Category: Male Infertility

Semen analysis

Semen analysis is the first and most important test of male fertility.

How to give a semen sample

Abstain from ejaculation for 2–7 days before the test (2–5 days is ideal). The sample should be collected by masturbation, not by interrupted intercourse. If masturbation is difficult, special non-toxic collection condoms can be supplied by the laboratory; ordinary condoms and lubricants should not be used, as they harm sperm. If the sample is collected at home, it must reach the laboratory within one hour, kept at body temperature.

Collect the whole ejaculate in the sterile container provided, without touching the inside or leaving it open, and make sure no part is lost, especially the first portion, which contains the most sperm. Do not let water, soap or lubricant contact the sample.

Choose an experienced, accredited laboratory. If a result is abnormal, the test should be repeated, ideally after a few weeks, because sperm parameters naturally vary from sample to sample.

Basic semen parameters

The World Health Organization’s 2021 manual gives lower reference limits for fertile men. Results below these limits make infertility more likely but do not prove it, and results above them do not guarantee fertility.

Volume

This is the volume of the whole ejaculate, not the number of sperm. The lower reference limit is 1.4 mL. Low volume can result from an incomplete sample, short abstinence, retrograde ejaculation, or problems with the seminal vesicles, prostate or ejaculatory ducts.

Sperm concentration and total count

The lower reference limit is 16 million sperm per mL, or 39 million per ejaculate. Concentration is used together with the total count, because ejaculate volume varies from one sample to the next.

Motility

Sperm movement is graded as progressive (moving forward, fast or slow), non-progressive (moving but not forward) or immotile. The lower reference limits are 42% total motility and 30% progressive motility.

Morphology (shape)

Most sperm in a normal sample are abnormally shaped. Using strict criteria, 4% or more normal forms is within the reference range. Defects may affect the head (large, small, tapered or irregular), the midpiece, or the tail (split, coiled, very long or absent).

Vitality

When motility is very low, a vitality stain checks whether the non-moving sperm are alive; at least 54% should be alive.

Agglutination

Sperm clumping together, which impairs movement and can suggest antisperm antibodies.

White blood cells

White blood cells (leukocytes) increase with infection or inflammation. Normally there are fewer than 1 million per mL; higher numbers (leukocytospermia) call for further assessment.

Viscosity and liquefaction

Semen clots immediately after ejaculation, then liquefies, usually within 15–60 minutes. Abnormally thick semen or delayed liquefaction can hinder sperm movement and may indicate inflammation of the seminal vesicles or prostate.

pH

Semen is slightly alkaline (pH 7.2 or more), which protects sperm from vaginal acidity. Acidic semen with low volume suggests blockage of the ejaculatory ducts or absent seminal vesicles.

Fructose

Fructose is produced by the seminal vesicles and fuels sperm movement. Its absence suggests absent seminal vesicles or a blockage of the ejaculatory ducts.

Advanced semen tests

• Semen culture: used when infection is suspected, for example with high white cell counts or symptoms, to identify the organism and choose the right antibiotic.
• Computer-assisted semen analysis (CASA): measures sperm movement objectively, reducing human error, though it must be carefully calibrated.
• Sperm DNA fragmentation: measures damage to the genetic material in sperm. It may help in recurrent miscarriage, repeated IVF failure or unexplained infertility.
• Antisperm antibody testing: when there is agglutination or a history of testicular injury, surgery or vasectomy reversal.
• Post-ejaculatory urine: when the volume is low, to check for retrograde ejaculation.
• Hypo-osmotic swelling test: identifies live sperm with intact membranes, sometimes used to choose sperm for ICSI when all sperm are immotile.

Older tests, such as the hamster egg penetration test, cervical mucus penetration tests, routine acrosome reaction testing and sperm survival tests, are no longer used in routine practice, because they do not change treatment.

Examination and ultrasound for varicocele

A varicocele is a swelling of the veins around the testis caused by weak vein valves, which raises the temperature of the testis and can harm sperm production. The doctor examines the man standing, feeling for the “bag of worms” texture above the testis, which increases when he coughs or strains. Scrotal ultrasound shows the dilated veins and assesses the testes, and colour Doppler shows backflow of blood in the veins when he strains. See varicocele and male infertility.

Hormone tests

Testosterone, LH, FSH and prolactin are measured in the blood, usually in the morning. Low testosterone with high FSH and LH indicates a problem in the testes (primary testicular failure). Low testosterone, FSH and LH together suggest a problem with the pituitary or hypothalamus, which is often treatable with hormone injections. Normal hormones in a man with no sperm and normal-sized testes suggest an obstruction or retrograde ejaculation. Raised prolactin can cause low libido and erectile problems.

Genetic tests

Men with no sperm or very low counts (under 5 million per mL) are offered a karyotype and Y-chromosome microdeletion testing, and men with absent vasa deferentia cystic fibrosis testing.

International Guidelines

In line with global standards, Dr. Sabry follows the latest recommendations from the American Society for Reproductive Medicine (ASRM), European Society of Human Reproduction and Embryology (ESHRE), and Royal College of Obstetricians and Gynaecologists (RCOG). Thus, patients receive care that is safe, ethical, and evidence-based.

Our Patient Reviews

Discover what patients say about us on Google Maps, Vezeeta, and WhatClinic.

Why Choose Dr. Ashraf Sabry?

Dr. Ashraf Sabry, consultant in obstetrics, gynecology, fertility, and aesthetic gynecology, is recognized among the best OBGYN and fertility specialists in Cairo. With over 20 years of experience, he combines science and compassion to provide world-class care. Book your appointment through the contact page, WhatsApp, or call +201022224442.

Azoospermia means there are no sperm in the ejaculate. It affects about 1% of all men and 10–15% of infertile men. There are two main groups: obstructive, where the testes produce sperm but a blockage prevents them from reaching the semen, and non-obstructive, where the testes produce few or no sperm.

Struggling to conceive? If natural conception is difficult in your case, IVF and ICSI with Dr. Ashraf Sabry may be the right solution. Learn about the steps, timing and who it suits.

Obstructive azoospermia (normal testes)

Blocked vas deferens or epididymis

The vas deferens carries sperm from the testis to mix with fluid from the seminal vesicles and prostate. A blockage traps the sperm, so they are absent or very few in the semen. The volume of semen may be normal, because most of the fluid comes from the seminal vesicles and prostate, not the testes. Blockages usually result from infection of the ducts (sexually transmitted, urinary or general), which causes scarring, or from injury during groin surgery such as hernia or varicocele repair. A vasectomy deliberately cuts the vas for contraception.

Congenital absence of the vas deferens

Some men are born without one or both vasa deferentia, sometimes with absent seminal vesicles. Congenital bilateral absence of the vas is strongly linked to cystic fibrosis gene mutations, so both partners should be tested before treatment.

Retrograde ejaculation

If the muscle at the bladder neck does not close during orgasm, semen flows back into the bladder instead of out of the penis. Causes include congenital problems, nerve or spinal cord injury, pelvic fractures, prostate or bladder neck surgery, diabetes and certain medications. The ejaculate then contains few or no sperm.

Non-obstructive azoospermia (testicular failure)

• Genetic causes: Klinefelter syndrome (47,XXY) is the most common; Y-chromosome microdeletions (AZF regions) are another; very rarely the testes are absent from birth.
• Infections: mumps orchitis after puberty, sexually transmitted infections and other genital infections can damage the testes.
• Radiation, accidental or therapeutic, depending on dose and duration.
• Chemicals and drugs, including chemotherapy, petroleum products, toxic fumes and lead, and anabolic steroids or testosterone.
• Undescended testes: the testis normally descends from the abdomen into the scrotum before birth. If it stays in the abdomen or groin, the higher temperature damages it and increases the risk of cancer. It should be brought down surgically in early childhood (ideally by 12–18 months); if this is not possible, it may need removal. A “retractile” testis that moves up and down in young boys is a normal variant.
• Hormonal causes: low FSH and LH from the pituitary (hypogonadotropic hypogonadism), which is very treatable.

Diagnosing the cause

The aim is to distinguish a problem with sperm production from a problem with sperm transport. Semen analysis should be repeated, and the sample centrifuged to look for even a few sperm.

Checking for ejaculation problems

A low semen volume suggests retrograde ejaculation or a duct obstruction. Examining a urine sample taken right after orgasm for sperm confirms retrograde ejaculation.

Hormone tests

Testosterone, LH, FSH and prolactin are measured. Low testosterone with high FSH and LH indicates testicular failure. Low testosterone, FSH and LH together suggest a pituitary or hypothalamic problem. Normal hormones with normal-sized testes suggest an obstruction or retrograde ejaculation. High prolactin can cause erectile problems and suppress sperm production.

Imaging

Scrotal ultrasound assesses the testes and epididymis, and transrectal ultrasound can show blockage of the ejaculatory ducts or absent seminal vesicles. Vasography (X-ray with dye injected into the vas) is now rarely used on its own, and is usually performed only during reconstructive surgery.

Genetic tests

Karyotype and Y-chromosome microdeletion testing are recommended for men with non-obstructive azoospermia or very low counts, and cystic fibrosis testing for men with absent vasa.

Testicular sperm retrieval

Testicular biopsy is now combined with sperm retrieval, so that any sperm found can be used for ICSI at the same time or frozen for later. Under local or general anaesthesia, small samples are taken from the testis and examined by the embryologist. Because sperm production can be patchy, microdissection TESE (micro-TESE), using an operating microscope to find the areas most likely to contain sperm, gives the best results in non-obstructive azoospermia.

Treatment

• Obstruction after vasectomy or injury: microsurgical vasectomy reversal (vasovasostomy) or bypass of an epididymal blockage (vasoepididymostomy) can restore sperm in the semen and allow natural conception, with good results in experienced hands. Alternatively, sperm can be retrieved surgically for ICSI.
• Ejaculatory duct obstruction: can be opened by a transurethral procedure.
• Retrograde ejaculation: medication to tighten the bladder neck, or sperm recovered from urine for IUI or ICSI.
• Hormonal causes: hCG and FSH injections restore sperm production in most men.
• Testicular failure: micro-TESE with ICSI. Sperm are found in about half of men, including many with Klinefelter syndrome. Sperm can be frozen at the time of retrieval so that the procedure does not need repeating.

International Guidelines

In line with global standards, Dr. Sabry follows the latest recommendations from the American Society for Reproductive Medicine (ASRM), European Society of Human Reproduction and Embryology (ESHRE), and Royal College of Obstetricians and Gynaecologists (RCOG). Thus, patients receive care that is safe, ethical, and evidence-based.

Our Patient Reviews

Discover what patients say about us on Google Maps, Vezeeta, and WhatClinic.

Why Choose Dr. Ashraf Sabry?

Dr. Ashraf Sabry, consultant in obstetrics, gynecology, fertility, and aesthetic gynecology, is recognized among the best OBGYN and fertility specialists in Cairo. With over 20 years of experience, he combines science and compassion to provide world-class care. Book your appointment through the contact page, WhatsApp, or call +201022224442.

Sperm made in the testes pass through the epididymis and vas deferens, mix with fluid from the seminal vesicles and prostate, and are ejaculated through the erect penis into the upper vagina. Problems with any step of this delivery, or with the ducts, can prevent sperm from reaching the egg.

Struggling to conceive? If natural conception is difficult in your case, IVF and ICSI with Dr. Ashraf Sabry may be the right solution. Learn about the steps, timing and who it suits.

Timing and frequency of intercourse

Pregnancy can be delayed if intercourse does not happen during the fertile window, the five days before ovulation and the day of ovulation. Infrequent intercourse lowers the chance of hitting this window. Current advice is intercourse every two to three days throughout the cycle, or daily or every other day around ovulation; frequent ejaculation does not harm sperm quality in most men.

No particular sexual position increases the chance of pregnancy, as long as ejaculation occurs inside the vagina, and there is no evidence that lying down afterwards helps. Avoid lubricants that may harm sperm, unless they are labelled fertility-friendly.

Erectile dysfunction

Erectile problems can prevent intercourse and therefore conception. Causes include psychological factors (depression, relationship conflict, general or performance anxiety), nerve disorders, blood vessel disease (from diabetes, high blood pressure, high cholesterol, smoking and obesity), certain medications (some blood pressure drugs, stomach-ulcer drugs, hormone treatments, antidepressants and antipsychotics), and hormonal problems such as low testosterone or high prolactin.

Abnormal position of the urethral opening (hypospadias)

Normally the urethra opens at the tip of the penis. In hypospadias, it opens on the underside of the penis. If the opening is far from the tip, semen may not be deposited high in the vagina, which can delay pregnancy.

Penile curvature

Curvature of the penis, whether congenital or acquired (Peyronie’s disease) or after previous surgery, can make penetration difficult or impossible.

Retrograde ejaculation

Normally, during orgasm, the muscle at the bladder neck closes to stop semen flowing back into the bladder. In retrograde ejaculation, this muscle does not close properly, and semen passes into the bladder instead of out through the penis, so little or no semen is ejaculated. Causes include congenital abnormalities, nerve or spinal cord injury, pelvic fractures, prostate, bladder neck or pelvic surgery, diabetes and certain medications (such as alpha-blockers for the prostate).

Medical treatment

Erectile dysfunction

Underlying conditions such as diabetes, thyroid disease and high prolactin are treated first; high prolactin responds to cabergoline. Lifestyle changes (stopping smoking, losing weight, exercise) help, and counselling or sex therapy is valuable when psychological factors are involved. PDE5 inhibitors such as sildenafil and tadalafil are the first-line medication and are safe for men trying to conceive. Injections into the penis are an option if tablets do not work. Testosterone replacement should be avoided in men trying to conceive, as it suppresses sperm production.

Premature ejaculation

Premature ejaculation is managed with behavioural techniques (the stop-start and squeeze methods, and pelvic floor exercises), medications such as dapoxetine or other SSRIs, and local anaesthetic sprays or creams. Treating any infection or erectile problem and involving both partners in counselling also helps. Surgical cutting of the penile nerves is not recommended, because it can cause permanent loss of sensation.

Retrograde ejaculation

Medications that tighten the bladder neck (sympathomimetics such as pseudoephedrine or imipramine) can restore normal ejaculation in some men, particularly those with diabetes. Stopping any responsible medication may also help.

Procedures and assisted reproduction

• Retrograde ejaculation: if medication does not help, sperm can be recovered from urine passed straight after orgasm (after making the urine less acidic) and used for IUI or ICSI.
• Hypospadias and penile curvature: these can be corrected surgically if they prevent intercourse; alternatively, IUI places sperm directly in the uterus.
• Anejaculation (no ejaculation, for example after spinal cord injury): penile vibratory stimulation or electroejaculation can obtain semen for insemination or ICSI, and sperm can also be retrieved directly from the testis.
• Severe erectile dysfunction: vacuum devices or a penile prosthesis may be used, and for conception, semen can be collected and used for IUI or IVF.

International Guidelines

In line with global standards, Dr. Sabry follows the latest recommendations from the American Society for Reproductive Medicine (ASRM), European Society of Human Reproduction and Embryology (ESHRE), and Royal College of Obstetricians and Gynaecologists (RCOG). Thus, patients receive care that is safe, ethical, and evidence-based.

Our Patient Reviews

Discover what patients say about us on Google Maps, Vezeeta, and WhatClinic.

Why Choose Dr. Ashraf Sabry?

Dr. Ashraf Sabry, consultant in obstetrics, gynecology, fertility, and aesthetic gynecology, is recognized among the best OBGYN and fertility specialists in Cairo. With over 20 years of experience, he combines science and compassion to provide world-class care. Book your appointment through the contact page, WhatsApp, or call +201022224442.

The testes produce sperm, which pass into the epididymis and then the vas deferens, mix with fluid from the seminal vesicles and prostate, and are ejaculated through the penis into the upper vagina. Male factors contribute to about 40–50% of infertility in couples, either through problems with sperm production, problems delivering sperm, or other causes.

According to the World Health Organization (2021), the lower reference limits for a fertile man are a semen volume of 1.4 mL, a sperm concentration of 16 million per mL, total motility of 42% (progressive 30%) and at least 4% normal forms. Most men have many abnormally shaped sperm; this is normal.

Problems with the hormones that control the testes

Sperm and testosterone production are controlled by glands in the brain. The hypothalamus releases GnRH, which stimulates the pituitary to release FSH and LH. LH drives the Leydig cells to produce testosterone, and testosterone together with FSH drives the seminiferous tubules to produce mature sperm. Problems with these glands lead to low or absent sperm production (hypogonadotropic hypogonadism).

Congenital causes

For example, Kallmann syndrome, in which GnRH is not produced, often with a reduced sense of smell.

Acquired damage

Damage to the hypothalamus or pituitary from injury, surgery, radiation, tumours or certain medications. The most common acquired cause today is the use of testosterone or anabolic steroids, which switch off FSH and LH.

Problems in the testes themselves

The testes sit in the scrotum, outside the body, because they need a lower temperature to produce sperm efficiently. Conditions affecting the testes can reduce sperm production:

• Unknown (idiopathic) causes, which account for a large share of cases.
• Genetic causes, such as Klinefelter syndrome (47,XXY) and Y-chromosome microdeletions, which are tested for when the sperm count is very low.
• Radiation, accidental or therapeutic, which can shrink the testes; the damage depends on the dose and duration.
• Chemicals and drugs, such as chemotherapy, petroleum products, toxic fumes and lead; the damage depends on the dose and duration of exposure.
• Heat, for example in men who work near furnaces or in the iron and steel industry.
• Direct injury to the testes.
• Varicocele, a swelling of the veins around the testis that raises its temperature and harms sperm count, motility and shape.
• Testicular torsion, in which the testis twists on its cord, cutting off its blood supply; it is a surgical emergency, and delay can lead to loss of the testis.
• Undescended testes and testicular tumours, which can damage sperm-producing tissue.

Surgical treatment

Undescended testes

An undescended testis should be brought down into the scrotum in early childhood (ideally by 12–18 months). If this is not possible, it may be removed to avoid the risk of cancer.

Testicular torsion

Torsion is treated by emergency surgery to untwist and fix the testis.

Varicocele repair

Older open operations tied the dilated veins in the groin, with recurrence rates of around 20% and a risk of fluid collecting around the testis (hydrocele) if lymphatic vessels were tied. Today, microsurgical varicocelectomy ties all the dilated veins, even small ones, while preserving the testicular artery and lymphatics. It has the lowest recurrence and complication rates, and the patient goes home the same day. Current guidelines recommend repair for a varicocele that can be felt on examination in a man with abnormal semen parameters whose partner is trying to conceive.

Medical treatment

• Hormone deficiency (hypogonadotropic hypogonadism): treatment with hCG and FSH injections is highly effective and can restore sperm production in most men.
• Testosterone: testosterone should not be given to men trying to conceive. It suppresses FSH and LH and can stop sperm production. Men with low testosterone who want children are treated instead with medications that stimulate their own production.
• Clomiphene, tamoxifen and FSH are sometimes used off-label for men with unexplained low sperm counts; the evidence is limited, and treatment should be supervised by a specialist.
• Antioxidants such as vitamins C and E, zinc, L-carnitine and coenzyme Q10, and drugs such as pentoxifylline, may improve some semen parameters, but there is little evidence that they increase live births.
• Thick (hyperviscous) semen: sperm can be separated from the seminal fluid in the laboratory for IUI or IVF.
• Antisperm antibodies: steroids are no longer used because of their side effects; ICSI is the effective treatment.
• Varicocele: tablets for the veins do not improve fertility; clinically significant varicoceles are treated surgically.

When sperm problems are severe or do not respond to treatment, ICSI allows pregnancy with very few sperm, including sperm retrieved directly from the testis.

International Guidelines

In line with global standards, Dr. Sabry follows the latest recommendations from the American Society for Reproductive Medicine (ASRM), European Society of Human Reproduction and Embryology (ESHRE), and Royal College of Obstetricians and Gynaecologists (RCOG). Thus, patients receive care that is safe, ethical, and evidence-based.

Our Patient Reviews

Discover what patients say about us on Google Maps, Vezeeta, and WhatClinic.

Why Choose Dr. Ashraf Sabry?

Dr. Ashraf Sabry, consultant in obstetrics, gynecology, fertility, and aesthetic gynecology, is recognized among the best OBGYN and fertility specialists in Cairo. With over 20 years of experience, he combines science and compassion to provide world-class care. Book your appointment through the contact page, WhatsApp, or call +201022224442.

The testes sit in the scrotum, outside the body, because they need a temperature slightly lower than the rest of the body to produce sperm efficiently. A varicocele is a swelling of the veins around the testis caused by weak vein valves, so that blood pools in them. This raises the temperature of the testis and causes oxidative stress, which can reduce sperm count and motility, increase abnormal forms and DNA damage, and in some men contribute to infertility.

Varicoceles are common, are found in about 15% of men, and often cause no symptoms; many are discovered during a fertility check-up. Larger varicoceles can cause a dull ache or heaviness in the scrotum.

Diagnosis

The doctor examines the man while he is standing and feels the upper scrotum, where a varicocele feels like a “bag of worms”. Asking him to cough or strain (Valsalva manoeuvre) makes the veins swell further.

Scrotal ultrasound shows the dilated veins around the testis, and colour Doppler measures blood flow and shows backflow (reflux) in the veins when the man strains.

When is treatment recommended?

Current guidelines recommend repair for a varicocele that can be felt on examination in a man with abnormal semen parameters and a couple trying to conceive. Microsurgical varicocelectomy has the lowest recurrence and complication rates; embolization by a radiologist is an alternative. Varicoceles seen only on ultrasound (subclinical) do not need repair. Because a sperm cycle takes about three months, semen improvement is usually checked three to six months after treatment. If the woman is older or other factors are present, going directly to IVF/ICSI may be more appropriate.

International Guidelines

In line with global standards, Dr. Sabry follows the latest recommendations from the American Society for Reproductive Medicine (ASRM), European Society of Human Reproduction and Embryology (ESHRE), and Royal College of Obstetricians and Gynaecologists (RCOG). Thus, patients receive care that is safe, ethical, and evidence-based.

Our Patient Reviews

Discover what patients say about us on Google Maps, Vezeeta, and WhatClinic.

Why Choose Dr. Ashraf Sabry?

Dr. Ashraf Sabry, consultant in obstetrics, gynecology, fertility, and aesthetic gynecology, is recognized among the best OBGYN and fertility specialists in Cairo. With over 20 years of experience, he combines science and compassion to provide world-class care. Book your appointment through the contact page, WhatsApp, or call +201022224442.

When there are no sperm in the semen (azoospermia), sperm can often be retrieved directly from the testis or the epididymis.

• Obstructive azoospermia (a blockage in the sperm ducts): the testis produces sperm normally, so sperm are found easily, by needle aspiration from the epididymis (PESA) or the testis (TESA).
• Non-obstructive azoospermia (a problem with sperm production): sperm may exist only in small pockets of the testis. Samples are taken from several areas (TESE), and microdissection TESE (micro-TESE), performed under an operating microscope, gives the best chance of finding sperm while removing the least tissue.

The samples are placed in a special medium and sent to the fertility laboratory, where sperm are searched for and either used immediately for ICSI or frozen for a later cycle, avoiding a repeat procedure. Hormone and genetic tests (karyotype and Y-chromosome microdeletions) are usually done beforehand to estimate the chance of success.

International Guidelines

In line with global standards, Dr. Sabry follows the latest recommendations from the American Society for Reproductive Medicine (ASRM), European Society of Human Reproduction and Embryology (ESHRE), and Royal College of Obstetricians and Gynaecologists (RCOG). Thus, patients receive care that is safe, ethical, and evidence-based.

Our Patient Reviews

Discover what patients say about us on Google Maps, Vezeeta, and WhatClinic.

Why Choose Dr. Ashraf Sabry?

Dr. Ashraf Sabry, consultant in obstetrics, gynecology, fertility, and aesthetic gynecology, is recognized among the best OBGYN and fertility specialists in Cairo. With over 20 years of experience, he combines science and compassion to provide world-class care. Book your appointment through the contact page, WhatsApp, or call +201022224442.

In some people, the immune system produces antibodies against sperm. These antisperm antibodies can coat sperm, reduce their movement and interfere with fertilization, which can delay pregnancy. In men, they usually follow injury, infection or surgery of the reproductive tract, a blocked sperm duct, or a reversed vasectomy.

It was once thought that antibodies in the woman’s cervical mucus were a common cause of infertility. Current evidence shows that routine antibody testing in women, and the post-coital test once used to look for it, do not help in planning treatment, so they are no longer recommended.

Treatment

When antisperm antibodies are significant, the most effective treatment today is ICSI (intracytoplasmic sperm injection), where a single sperm is injected directly into each egg, bypassing the antibodies’ effect on sperm movement and binding. Steroid treatment, used in the past, is no longer favoured because of its side effects and limited benefit.

International Guidelines

In line with global standards, Dr. Sabry follows the latest recommendations from the American Society for Reproductive Medicine (ASRM), European Society of Human Reproduction and Embryology (ESHRE), and Royal College of Obstetricians and Gynaecologists (RCOG). Thus, patients receive care that is safe, ethical, and evidence-based.

Our Patient Reviews

Discover what patients say about us on Google Maps, Vezeeta, and WhatClinic.

Why Choose Dr. Ashraf Sabry?

Dr. Ashraf Sabry, consultant in obstetrics, gynecology, fertility, and aesthetic gynecology, is recognized among the best OBGYN and fertility specialists in Cairo. With over 20 years of experience, he combines science and compassion to provide world-class care. Book your appointment through the contact page, WhatsApp, or call +201022224442.

Problems with semen and sperm production can have many causes, including:

• Testosterone and anabolic steroid use, which switch off the brain’s signals to the testes and can stop sperm production.
• Certain medications, such as some chemotherapy drugs, sulfasalazine and colchicine.
• Recreational drugs, particularly regular cannabis use.
• Smoking, which lowers sperm count and motility and increases sperm DNA damage.
• Heavy alcohol use, which reduces sperm production and indirectly affects sexual function by lowering testosterone.
• Genital infections and sexually transmitted infections, which can damage sperm through toxins and the body’s immune reaction, cause testicular atrophy, or block the sperm ducts.
• Obesity, overheating of the testes and varicocele.

Sperm can also have defects that prevent them from moving or fertilizing an egg, such as a missing acrosome (the cap on the sperm head), abnormal head or tail shape, completely non-moving or dead sperm (necrospermia), or semen that is thicker (more viscous) than normal.

Many of these causes are reversible. Because a sperm cycle takes about three months, improvements after stopping a harmful drug or habit usually appear in a semen analysis repeated around three months later.

International Guidelines

In line with global standards, Dr. Sabry follows the latest recommendations from the American Society for Reproductive Medicine (ASRM), European Society of Human Reproduction and Embryology (ESHRE), and Royal College of Obstetricians and Gynaecologists (RCOG). Thus, patients receive care that is safe, ethical, and evidence-based.

Our Patient Reviews

Discover what patients say about us on Google Maps, Vezeeta, and WhatClinic.

Why Choose Dr. Ashraf Sabry?

Dr. Ashraf Sabry, consultant in obstetrics, gynecology, fertility, and aesthetic gynecology, is recognized among the best OBGYN and fertility specialists in Cairo. With over 20 years of experience, he combines science and compassion to provide world-class care. Book your appointment through the contact page, WhatsApp, or call +201022224442.