Infertility in men is a problem experienced by 15-20 percent of men. Male Infertility means the absence of impregnating the female partner despite frequent (2-3 timer per week) unprotected intercourse.

Factors that impact male fertility; chronic health problems, some traumas and injuries and an unhealthy lifestyle. Sometimes changing small, easy lifestyle habits positively impact men’s infertility problems.

Treatment of infertility in men can be difficult because men tend to be embarrassed to talk openly to their doctor about sexual issues or unhealthy lifestyle habits! A good history taking, and openness is key to treating infertility in men. A thorough examination of the partner is also required to make sure there are no other factors that could influence the couple’s fertility apart from the male factor. If there is a female factor adding to the couple’s infertility the male and female partner should be treated simultaneously. Treatment of infertility in men has several approaches depending on the variable factors that cause it, sometimes medication and lifestyle changes do the trick and in other cases it is advised that the couple undergoes assisted reproductive technology (ART) methods like IVF/ICSI

 

Diagnosis of male infertility

Like any disease male infertility treatment begins with a systematic approach to properly diagnose the condition:

  • Patient history taking
  • Physical Examination of penis and testes (would show varicocele)
  • Semen analysis (count, motility and form of spermatozoa)
  • Hormone analyses.
  • Ultrasound to evaluate reproductive and urinary tract

 

 

Male infertility treatment

After setting a diagnosis and determining any variables that could be of added influence a treatment plan is set up. Treatment consists either of medication, surgery or ART.

Infertility in men treatments;

 

Medications

Medications help improve fertility in cases of erectile dysfunction and premature ejaculation.
Antibiotics can treat bacterial infections of the reproductive system that play an additional role in the infertility problem even if not directly responsible.
A man’s fertility depends for a great deal on healthy hormonal pathways, hormone therapy can be recommended if there is s deficit in the production in any of the hormonal pathways that causes a disbalance.

 

Surgeries

Surgical intervention is the method of choice in several conditions that affect male fertility. Surgical intervention when done by a skillful experienced surgeon gives good results in cases of varicocele, obstruction of

Testicular varicose veins can be treated with a surgical intervention and in most cases sperm production and quality improve after it. Surgical intervention is also successful in cases of blockage of the semen seminal ducts.

 

Assisted Reproductive Technology

In Assisted Reproductive Technology (ART), different techniques are used to help couples get pregnant. This may help people who have undergone many attempts.

 

Intrauterine insemination (IUI)

IUI is a procedure for the treatment of infertility. Healthy sperm is inserted into a woman's uterus around the time of ovulation. IUI is a perfect treatment for couples where there is mild infertility in men like slight problems in count or motility. If the male sample has at least 10.000.000 moving sperms per ml IUI can be an option for this type of infertility in men. The semen sample is washed and processed enhancing its quality and injected in the female uterine cavity.

 

In vitro fertilization (IVF) /Intracytoplasmic sperm

IVF is the fertilization of the female oocytes (eggs) outside the body fertilizing them with the male sperm creating embryos and putting them back in the uterus. In IVF this fertilization happens in a test tube and in ICSI under the microscope one single sperm cell is injected into each oocyte. These techniques make the pathway the sperm cells need to travel to the oocyte much shorter thus helping in cases where there is low count, low motility and morphology issues.

 

Testicular biopsy

In seminal fluid where there are no spermatozoa (sperm cells) or where the count, movement or forms are of such bad quality they can’t be used in IVF or ICSI a testicular biopsy is taken. Under the microscope sperm cells are taken right from the source and thus of good quality are hoped to be found for usage in an ICSI procedure.

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What causes male infertility?

  • Seminal fluid with sperm cells of inferior quality in numbers, movement and morphological form that make it harder to reach and penetrate the oocyte.
  • Varicose veins enlarged veins within the scrotum (skin surrounding the testicles) can cause a decrease in sperm count due to the stagnation of blood in the veins impairing proper blood flow to the male reproductive organs.
  • Infection in male reproductive organs.
  • Retrograde ejaculation, in which a man's semen during ejaculation goes to his bladder and not outside the penis as normal.
  • Autoimmune disorders.
  • The presence of benign or malignant tumors
  • Undescended testicle (s), where one or both man’s testicles remain in the abdominal cavity where they are developed in the gestational phase. They should descend into the scrotum in the first six months after birth.
  • Hormonal imbalance.
  • Blockage in the ducts through which sperm travels (Epididymis, vas deferens and urethra) or the seminal vesicles.
  • Some medications that treat cancer, fungi and ulcers.
  • Smoking, drinking and drug use.
  • Exposure to industrial chemicals and heavy metals.
  • Exposure to radiation and X-rays.
  • Overheating of the testicles, this may occur when wearing very tight underwear or pants, as can also happen by using a hot tub for long periods.