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The Health | february, 2019
Fertility journey
Azoospermia:
It’s not you, it’s me
W
hen it comes to
couples not being
able to conceive a
baby, men could also
be the cause
“Mr
John,
after an extensive evaluation, it
gives me no pleasure to tell you
that we could not find any sperm.”
These words can be the most excruciat-
ing thing to hear, especially among men
who are trying to start a family with their
partners.
Yet, it’s time to face the cold, hard
facts on azoospermia, an rising condition
among men in Malaysia. It is a medical
condition which leaves men with no
sperm in their semen, and it can either
be hereditary or, more importantly,
lifestyle induced.
We speak to Dr Agilan Arjunan,
Obstetrician and Gynaecologists from
KL Fertility Centre on this silent disease
and how it mentally affects men.
is no follow-up. Instead they repeat the
test year after year, hoping things would
take a miraculous turn. Those who have
walked into this clinic are those who
have made up their mind to get help. I
believe the numbers will rise up as aware-
ness regarding male infertility increase,”
explains Dr Agilan hopefully.
What causes it?
Besides it being hereditary, azoosper-
mia can develop through poor lifestyle
habits. “In a nutshell, men are poison-
ing themselves. Smoking, alcohol, diet,
obesity and stress can lead to it. And
for some, the stress of not being able to
have children becomes a reason to pick
up habits like smoking and drinking. It’s
a vicious cycle.”
Dr Agilan Arjunan.
Could I have been
misdiagnosed?
“Many doesn’t really understand
azoospermia well enough. They might
ask; how could they had been diagnosed
with azoospermia when they have clearly
release fluid during ejaculation? The first
thing that pops into their head is could
the test be wrong?”
Dr Agilan explains that is very
Azoospermia on the rise
“We receive roughly 1 to 2 azoospermia
cases weekly. I’d chalk it up to 12 to
15 cases a month. Many of them get a
sperm test in a lab or a clinic but there
Azoospermia is
not a dead end
My husband and I are from Indonesia, and we got
married in August 2008. We had a wonderful mar-
riage, and he was most eager to have children from
the start. We tried for two years, and was puzzled as
to why we were unsuccessful. We started our journey
to finding the problem, and the doctors gave us the
news. My husband was diagnosed with azoospermia.
We consulted many doctors, and each of them told
us we would never be able to conceive naturally. Both
of us had to undergo treatment to help us conceive,
and we were determined to start a family.
My husband underwent Intracytoplasmic sperm
injection (ICSI) procedure where sperm is to be
extracted from my husband through surgery. To
heighten our chances, I will also undergo IVF treat-
ment.The journey was long and difficult. My husband
had to undergo two varicocele surgeries, as well as
Percutaneous Epididymal Sperms Aspiration (PESA)
and Microsurgical Epididymal Sperm Aspiration
(MESA). I was also going through IVF to prepare.
Despite our efforts and multiple surgeries, luck
was not on our side. We were unable to conceive.
What’s worst was that we weren’t being notified or
explained to as to why the procedure didn’t work. The
information was kept from us.
We felt sad, depressed and hopeless, it was one
of the most testing times for us as a couple. Yet, we
never gave up hope. We trailed our way to other places
that might provide us with better services, and found
ourselves in Malaysia.
The journey then was not an easy one as well, but
after six long years of trying, we finally received the
best news. October 11th, 2014 was the date we found
out we were having a child. Our journey was not an
easy one to traverse. Looking back, we were grateful
to have the opportunity, even though it was very
difficult.
Our advice to other couples struggling with infer-
tility? Believe that nothing is impossible!
Source: Catching My Baby Dust, First Edition 2016
(Available in MPH and Borders bookstore)
unlikely to miss the signs of azoosper-
mia. Symptoms, apart from inability to
have children, are low sex drive, erectile
dysfunction, pain or swelling around the
testicles, and hormonal imbalance.
A simple test at a fertility clinic can be
the definitive proof of the condition, and
should therefore be the step to be taken.
“A proper fertility centre with a trained
eye will have no issue in identifying the
condition. The next step it to assess it
and see where the problem lies.”
Treatment
Depending on an individual’s condition,
medication or surgery can be done to
help them start a family. “If I know that
the testicles are still able to produce
sperm, medications will be given to up
the sperm count. I believe the medical
pathway should be attempted first before
Unclogging
your worries
facing fertility issues. If you still have not conceived
within a year, you should get checked. Having regu-
lar periods does not mean that you are ovulating
regularly, or that your fallopian tubes are clear of
any blockages. If a couple wants to know whether
they have fertility issues, it is best that the couples
assess and see if within the span of one year if they
conceive or not. However, for women who are more
than 35 years old, have know issues with polycystic
ovarian syndrome or endometriosis, do seek help
within 6 month of trying to conceive.
Dr Natasha Ain.
A
Blocked pipes?
regular period may not be everything,
you could have blockages in your fal-
lopian tubes which prevents you from
conceiving. It’s no secret that many
couples experience infertility.
It is estimated that 1 in every 6
couples will have issues in conceiving. It can cause
significant stress and put a strain on couple’s
relationship.
We spoke to Dr Natasha Ain binti Mohd Nor, a
Fertility Specialist at KL Fertility and Gynaecology
Center on infertility among couples, focusing on
blocked fallopian tubes as a contributor to this
issue.
Does a regular cycle mean
everything?
If you have regular periods, there is still a chance of
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Blocked fallopian tubes can be diagnosed through
several methods depending if it is invasive or non-
invasive. For non-invasive, one of the simplest test
is an X-ray test which is called HSG (Hysterosal-
pingogram), where the patient will have to see a
radiologist for this test to be done. HSG is usually
scheduled between day nine to eleven of a women’s
menstrual cycle.
If one tube is blocked, hopefully the other tube
is normal enough to have a spontaneous concep-
tion. If both are blocked, the invasive part of the
testing begins involving questions such as ‘why are
the tubes blocked?’ An operation called a Keyhole
Surgery (diagnostic laparoscopy and dye test) would
be conducted.
The two main reasons for blocked tubes is either
infections such as pelvic inflammatory disease or
a condition known as endometriosis. During the