A zero sperm count, known as azoospermia, is often treatable, and many men with this condition still father biological children. Treatment depends on the cause. If a hormone imbalance is responsible, medications like clomiphene citrate or gonadotropin injections can stimulate sperm production. If the issue is an infection, antibiotics are used. For blockages, minor surgery can often restore sperm flow. Even if sperm production is very low, specialists can often retrieve sperm directly from the testes using minor procedures (like TESE) for IVF. I highly recommend your friend consult a urologist or fertility specialist for a thorough evaluation to determine the best approach.