Infertility affects 1 in 6 couples in Nigeria — and in approximately 40–50% of cases, a male factor is either the primary or a contributing cause. A semen analysis at Mascot Healthcare, Akoka is the single most important first investigation for male infertility. Confidential, same day.
Low sperm count (oligospermia), absent sperm (azoospermia), or abnormal sperm. Causes include: varicocele (most common treatable cause), previous mumps orchitis (common in Nigeria), testicular torsion, chemotherapy, or genetic factors.
Normal sperm production but blocked ducts — epididymal blockage from prior infection (chlamydia, gonorrhoea), congenital absence of the vas deferens, or post-vasectomy. Azoospermia (no sperm) on semen analysis with normal hormones suggests obstruction.
Low FSH/LH signals from the pituitary reduce testicular testosterone and sperm production. Causes: prolactinoma, obesity, steroid use, or pituitary tumour. Hormonal causes are among the most treatable.
Heat (tight underwear, laptops on lap), heavy alcohol, anabolic steroids, smoking, obesity, and chronic stress all significantly impair sperm parameters — and all are reversible. Semen analysis before and after lifestyle change shows the impact.
In Nigerian culture, male infertility is heavily stigmatised — a man's fertility is often conflated with his masculinity and social standing. The consequence is that when couples fail to conceive, women are almost always investigated first, second, and third — while men are rarely tested, or only tested after years of the woman undergoing procedures.
This is medically irrational. A semen analysis takes 30 minutes, is non-invasive, and costs far less than the majority of female fertility investigations. It should be done in the first month of any infertility assessment — simultaneously with, not after, female investigations.
A standard semen analysis (WHO 2021 parameters) measures: total sperm count (normal ≥39 million per ejaculate), concentration (≥16 million/mL), motility (≥42% motile; ≥30% progressively motile), morphology (≥4% normal forms — Kruger strict criteria), semen volume (≥1.4mL), and pH. Each parameter points to a different type of problem and guides further investigation.
A varicocele is a dilation of the pampiniform venous plexus in the scrotum — present in 15% of all men and 35–40% of men investigated for infertility. It impairs testicular cooling (the testicles require 2–4°C below core body temperature for optimal sperm production) and causes oxidative stress. Surgical or radiological repair of a varicocele improves sperm parameters in 60–70% of men.
Confidential semen analysis + hormonal testing at Mascot Healthcare, Akoka. Walk-in available.