Male Infertility: What You Need To Know
Not being able to conceive despite frequent, unprotected sexual intercourse for at least a year or longer could be worrisome. A man’s inability to impregnate a woman can be stressful and frustrating for a couple.
The risk of male infertility is high if there has been previous inflammation of the prostate or genital tract infections (such as gonorrhea and chlamydia) in the past. The use of over-the-counter non-orthodox medicines may also increase the risk.
Male infertility may be as common as female infertility and can be due to several causes. It could be due to inadequate production of sperm or the inability to produce healthy sperm. It may be inherited or acquired. There may be some genetic problem causing blockage of the male genital tract, undescended testes, total absence of the testes, or incomplete formation of the tract through which sperm moves.
Causes of male infertility.
There are some causes of male infertility that may be preventable. Some of these include smoking, alcoholism, drug use, obesity, stress, and exposure to toxins. Illnesses, injuries, chronic health problems such as diabetes and hypertension, lifestyle choices, and other factors are part of the male infertility problem.
Married couples unable to achieve pregnancy after a year of regular, unprotected sexual intercourse, should see the doctor. Problems of low sex drive, or other issues with sexual function are red flags.
To impregnate a woman, a man needs to produce healthy sperm that is carried by the semen which consists of secretions from other organs. The sperm should be of good count (preferably above 20 million per ml, and must be normal and able to move in forward progressive motion. If the movement or shape is abnormal, the sperm may not be able to reach the ampullary region of the fallopian tube where most egg fertilization occurs.
Male fertility problems can be caused by chronic health issues and their treatments. For instance, swelling of the veins in the testicles can cause male infertility. It leads to reduced sperm count and fewer active sperm because of the increased temperature around the engorged scrotal veins called varicoceles.
Infections from sexually transmitted infections are also significant. Inflammation of the prostate and testicles due to mumps orchitis has also been implicated in the etiology of male infertility.
A condition known as retrograde ejaculation occurs when semen enters the bladder during orgasm instead of emerging out of the penile urethra and may cause male infertility.
How do I know if I have infertility?
An infertile couple may have more than one cause of infertility, and it may require proper orthodox evaluation and investigations to determine the causes. The diagnosis is a painstaking procedure. It includes a review of the health history and a physical examination.
A sperm count (semen analysis) is carried out. A semen sample is collected and sent to a laboratory. The number of sperm present and abnormalities in the shape and movement of the sperm are checked. The lab will also check for signs of infections.
Blood is also drawn to check both male and female hormone levels. Other tests are done to determine the cause of sperm defects or problems in the male reproductive system.
A testicular biopsy may be necessary. It involves checking a small piece of tissue from the testicles and checking under a microscope. Scrotal ultrasound may be done to check for obstructions in the testicles and the tubes that carry semen. A blood test is done to measure testosterone levels. Sperm in the urine could indicate an abnormality with ejaculation. There could be genetic causes of low sperm.
If the problem is likely caused by a blockage or another problem with sperm transport, appropriate treatment commences. Anti-sperm antibody tests are used to check for immune cells that attack sperm. Tests can check if live sperm cells are visible in an ejaculate. How well sperm can penetrate an egg, and whether there’s any problem attaching to the egg can also be done. This is called sperm penetration test.
Can male infertility be treated?
Fertility is improved through the correction of the underlying problem. Some medications may improve fertility when the problem is premature ejaculation. Assisted reproductive technology (ART) treatments may be used to obtain sperm cells through normal ejaculation, surgical extraction, or donor individuals, depending on your specific case and wishes.
Steps that can be taken at home to increase the chances of conception include increasing the frequency of sex. Sexual intercourse every other day around the time of ovulation may increase the chances of pregnancy. It is recommended that couples meet sexually at least 3 times that are well spaced out a week in order to increase the chances of conception.
Treatment depends on the cause or causes. The goal is to achieve pregnancy with the woman. Among the treatment methods is artificial insemination. The process involves injection of healthy sperm cells at the entrance of the cervix or in the uterus. Other techniques include In vitro fertilization (IVF) involves the collection of the sperm and egg(s) and mixing in the lab. After fertilization, the resulting embryo is placed back inside the uterus.
Another treatment method is the injection of a single sperm into an egg and then fertilization takes place. This is called ICSI and it is the goal standard in IVF/ICSI at the moment. Afterward, the fertilized egg is transferred into the woman’s uterus (Intracytoplasmic Sperm Injection). Hormone treatment is also available if there is proof of a hormone disorder causing your infertility.
Surgery may be indicated in some cases such as varicocelectomy for testicular varicocele to improve the quality of sperm produced. The merits of these procedures are still debatable. The fertility physician will advise on the best option of management at
presentation for assessment of the couple.
