Male infertility: What you need to know?
Infertility is not just a female problem since you need an egg and a sperm from each partner to create a new life. It is estimated that 1 in 20 men has some fertility problem. Infertility may be entirely due to a male factor in about 30% and as a contributory factor in another 20% couples.
In majority of cases, there are no symptoms to suggest a fertility issue in the male partner and the problem is first diagnosed when a semen analysis is performed. It is therefore a standard protocol in all infertility clinics to get a semen analysis before doing invasive tests on the female. Semen sample should be given after avoiding sexual contact for 2-3 days. Important parameters in the semen for fertility are the sperm count, percentage of sperms which show good motility and normal morphology (physical characteristics).
Problems in a semen sample may be due to defects in sperm production, a blockage in path of transport of sperms, or a failure to be able to ejaculate semen (erectile dysfunction / impotence). This may result in too few sperms or no sperms at all in the semen, not enough motile sperms, or sperms looking abnormal.
Some causes of male infertility are:
- Infection of the testes affecting sperm production like mumps
- Varicocele or dilated blood vessels around the testicles which increase the temperature of the testes and affect sperm production
- Undescended testis when the testes fail to descend down to the scrotum
- Alcohol, smoking, drugs, sedentary lifestyle
- Rarely hormonal and genetic conditions
How can we treat male infertility?
Lifestyle modifications focusing on diet and exercise, consuming more fruits which provide natural source of vitamins and antioxidants are helpful in improving mild abnormalities in the semen.
IUI (Intrauterine insemination): Semen parameters can be improved by washing and concentrating the semen. This is then injected into the uterus at the time when an egg is released from the ovary, thus increasing the chances of fertilization and pregnancy. This technique is however not useful when the count or motility of the semen is severely affected.
IVF-ICSI (In vitro fertilization – Intracytoplasmic sperm injection): In men, where semen parameters are severely affected, IVF and ICSI gives new hope of achieving fertility. Even if a few good sperms are available, the embryologist can inject the eggs with these sperms and offer a good chance of fathering their own biological child.
Surgical sperm retrieval: When there are no sperms found in the semen sample, it may be due to poor sperm production or a blockage preventing the sperms to appear in the semen. Some cases of blockage can be treated by surgery. Alternatively, sperms can be retrieved from the testis by aspirating with a needle (PESA, TESA) or a small cut (TESE), which can then be used for doing IVF and ICSI.