Guiding You Towards A Successful Fatherhood

Male infertility is commonly understood as any health issue present in a man that lowers/prevents his chances of getting his female partner pregnant. Studies show that around thirteen out of every hundred couples fail to get pregnant with unprotected intercourse.

Infertility is a serious condition and the causes for this in men and women are many. In one third of infertility cases, the problem is with the man – due to low sperm production, abnormal function or blockages that prevent the delivery of sperm. Illnesses, injuries, chronic health problems, lifestyle choices, and other factors can also play crucial role in causing male infertility.

Symptoms: There may be no obvious signs or symptoms for male infertility. In some cases, however, underlying problem such as inherited disorder, hormonal imbalance, dilated veins around the testicle, or conditions that blocks the passage of sperm, etc. can manifest as signs and symptoms. These can also be the causes of infertility.

Most men with male infertility do not notice any symptoms other than the inability to conceive a child. Following are some of the common signs and symptoms related to male infertility that you have to look out for:

• Problems related to sexual function — like difficulty with ejaculation or small volume of ejaculated fluid, reduced sexual desire, or difficulty maintaining an erection (erectile dysfunction).
• Pain, swelling or lumps in the testicle area.
• Various surgeries – groin, testicle, penis or scrotum.
• Respiratory infections that are frequent.
• Loss of smell or inability to discern smell.
• Normal than usual breast growth or gynecomastia.
• Decreased facial or body hair.
• Drastic loss in sperm count (fewer than 15 million/mL of semen or a total sperm count of less than 39 million per ejaculation).

When To See A Doctor?

Do consult a doctor if you have been unable to conceive a child after a year of regular and unprotected intercourse, or sooner if you have any of the above problems.

To Get Your Partner Pregnant, The Following Must Occur:

 The first thing is that you must produce healthy sperm. Firstly, this require the development and shaping of the male reproductive organs during puberty. The conditions are, either one of your testicles needs to function correctly, and there must be adequate production of testosterone and other hormones to set off and nurture the sperm production. The semen must carry enough sperms as well. Once sperm is produced in the testes, it is carried in a delicate tube until it combines with the semen and ejaculates from the penis. 

A low sperm count (sperm count) in semen reduces the likelihood that one of the sperms will fertilize a partner’s egg. Low sperm count means less than 15 million / mL of semen, or less than 39 million per ejaculation. Sperm ought to be functional and free to move around. Abnormal function or the condition of lesser movement result in the failed penetration of your partner’s egg.

Medical Causes

Varicocele:

 This is a condition identified by the swelling-up of the veins which in turn drains the testicles. It is one of the most common causes of male infertility, which can be reversed. Varicocele causes infertility due to abnormal testicular temperature. This condition leads to poor sperm quality. The treatments of these can improve sperm count and function, and may also improve outcomes when using assisted reproductive technology such as in vitro fertilization.

Infections:

Some infections can interfere with sperm production or can cause scarring that blocks the passage of sperm. Inflammation of the epididymis (epididymitis) or testicles (orchitis) and Gonorrhoea or Chlamydia – sexually transmitted infections. 

Ejaculation Issues:

 Retrograde ejaculation occurs when semen enters the bladder during orgasm rather than exiting through the tip of the penis. Various health conditions can cause retrograde ejaculation, including diabetes, spinal cord injury, dosing, bladder, prostate, and urethral surgery. Some men with spinal cord injuries or certain diseases can’t ejaculate semen even though they produce adequate amount of sperm. Often, for use in assisted reproductive techniques, sperm can still be retrieved from them.

Antibodies:

Antibodies that target the sperm immune system cells that mistakenly identify sperm as hostile invaders are called anti-sperm antibodies. They attempt to eliminate the sperm.

Tumorous Cancers and Non-Malignant:

Tumorous Cancers and Non-Malignant Tumours can affect the male reproductive organs directly through the glands that release hormones related to reproduction, such as the pituitary gland, or through unknown causes. In some cases, surgery, radiation, or chemotherapy to treat tumours can affect male fertility. 

Undescended Testicles:

 The condition in which one or both the testicles fail to descend from the abdomen into the scrotum (the testicle sac). Fertility is more likely to decrease in men who have this condition.

Hormone Imbalances:

Infertility can result from disorders of the testicles themselves or an abnormality that affect other hormonal systems including the hypothalamus, pituitary, thyroid and adrenal glands. There may be a number of possible underlying causes for low testosterone (male hypogonadism) and other hormonal problems.

Defects of Tubules That Transport Sperm:

Many different tubes carry sperm. They can be blocked due to various causes including inadvertent injury from surgery, prior infections, trauma or abnormal development with cystic fibrosis, or similar inherited conditions. The possible chances for blockages to occur are: within the testicle; inside the tubes that drain the testicle; in the epididymis; in the vas deferens; near the ejaculatory ducts; or in the urethra.

Chromosome Defects: 

 Normally a male is born with one X chromosome and one Y chromosome. But, in some inherited disorders such as Klinefelter’s syndrome, there may be chances of a male to born with two X chromosomes and one Y chromosome. This can result in abnormal development of the male reproductive organs. It is a mutation of the gene that determine the male sex.

Problems With Sexual Intercourse:

These problems include trouble maintaining an erection sufficient for sex (erectile dysfunction), premature ejaculation, painful intercourse, anatomical abnormalities such as having a urethral opening beneath the penis (hypospadias), or psychological or relationship problems that interfere with intercourse.

Celiac Disease

 A sensitivity to gluten results in this digestive disorder. This disease can cause male infertility. Adopting a gluten-free diet can improve this condition.

Certain Medications

 Testosterone replacement therapy, prolonged anabolic steroid use, cancer medications (chemotherapy), some of the antifungal medications, ulcer drugs, and such can impair sperm production and decrease male fertility.

Prior Surgeries

Certain surgeries may prevent you from having sperm in your ejaculation. These include vasectomy, inguinal hernia repairs, scrotal or testicular surgeries, prostate surgeries, and large abdominal surgeries performed for testicular and rectal cancers, among others. Two of the most common scenarios for which the surgery is performed are either to reverse these blockages or to directly retrieve sperm from the epididymis and testicles.

Environmental Causes

Extended exposure to Industrial Chemicals such as benzenes, toluene, xylene, pesticides, herbicides, organic solvents, painting materials, and lead may contribute to low sperm counts. Exposure to Radiation (or) x-rays can also reduce sperm production temporarily. Sperm production can permanently decline to high doses of radiation.

Overheating of the Testicles

 Although studies are limited and are inconclusive, frequent use of saunas and hot tubs may temporarily impair your sperm count. Wearing tight cloths and working long hours on laptop while sitting down may also increase the temperature of scrotum and may reduce sperm production.

Risk Factors

• Drug Use: Anabolic steroids taken to stimulate muscle strength and growth can cause the testicles to shrink and sperm production to decrease. Taking cocaine and smoking marijuana may temporarily reduce sperm in number and quality.
• Alcohol Use: Drinking excessive amount of alcohol can lower testosterone levels, cause erectile dysfunction, and can decrease sperm production.
• Smoking: Men who smoke may have a lower sperm count than those who don’t. Male fertility is affected in second-hand smokers also.
• Emotional Stress: Stress can interfere with the production of certain hormones that are needed to produce sperm. Emotional and mental stress including the ones you face with fertility, can significantly affect your sperm count.
• Depression causes sexual dysfunction due to reduced libido, erectile dysfunction, or delayed or inhibited ejaculation.
• Weight: Obesity can impair fertility in several ways, directly impacting sperm themselves as well as by causing hormone changes that reduce male fertility.

Diagnosis

History and Physical Exam

 Your doctor will ask you about childhood illnesses, current health problems, or medications that might harm sperm production. Conditions like mumps, diabetes and steroid use may affect fertility. Use of alcohol, tobacco, marijuana and other recreational drugs, exposure to ionizing radiation, heavy metals, or pesticides can also impact fertility. Your penis, epididymis, vas deferens, and testicles are examined for problems. Your doctor will look for varicoceles which can be found easily with a physical exam.

Semen Analysis

 This is a routine lab test. The causes of male infertility are revealed in this test. The patient is to masturbate into a sterile cup after a period of abstinence, so that the sample semen can be collected. This sample is studied for sperm volume, liquefaction, the count, concentration, motility, and structure. Do not conclude that you are permanently infertile even if the semen test shows low sperm or no sperm. This result may be an indication that there is some problem with the growth or delivery of sperm. More tests may be needed.

Transrectal Ultrasound

 A probe is placed in the rectum. Sound waves are then beamed on to the nearby ejaculatory ducts. This gives information regarding possible blockages in the transportation of sperms.

Testicular Biopsy

 A testicular biopsy is advised if the semen test shows significant reduction in the number of sperms or no sperm. This test can be done in an operating room with general or local anaesthesia. A tiny piece of tissue is removed from each testicle and studied under a microscope. The biopsy serves two purposes: it helps find the cause of infertility, and it can also collect sperm to use in assisted reproduction.

Hormonal Profile

 This is done to learn how well your testicles make sperm. The profiling helps us to rule out other major health problems.

Treatment

• Avoid smoking and alcohol.
• Avoid activities and dressing style that may lead to prolonged heating of the testicles.
• Reduce stress.
• Exposure to pesticides, heavy metals, and other toxins must be avoided.
• Supplement Vitamins, Folic Acid, L-Carnitine, Zinc, and Antioxidants.
• Take surgery to reverse vasectomy or to repair condition like varicocele.

ART Treatments

In cases of mild semen abnormalities and of sexual dysfunction, a simple insemination procedure like IUI is sufficient.

Assisted Reproductive Techniques (ART) like IVF and ICSI today are able to help men with even the most severe count issues and motility problems to have their own genetically linked children.

In Azoospermic males (absent sperms), sperms can be surgically retrieved through needle aspiration from the testis (TESA) and can be used in ICSI procedure to father their own child.

Hegde Fertility is the best among the few comprehensive dedicated IVF Center in Hyderabad. We offer our years of experience, expertise, and latest reproductive treatments in the area of infertility and treatment plans intended for individual desires.