Male infertility is a medical condition where a man has difficulty or is unable to father a child. This is often due to problems with his sperm or other functional problems. Problems with sperms include low sperm count, poor sperm motility, and abnormal sperm shape or function.
Male infertility is mostly treatable. Treatment options for male factor infertility include medication, surgery, artificial insemination, and in vitro fertilization (IVF).
Risk factors for male infertility:
There are severalrisk factorsthat can contribute to male infertility, including:
- Age: As a man gets older, his fertility naturally decreases.
- Lifestyle factors: Substance abuse, smoking, and excessive alcohol consumption can all have a negative impact on sperm quality and fertility.
- Weight: Being overweight or underweight can cause hormonal imbalances that can lead to infertility.
- Sexual problems: Erectile dysfunction, premature ejaculation, and other sexual problems can affect a man’s ability to father a child.
- Environmental toxins: Exposure to certain chemicals, such as lead and pesticides, can affect sperm quality and fertility.
- Medical conditions: Medical conditions, such as diabetes, mumps, and sexually transmitted infections, can increase the risk of infertility in men.
- Genetic disorders: Certain genetic conditions, such as Klinefelter syndrome and cystic fibrosis, can cause infertility in men.
- Injury to the reproductive system: Testicular trauma, surgery, or radiation can all increase the risk of infertility in men.
Treatment options for male infertilityinclude:
Medications for male infertility
Doctors can use hormonal therapy, such as testosterone replacement, to treat hormonal imbalances that can cause infertility.
Surgery for male infertility
Surgical procedures, such as varicocele repair may improve fertility in men. Procedures such as vasectomy reversal may restore fertility. Procedures like TESA, Micro TESA and PESA may help in extracting sperms for other procedures.
Artificial Insemination or IUI for mild male factor infertility
Intrauterine insemination or IUI can be an effective treatment for mild male factor infertility. This involves injecting sperm directly into a woman’s uterus to increase the chances of fertilization. IUI can also be effective in cases of functional disorders such as erectile dysfunction or premature ejaculation.
In vitro fertilization (IVF) or ICSI for male factor infertility
The IVF procedure involves fertilizing an egg with sperm outside of the body. The laboratory forms the embryo, and then they transfer it back into the woman’s uterus. ICSI is a form of IVF that involves injecting a single sperm directly into an egg to achieve fertilization.
Lifestyle changes for male infertility
You can improve your fertility by eating a healthy diet and maintaining a healthy weight. Abstain from smoking and alcohol if you are keen to conceive. Testis are sensitive to heat. Avoid hot baths and tight fitting undergarments to improve your sperms. Certain activities such as cycling may cause male infertility.
A combination of treatments may be necessary to improve fertility in some cases. It is important to consult a fertility specialist for a personalized and effective treatment plan.
Oligospermia- Low sperm count
Oligospermia, is a condition in which a man has fewer sperm in his semen than normal. A normal sperm count is considered to be at least 15 million sperm per milliliter of semen. A sperm count below this level can make it more difficult to conceive and may be indicative of male infertility. Your sperm count is tested during a semen analysis.
Teratospermia
Teratospermia is a condition in which there is a significant percentage of abnormally shaped sperm seen during a semen analysis. This can impact fertility because abnormally shaped sperm may have trouble reaching and fertilizing an egg.
The World Health Organization (WHO) defines normal sperm morphology as having at least 4% of sperm in a sample having a normal shape. A semen analysis that shows less than 4% normal sperms is diagnostic of teratospermia.
It’s important to note that a diagnosis of teratospermia does not necessarily mean that a man is infertile. Fertility depends on many factors, and treatment options and success rates vary based on individual circumstances. A fertility specialist can provide a more detailed evaluation and recommend the best course of action.
Asthenospermia
Asthenospermia is a condition in which there is a decreased ability of sperm to move properly. Sperm motility is an important factor in fertility, as it affects the ability of sperm to reach and fertilize an egg.
The World Health Organization (WHO) defines normal sperm motility as having at least 40% of sperm in a sample showing progressive motility, which is the ability of sperm to move forward in a straight line. In cases of asthenospermia, the percentage of progressively motile sperm may be lower.
It’s important to note that a diagnosis of asthenospermia does not necessarily mean that a man is infertile. Fertility depends on many factors, and treatment options and success rates vary based on individual circumstances. A fertility specialist can provide a more detailed evaluation and recommend the best course of action.
Azoospermia
Azoospermia is a condition in which there is a complete absence of sperm in the semen. This can impact fertility because without sperm, fertilization cannot occur.
There are two types of azoospermia: obstructive and non-obstructive. A blockage in the ducts that carry sperm, such as the vas deferens, causes obstructive azoospermia. On the other hand, a problem with sperm production causes non-obstructive azoospermia.
Treatment for azoospermia may include surgical procedures to remove blockages, hormone therapy to stimulate sperm production, or assisted reproductive technologies such as in vitro fertilization (IVF) using sperm obtained through other means such as testicular sperm extraction (TESE). In cases of testicular failure, doctors may suggest the use of donor sperm.
It’s important to note that a diagnosis of azoospermia does not necessarily mean that a man is infertile. Fertility depends on many factors, and treatment options and success rates vary based on individual circumstances. A healthcare professional can provide a more detailed evaluation and recommend the best course of action.
Erectile Dysfunction and Male Infertility
Erectile dysfunction (ED) is the inability to achieve or maintain an erection sufficient for sexual intercourse. ED is a common condition that affects men of all ages. It can be caused by a variety of physical and psychological factors.
Physical causes of ED can include cardiovascular disease, diabetes, hormonal imbalances, nerve damage, and the use of certain medications.
Psychological causes can include stress, anxiety, depression, and relationship problems.
Treatment for ED may include lifestyle changes, such as exercising regularly and reducing stress, as well as medical treatments such as phosphodiesterase type 5 (PDE5) inhibitors (such as sildenafil, tadalafil, vardenafil), vacuum erection devices, penile injections, and penile implants.
An underlying health condition can manifest as a symptom of ED. See a healthcare professional for a proper evaluation.
Premature Ejaculation and Male Infertility
Premature ejaculation (PE) is a common sexual dysfunction. PE is characterized by a man ejaculating too soon during sexual activity. It can occur before or shortly after penetration and can cause significant distress to both partners. Psychological or physical factors cause PE, and doctors can treat it with medication, therapy, or behavioral techniques. It is important to seek medical advice if you are experiencing premature ejaculation.
There are several treatment options for premature ejaculation, including:
- Medication: Selective serotonin reuptake inhibitors (SSRIs) such as dapoxetine are often used to treat premature ejaculation.
- Behavioral techniques: Techniques such as the “squeeze technique” and “stop-start method” can help to increase control over ejaculation.
- Therapy: Talking to a therapist can help to address any underlying psychological issues that may be contributing to premature ejaculation.
- Topical anesthetics: Local anesthetic creams or sprays can be applied to the penis to decrease sensation and help delay ejaculation.
- Pelvic floor muscle exercises: Strengthening the pelvic floor muscles through exercises such as Kegels can improve control over ejaculation.
It’s important to note that the best treatment will depend on the individual and the underlying cause of their premature ejaculation. Consult with a healthcare provider for an accurate diagnosis and personalized treatment plan.
Retrograde Ejaculation
In retrograde ejaculation, semen enters the bladder instead of the penis during ejaculation.
Various factors, including nerve damage, certain medications, and certain medical conditions such as diabetes, can cause this condition.
Symptoms of retrograde ejaculation include a reduced amount of semen during ejaculation and cloudy urine after sexual activity.
The condition is generally benign and does not cause any harm to the individual, but can lead to infertility if not treated.
Treatment options include medications to increase bladder neck closure and surgical procedures to redirect the flow of semen. In some cases, treatment may not be necessary if the individual does not wish to conceive. It is important to seek medical advice if you are experiencing symptoms of retrograde ejaculation.
Varicocele and Male Infertility
Varicocele is a condition in which the veins in the scrotum become enlarged, similar to varicose veins in the legs. This can cause a decrease in sperm quality and quantity, leading to infertility. Studies suggest that up to 40% of men with infertility may have a varicocele. Treatment options for varicocele include surgery to repair the veins and improve blood flow, and assisted reproductive technologies such as in vitro fertilization (IVF). In some cases, treating the varicocele can improve fertility, but success is not guaranteed and depends on the individual’s specific circumstances. It is important to seek medical advice if you are concerned about infertility, as there may be other factors contributing to your condition.
There are several surgical options for treating varicoceles, including:
- Microsurgical Varicocelectomy: This is a minimally invasive procedure in which the surgeon makes a small incision in the scrotum and ties off the affected veins. This procedure is performed under local or general anesthesia.
- Laparoscopic Varicocelectomy: This procedure involves making several small incisions in the abdomen and using a laparoscope to visualize and repair the veins.
- Open Varicocelectomy: This is a traditional surgical procedure in which an incision is made in the scrotum to access and repair the veins.
The choice of surgery will depend on the individual’s specific circumstances, including the size and location of the varicocele, as well as any other medical conditions they may have. Most varicocele surgeries are successful in relieving symptoms and improving blood flow, but there is no guarantee that fertility will be restored. It is important to discuss the potential benefits and risks of each surgical option with a qualified healthcare provider.