Male Infertility Treatment in Singapore

A clinical evaluation is recommended after 12 months of regular, unprotected intercourse without conception. Earlier evaluation is warranted if the male partner is over 40, has a history of testicular or scrotal conditions, prior groin surgeries (such as hernia repair), chemotherapy, varicocele, or known hormonal or genetic conditions. If the female partner has a known fertility issue, simultaneous evaluation of the male partner is advisable from the outset.

A semen analysis is a laboratory examination of an ejaculated semen sample, measuring sperm count, concentration, motility (movement), morphology (shape), and semen volume. The sample is typically produced at the clinic or laboratory following a period of sexual abstinence of 2 to 5 days. A single result may not provide a complete picture, as sperm parameters can fluctuate; your doctor may recommend a repeat test to account for natural biological variation.

Low sperm count (oligospermia) can result from varicocele, hormonal imbalances affecting the hypothalamic-pituitary-gonadal axis, obstructions within the reproductive tract, genetic conditions including Y-chromosome microdeletions, certain medications (such as testosterone therapy or anabolic steroids), prior infections including mumps orchitis, and lifestyle factors such as prolonged scrotal heat exposure or tobacco use. A comprehensive evaluation is required to identify the specific cause in each individual.

Not necessarily. Obstructive azoospermia, where the testes produce sperm normally but a blockage prevents it from appearing in the ejaculate, may be amenable to surgical correction or sperm retrieval via PESA or TESE. Non-obstructive azoospermia, where sperm production itself is impaired, is more complex; however, in some cases sperm may still be present in isolated areas of testicular tissue and may be retrieved using Micro-TESE. The clinical picture varies considerably between individuals and requires thorough assessment before a management plan can be formed.

These procedures are performed under local anaesthesia or sedation to minimise discomfort during the procedure itself. Some degree of soreness or mild swelling in the scrotal region may be experienced in the days following the procedure, which is generally manageable with prescribed analgesia. Your doctor will provide a detailed explanation of what to expect before, during, and after any procedure at your pre-operative consultation.

A varicocele causes abnormal dilation of the pampiniform venous plexus within the scrotum, which is thought to impair sperm quality primarily through an elevation in local testicular temperature. Normal sperm production requires temperatures slightly below core body temperature, and sustained thermal stress can reduce sperm motility, concentration, and morphology. Varicocele is one of the more commonly identified causes of male infertility and, depending on clinical findings, may be amenable to surgical management . For further information on assessment and treatment, please refer to our Varicocele Treatment page.

Sperm DNA fragmentation refers to single- or double-strand breaks in the genetic material packaged within sperm cells. Elevated fragmentation levels have been associated in published research with reduced natural conception rates, lower fertilisation rates in IVF or ICSI cycles, and higher miscarriage rates. Testing may be appropriate for men who are over 40, have experienced recurrent miscarriages where female factor causes have been excluded or are under investigation , have had repeated failed IVF or ICSI cycles, or have a semen analysis that does not fully explain the fertility difficulties being experienced. A sperm DNA fragmentation test is a straightforward add-on to standard semen analysis and can be discussed at your consultation.

Where a male partner requires surgical sperm retrieval for an IVF or ICSI cycle, the urologist performs the retrieval procedure and ensures the recovered sample is appropriately handled and transferred to the embryology team. Coordinating the timing of sperm retrieval with the female partner’s egg collection requires close liaison with the treating fertility clinic, and this coordination is managed as part of the integrated care provided by Dr Azhari.

MediSave and other applicable subsidy schemes may apply to certain surgical procedures or hospitalisation costs associated with male infertility treatment, depending on the specific procedure, diagnosis, and individual eligibility. We recommend discussing applicable payment and subsidy options directly with our clinic’s administrative team at the time of your consultation, as individual circumstances vary and scheme eligibility criteria are subject to change.