducts. This type represents about 15-20% of male infertility cases.

Non-obstructive Infertility

Non-obstructive infertility involves problems with sperm production in the testicles themselves. This category includes hormonal imbalances, genetic abnormalities, and testicular failure. It represents the majority of male infertility cases and requires thorough evaluation to determine appropriate treatment.

Causes

Male infertility stems from various medical, environmental, and lifestyle factors affecting sperm production or delivery:

• Varicocele: Enlarged veins in the scrotum affecting 15% of all men and 40% of infertile men
• Infections: Previous sexually transmitted infections, mumps orchitis, or urinary tract infections
• Hormonal imbalances: Low testosterone, elevated prolactin, or thyroid disorders
• Genetic defects: Klinefelter syndrome, Y chromosome deletions, or cystic fibrosis gene mutations
• Undescended testicles: Failure of testicles to descend during foetal development
• Ejaculation disorders: Retrograde ejaculation, premature ejaculation, or anejaculation
• Antibody problems: Immune system attacking sperm as foreign invaders
• Tumours: Cancers or benign tumours affecting reproductive organs or hormone-producing glands
• Medication effects: Certain antibiotics, antidepressants, or blood pressure medications
• Previous surgeries: Vasectomy, hernia repairs, or prostate surgeries

Risk Factors

Several factors increase the likelihood of developing fertility problems:

• Age: Men over 40 show decreased sperm quality and DNA integrity
• Obesity: BMI over 30 linked to reduced sperm count and testosterone
• Smoking: Reduces sperm count by up to 23% and affects sperm motility
• Excessive alcohol: More than 14 units weekly impacts hormone production
• Drug use: Anabolic steroids, marijuana, and cocaine affect sperm production
• Heat exposure: Regular hot tub use, saunas, or tight clothing
• Occupational hazards: Exposure to pesticides, heavy metals, or radiation
• Chronic stress: Prolonged stress affects hormone balance and sexual function
• Poor nutrition: Deficiencies in zinc, folate, and antioxidants
• Sedentary lifestyle: Lack of exercise linked to poor sperm quality

Physical Symptoms

• Difficulty maintaining erections sufficient for intercourse
• Problems with ejaculation including reduced volume or absence
• Pain, swelling, or lumps in the testicular area
• Decreased facial or body hair indicating hormonal issues
• Gynaecomastia (enlarged breast tissue) suggesting hormone imbalance
• Small, firm testicles indicating impaired sperm production

Sexual Function Issues

• Reduced sexual desire or libido
• Difficulty achieving orgasm
• Premature or delayed ejaculation
• Painful intercourse or ejaculation

Associated Health Signs

• Recurring respiratory infections (may indicate cystic fibrosis)
• Inability to smell (Kallmann syndrome)
• Abnormal weight gain or loss
• Chronic fatigue or weakness
• Changes in vision or headaches (possible pituitary issues)

The primary sign of male infertility remains the inability to conceive after one year of trying. Many men experience no obvious symptoms beyond this, making professional evaluation essential for accurate diagnosis.

Seek medical evaluation if you and your partner have been unable to conceive after 12 months of regular, unprotected intercourse. Consider earlier consultation after 6 months if your female partner is over 35, as female fertility declines more rapidly with age. Immediate medical attention is warranted if you experience pain, swelling, or lumps in the testicular area, as these may indicate conditions requiring prompt treatment.

Schedule an appointment if you have known risk factors including previous groin surgery, undescended testicles, or family history of infertility. Men with chronic health conditions like diabetes or those taking medications known to affect fertility should seek preconception counselling. During your initial consultation, expect comprehensive medical history review, physical examination, and discussion about timing and frequency of intercourse. Your urologist will explain necessary tests and create a personalised evaluation plan.

Early intervention often leads to simpler treatment solutions and improved outcomes. Many causes of male infertility are treatable, particularly when identified early.

Accurate diagnosis begins with comprehensive semen analysis, the cornerstone of male fertility evaluation. This test examines sperm count, motility (movement), morphology (shape), and semen volume. You’ll need to provide samples through masturbation after 2-5 days of abstinence, with at least two samples analysed to account for natural variations.

Hormone testing measures testosterone, follicle-stimulating hormone (FSH), luteinising hormone (LH), and prolactin levels through blood samples. These tests identify hormonal imbalances affecting sperm production. Genetic testing may be recommended for severe male factor infertility, checking for Y chromosome deletions, karyotype abnormalities, or cystic fibrosis mutations.

Scrotal ultrasound visualises testicular structure, identifies varicoceles, and detects obstructions or abnormalities. Post-ejaculation urinalysis checks for retrograde ejaculation by detecting sperm in urine. Specialised tests include anti-sperm antibody testing, sperm DNA fragmentation analysis, and testicular biopsy when azoospermia (no sperm in ejaculate) is present.

Results typically available within 1-2 weeks for basic tests, though genetic testing may take 3-4 weeks. Your urologist will explain findings and their implications for treatment planning.

Lifestyle Modifications

Lifestyle changes form the foundation of fertility improvement for many men. Weight loss through balanced nutrition and regular exercise can restore hormonal balance and improve sperm parameters within 3-6 months. Smoking cessation increases sperm count and motility, with improvements visible after three months. Limiting alcohol intake to moderate levels and avoiding recreational drugs supports optimal sperm production. Stress management through meditation, counselling, or yoga helps normalise hormone levels affecting fertility.

Nutritional Supplementation

Targeted supplementation addresses nutritional deficiencies impacting sperm health. Antioxidants including vitamin C, vitamin E, and coenzyme Q10 protect sperm from oxidative damage. Zinc supplementation improves sperm count and testosterone levels in deficient men. Folic acid combined with zinc shows synergistic benefits for sperm concentration. Omega-3 fatty acids enhance sperm membrane integrity and motility. L-carnitine supplementation particularly benefits sperm motility. Treatment duration typically spans 3-6 months to allow complete spermatogenesis cycle.

Hormonal Treatments

Hormonal therapy corrects endocrine imbalances affecting fertility. Clomiphene citrate stimulates natural testosterone production in men with low levels. Human chorionic gonadotropin (hCG) injections mimic LH, stimulating testosterone production. FSH injections directly stimulate sperm production in cases of hypogonadotropic hypogonadism. Aromatase inhibitors prevent testosterone conversion to oestrogen, maintaining optimal hormone ratios. Treatment protocols vary from 3-6 months depending on baseline hormone levels and response.

Medical Management

Specific medications address underlying conditions affecting fertility. Antibiotics treat reproductive tract infections that impair sperm function. Alpha-blockers or pseudoephedrine help with retrograde ejaculation. Bromocriptine normalises elevated prolactin levels. Thyroid medications correct hypothyroidism or hyperthyroidism affecting fertility. Immunosuppressive therapy may benefit men with anti-sperm antibodies, though use remains selective.

Surgical Interventions

Varicocelectomy repairs enlarged scrotal veins, improving sperm parameters in 60-70% of cases. The procedure involves microsurgical techniques ensuring preservation of arteries and lymphatics. Vasovasostomy or vasoepididymostomy reverses vasectomy or repairs obstructions. Transurethral resection of ejaculatory ducts opens blocked ducts preventing sperm release. Testicular sperm extraction (TESE) retrieves sperm directly from testicles for assisted reproduction. Recovery varies from 1-2 weeks for minor procedures to 4-6 weeks for complex reconstructions.

Assisted Reproductive Technologies

When other treatments prove insufficient, assisted reproductive technologies offer alternative paths to parenthood. Intrauterine insemination (IUI) places concentrated sperm directly into the uterus. In-vitro fertilisation (IVF) combines eggs and sperm in laboratory conditions. Intracytoplasmic sperm injection (ICSI) injects single sperm directly into eggs, bypassing natural barriers. These procedures utilise sperm from ejaculate, or surgically retrieved sperm when necessary. Success rates vary based on female partner age, sperm quality, and specific technique employed.

Untreated male infertility extends beyond inability to conceive, potentially indicating serious underlying health conditions. Infertility may signal hormonal disorders, genetic abnormalities, or tumours requiring medical attention regardless of fertility desires. Varicoceles left untreated can cause progressive testicular damage and chronic pain. Infections may spread throughout the reproductive tract, causing permanent scarring and obstruction.

Psychological impacts include relationship strain, depression, and anxiety affecting overall quality of life. Studies show infertile couples face higher divorce rates and mental health challenges. Sexual dysfunction often worsens without intervention, creating additional relationship stress. Some causes of infertility, particularly hormonal imbalances, affect bone density, muscle mass, and cardiovascular health over time.

Delayed treatment reduces success rates as both partners age. Female partner fertility declines significantly after 35, making early male evaluation crucial for family planning. Untreated genetic conditions may be unknowingly passed to offspring through assisted reproduction without proper counselling.

While not all causes of male infertility are preventable, several strategies can help reduce risk and improve fertility potential. Maintaining a healthy weight through a balanced diet and regular exercise supports optimal hormone production and sperm health. Avoid tobacco, excessive alcohol, and recreational drugs that can damage sperm DNA and lower counts. Limit heat exposure by avoiding hot tubs, saunas, and placing laptops directly on your lap.

Practicing safe sex helps prevent infections that can harm the reproductive tract. Managing chronic conditions like diabetes and hypertension through proper medical care is also important. A urologist in Singapore can provide personalised advice on maintaining reproductive health, addressing risk factors, and identifying early signs of fertility problems.

Nutrient-rich foods, adequate zinc and folate intake, and reduced processed food consumption support sperm quality. Regular health check-ups, stress management, and adequate sleep further promote reproductive wellness.