What is Male Infertility?
A man’s fertility generally relies on the quantity and quality of his sperm. If the number of sperm a man ejaculates is low or if the sperm is of a poor quality, it will be difficult, and sometimes impossible, for him to cause a pregnancy.
Male infertility is diagnosed when, after testing both partners, reproductive problems have been found in the male. The “male factor” contributes to infertility around half the time, and about one-third of the time, it’s the main cause of infertility.
Common Causes of Male Infertility
Male infertility is usually caused by problems that affect either sperm production or sperm transport.
Problems affecting sperm production include:
Varicocele( an abnormal collection of bulging veins above the testicle; they’re the most common cause of correctable male infertility, accounting for 38% of cases), Undescended testicle, Infections in the testicle (orchitis), the prostate (prostatitis), or elsewhere in the body that causes a fever,
Chemotherapy for cancer, Medicines such as anabolic steroids or anti-seizure medicines, Genetic abnormalities, Hormone problems etc.
Problems affecting sperm transport include Infections, Prostate-related problems, Absence of vas deferens, Vasectomy, Anti-sperm antibodies.
Other less common causes of infertility include sexual problems that affect whether semen is able to enter the woman’s vagina for fertilization to take place (one in 100 infertile couples); low levels of hormones made in the pituitary gland that act on the testes (one in 100 infertile men).
Diagnostic Tests For Male Infertility
- Physical examination: A thorough physical exam can detect Varicocele and give clues to hormone problems.
- Sperm analysis: a fresh sample of semen is collected. And it is checked for the presence of sperm, their number, their shape and their motility etc.
- Hormone evaluation: Testosterone and multiple hormones made in the brain control sperm production. However, hormones are not the main problem in 97% of infertile men.
- Testicular biopsy: This is done for men with very low or no sperm in their semen. A needle biopsy of the testicle can show whether a man is making healthy sperm. If abundant good sperm is found in the testicle, there’s likely a blockage somewhere.
- Genetic Testing: Genetic tests can identify specific obstacles to fertility and problems with sperm.
Treatment Of Male Infertility
Treating infections: Antibiotic treatment might cure an infection of the reproductive tract but doesn’t always restore fertility.
Treatments for sexual intercourse problems. Medication or counseling can help improve fertility in conditions such as erectile dysfunction or premature ejaculation.
Hormone treatments. Your doctor might recommend hormone replacement or medications in cases where infertility is caused by high or low levels of certain hormones or problems with the way the body uses hormones.
Surgery. For example, a Varicocele can often be surgically corrected or an obstructed vas deferens repaired. Prior vasectomies can be reversed. In cases where no sperm is present in the ejaculate, sperm can often be retrieved directly from the testicles or epididymis using sperm retrieval techniques (TESA/MESA/PESA techniques).
Assisted reproductive technology (ART). ART treatments involve obtaining sperm through normal ejaculation, surgical extraction or from donor individuals, depending on your specific case and wishes. The sperm is then inserted into the female genital tract (IUI) or used to perform in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Details of these techniques are given elsewhere in the website.