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Causes and Treatment of Male Infertility:

Infertility in a couple is not always the incapability of a female to contribute to conception. In many of the cases of infertile couples, male infertility plays a strong role.

There is a significant difference between infertility and impotence.

Infertility however is a condition wherein a man is unable to produce children while have completely satisfactory sexual relations with their partner but cannot achieve conception.

Impotence is a condition wherein the male is unable to attain or sustain erections for satisfactory sexual intercourse. An impotent man can be fertile and pregnancy is possible for such a couple by the insemination of the man’s semen.

Nearly 80 percent of couples with infertility problems can be successfully treated with medications.

Male infertility causes mainly ;

  • Low/Poor sperm count
  • Slow sperm motility
  • Abnormal morphology (shape and size of sperm)
  • Retrograde Ejaculation
  • Lack of ejaculation
  • Infection and tumors
  • Hormonal imbalances, and genetic defects

The main problem infertility in men is due to sperm abnormalities caused by a range of factors, including congenital birth defects, disease, chemical exposure, and lifestyle habits.

Low Sperm Count (Oligospermia) :

A sperm count of less than 20 million/mL is considered low sperm. Azoospermia refers to the complete absence of sperm cells in the ejaculate.

Poor Sperm Motility (Asthenospermia):

Ability of sperm’s ability to move. If movement is slow, not in a straight line, or both, the sperm have difficulty invading the cervical mucous or penetrating the hard outer shell of the egg and capable to have genetic or other defects.

Abnormal Sperm Morphology (Teratospermia) :

Morphology refers to abnormally shaped sperm and structure cannot fertilize an egg. About 60% of the sperm should be normal in size and shape for adequate fertility. The perfect sperm structure is an oval head and long tail.

Retrograde Ejaculation :

In this defect semen enters the bladder instead of coming out of the tip of the penis during ejaculation. This condition can be an effect of diseases like diabetes, multiple sclerosis, spinal injuries, and surgery of the bladder, prostate or urethra. Also certain medications can lead to retrograde ejaculation.

Varicocele :

This is amongst the most common cause of infertility in men. A varicocele is the swelling of the veins that that drain the testicle. This causes the scrotum to enlarge and decreases sperm motility and volume. This obstructs normal cooling of the testicle and also leads to lower sperm quality.

Lack of ejaculation :

In this condition the male reproductive system cannot ejaculate semen even if the sperm production is normal.

Infections and Tumors:

Certain infections that interfere with sperm production, sperm health, scarring that can block the passage of the sperm. Diseases like cancer and non malignant tumors affect the male reproductive organs directly. They can harm the glands that release hormones related to reproduction. Also the treatment given to cure tumors can lead to male infertility.

Sperm duct Defects:

Damage to the sperm ducts that carry the sperms can also be a potent cause of male infertility due to blockages in testicle that stores sperm or in the tubes that carry sperm out of the testicles.

Hormonal Imbalances :

Since hormones have a great control over the reproductive systems any disorder affecting the testicles or the glands in the brain that produce testosterone and other hormones that control the testicles, can also be the cause of male infertility.

Other factors of infertility in men includes ;

Exposure to radiation or X-rays
Heavy alcohol, smoking and  usage of illegal drugs
Radiation treatment and chemotherapy for cancer
Long-term anabolic steroid usage
Overheating the testicles
Health problems such as mumps, serious conditions like kidney diseases etc
Injury
Prolonged bicycling
Emotional stress
Some men may diagnose with an “Unexplained Fertility Problem” in this case the doctors can’t pinpoint the cause of your trouble conceiving.

Treatment for Infertility in men :

Medical treatment :

Doctors may prescribe certain drugs that improve seminal quality like Clomiphene citrate, mesterolone, tamoxifen, gonadotropin injections, antibiotics, steroids and a whole lot of other medicines etc.

Surgical treatment :

Defects like Obstructions in the sperm conduction pathway, varicoceles, undescended testes etc can be treated surgically. Also the latest microsurgical techniques help greatly.  Patients who have undergone vasectomy previously can get it reversed through microsurgery.

Assisted reproduction :

However there are cases where neither medicine nor surgery can help the patient restore fertility. For such cases a process is carried out in the reproductive laboratory to improve semen quality and facilitate the penetration of the sperm into the ovum. This process involves procedures like sperm washing/capacitation, intra-uterine insemination (IUI), gamete intra-fallopian transfer (GIFT), in vitro fertilisation (IVF) and micro-manipulation (ICSI).

However there have been cases wherein all the above mentioned treatments have been unsuccessful. For such couples are suggested the option of AID (donor insemination) or adoption.

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