What is Male Infertility?
Infertility is defined as when a couple is not able to conceive after one year or 6 months in a few specific cases after regular, unprotected intercourse.
When this condition is due to abnormal semen parameters it is called male infertility.
Male infertility patients will usually present with abnormal semen test parameters like- low sperm count, low sperm motility or low sperm morphology.
How common is Male Infertility?
Around 15 % of reproductive age couples suffer from infertility. Male factor is being solely responsible in 20 % cases and as a contributing factor with female infertility is in 30 % – 40 % cases. So around 50 % of infertility cases are caused by male factors.
Male fertility evaluation is a window to health :
Evaluation of male is often being neglected because the women are the usual drivers of the care seeking for fertility treatment. This trend is worrisome because a thorough male evaluation can uncover a lot of aspects and can lead to improved outcomes, cost-effectiveness and decreased physical and emotional burden on couples.
Male infertility evaluation is important for the general health of male partners also. There is some growing evidence indicating the association of male infertility with increased risk of certain diseases.
Male Infertility Diagnosis
- A thorough reproductive history and physical examination is the first step to assess risk factors that could contribute to male infertility.
- Initial evaluation should include one or more semen test ( Semen analysis). SA is the cornerstone of the male infertility evaluation, driven by predominantly WHO ( World Health Organization).
- Sometimes ultrasound and hormonal evaluation can be required. Hormonal evaluation like FSH, Testosterone or LH is not always required. It’ll be done after evaluation of semen analysis.
- Genetic evaluation may be required in a few cases depending on semen analysis and history.
- In cases of recurrent pregnancy losses ( repeated miscarriages or abortions ) or repeated IVF failure DFI evaluation is required.
Male Infertility Causes
- Varicocele:
Approximately varicocele in testis contribute to nearly 40% of male infertility cases. Varicocele refers to the enlargement of veins within the scrotum, which can lead to decreased sperm production or quality. Only palpable varicocele has been shown to be linked to infertility.
Varicocele treatment should be considered only if the female partner has normal fertility, when abnormal semen parameters are documented and when the patient has palpable varicocele vein.
- Sexual dysfunction:
Sexual dysfunction is a fairly prevalent problem among men of reproductive age. It is significantly worsened by the stress of infertility.
Male sexual dysfunction commonly present as erectile dysfunction (ED). Erectile dysfunction, characterized by the inability to achieve or maintain a penile erection of sufficient quality to permit satisfactory sexual intercourse.
ED increases with age. Around 18 % to 89 % of men with male infertility present with ED. Consulting a male fertility specialist can help diagnose and address this issue, potentially improving fertility outcomes.
Ejaculatory dysfunction is another example , it also has an impact on fertility. These patients may present as retrograde ejaculation or premature ejaculation that can lead to infertility. Treatment options may include medication, behavioral therapy, or assisted reproductive techniques.
- Infections:
Acute and chronic infection of the urogenital tract can rise to abnormal semen parameters and male infertility.
Few infections are sexually transmitted. Prompt diagnosis and appropriate treatment of these infections are vital to prevent long-term damage to fertility.
- Genetic causes:
Genetic testing of infertile male is recommended in specific circumstances such as azoospermia or severely low sperm count ( < 5 million total count ) or recurrent pregnancy losses cases.
Genetic disorders, such as Klinefelter syndrome or Y chromosome microdeletions can present as azoospermia or severely low sperm count.
A visit to a fertility specialist is a must to plan a treatment strategy in these cases.
- Lifestyle Factors:
Unhealthy lifestyle choices like smoking, excessive alcohol consumption, drug use, obesity, and poor diet can have a negative impact on male fertility.
Obesity can be associated with decreased sperm count, increased DNA fragmentation ( High DFI ) and impaired morphology.
Smoking has a deleterious impact on sperm health. Excessive alcohol intake can impact male fertility.
Making positive lifestyle changes, such as regular exercise, a balanced diet, and avoiding harmful substances, can greatly improve fertility outcomes.
- Environmental Factors:
Exposure to certain environmental factors, such as toxins, chemicals, radiation, or excessive heat, can impair sperm production and function.
It is advisable to avoid hot water swimming and prolonged hot water bathing.
- Stress and Psychological Factors:
Chronic stress, anxiety, and depression can disturb hormonal balance and interfere with reproductive function like lower sperm count, abnormal sperm production, and reduced sperm motility.
It is crucial to seek professional help, such as counseling or therapy to effectively manage these psychological factors and their impact on fertility.
- Testicular Factors:
Problems with the testicles, such as undescended testicles, testicular injury, or testicular cancer, can affect sperm production and quality.
In some cases, surgical intervention or assisted reproductive techniques may be necessary to achieve pregnancy.
Male Infertility Treatment
The treatment options for male infertility can be natural intercourse or IUI or ICSI depending on many other factors.
To prepare the best treatment plan it should be a combined approach of fertility specialist, andrologist and embryologist.
At our fertility centre in Madhapur, we offer a wide range of fertility checkups and male infertility tests to diagnose and address male infertility causes accurately.
Our experienced best fertility doctors, state-of-the-art facilities, and personalised treatment plans make us the best fertility hospital in Hyderabad.
Take the first step towards your parenthood journey by scheduling a consultation with our renowned fertility specialists.
