Male Infertility: Symptoms, Causes And Treatment
Reproduction is a natural phenomenon and is all that normal people aim at. But there are many conditions that both men and women sometimes are deprived of this joy to extend their family. Medically, it termed as infertility. In a patriarchal society, it is devastating for males to know and accept that they are not capable of having children. This brings a lot of emotional and social trauma.
let’s look at the male reproductive system and how it works
However, education and awareness, combined with medicine have been proved to be a boon in the current scenario. There are treatments for both male and female infertility today, and here in this article, we shall throw some light on everything you must know about male infertility, and how it can be treated.
What Is Male Infertility?
Male infertility is the incapacity of a man to make his female partner pregnant. In medical terms, if the sperm count is less than 20 million per ejaculation with morphology < 4%, a man is less likely to be impregnate partner naturally. However, the fertility of a man also depends on the quality and quantity of his sperm. So it becomes difficult, and sometimes, it may take years to make his female partner conceive.
Out all infertility cases, 30% of the cases are accounting for male infertility problem.
Sperm and testosterone (male sex hormones) are generated in the testicles. When the sperm leaves the testicles they go inside epididymis, it lies on top of each testicle. during ejaculation, the sperm mixed with some fluids released from the prostate and seminal vesicles to form semen. Finally, this Semen travels through the urethra and out of the penis.
When To See A Doctor
Most of the men with infertility may not notice the symptoms other than the inability to make his female partner pregnant. However, some signs and symptoms associated with male infertility problem are:
- Sexual problems like difficulty in sperm ejaculation or ejaculation in small volumes, erectile dysfunction
- Low sperm count / poor morphology/ No sperm in ejaculation
- Lack of sexual desire
- Hypospadias/epispadias is a birth defect of the urethra where the tube stops short of the tip of the penis. In boys, the urethra is the tube that goes to the tip of the penis and also carries semen.
- Respiratory infections
- Not able to smell properly
- Pain, discomfort, swelling in the testicle area
- Decreased facial or body hair
- Gynecomastia (abnormal breast growth)
- STD (Sexually transmitted disease) any transmitted infections through sexual contact which is caused by bacteria, viruses or parasites
- Testicular injuries – prior injuries to testicles in childhood or in any accidents
What Causes Male Infertility?
In some cases, infertility will be an underlying problem such as inherited, hormonal imbalances, dilated veins around the testicles. Sometimes it causes due to certain medical factors, environmental factors and lifestyle also which includes
Environmental Factors Causing Infertility
Exposure to certain environmental elements like heat, toxins and chemicals which can reduce the production and function of sperm and specific causes includes
Industrial Chemicals: Overexposure to certain chemicals like xylene, benzenes, pesticides, herbicides, painting materials, organic solvents may lead to low sperm counts.
Radiation or X-rays: Exposure to radiation reduces sperm production and sometimes it will eventually return to normal. But exposure to high doses of radiation, sperm production can be reduced permanently.
Overheating of The Testicles: frequent use of hot tubs for bathing, Sitting for a long period of time, wearing tight clothing, working over a laptop computer for a long time also may increase the temperature in your testicles may slightly reduce sperm production.
Medical Factors Causing Infertility
Male infertility can also be caused due to a number of health issues and some medical conditions, which includes
Hormonal Problems: Hypogonadism in male (low testosterone) and other hormonal problems have a number of underlying causes. Infertility problem can arise from the disorders of testicles themselves or abnormality affecting other hormonal systems which include adrenal, thyroid, hypothalamus, and pituitary glands.
Varicocele: A varicocele means enlargement of varicose veins in the scrotum(pouch of skin containing the testicles). Even though the exact reason behind varicocele cause infertility is unknown, it affects the reproductive function in many ways such as sperm production, quality, and transport.
Ejaculation Problems: During orgasm semen enters the bladder instead of emerging out through the tip of the penis leads to retrograde ejaculation. Retrograde ejaculation caused due to Various health conditions, including diabetes, spinal injuries, medications, and surgery of the bladder, urethra. Some men with certain diseases and spinal cord injuries not able to ejaculate semen, but can produce sperm. These cases can be assisted through different reproductive techniques.
Sexual Problems: Erectile dysfunction, premature ejaculation, painful intercourse while sexual intercourse, are also reasons for infertility in men. Some other problems such as hypospadias (having a urethral opening beneath the penis), or physical relationship problems that interfere with sex.
Infections: Some infections affect sperm production or block the passage of sperm. These include inflammation of the testicles and some sexually transmitted infections like gonorrhoea or HIV.
Genetic or Inherited Disorders: Inherited disorders such as cystic fibrosis, and Klinefelter’s syndrome (where a male is born with two X chromosomes and one Y chromosomes instead of having one X and one Y chromosome. Two X and one Y chromosome in a man could cause abnormal development of the male reproductive organs. Other genetic problems like Kallmann’s syndrome and Kartagener’s syndrome also associated with infertility.
Tumors: Cancerous and benign tumors can directly affect the male reproductive organs, such that they affect the glands that release the hormones related to reproduction like the pituitary gland, or the causes may be unknown. In some cases, treating tumours through radiation, chemotherapy or through surgery can also affect male fertility.
Previous Surgeries: Specific surgeries such as vasectomy, inguinal hernia repairs, scrotal surgeries, prostate surgeries, and large abdominal surgeries performed for rectal cancers can prevent sperm ejaculation. In some cases, these surgeries are performed to reverse the blockage or to redeem the sperm from epididymis and testicles.
Some other causes which include celiac disease (the digestive disorder caused by sensitivity to gluten), Undescended testicles(testicles fail to descend from the abdomen into the scrotum), some antibodies that attack sperm etc.
Lifestyle and other Causes
Severe Depression and Stress: Studies found that severe depression causes infertility in men. This depression in men may lead to erectile dysfunction, delayed ejaculation and sexual dysfunction. Emotional stress can interfere with certain hormones can affect your sperm count.
Smoking and Alcohol: Tobacco smoking can reduce the sperm count compared to non-smokers. Consumption of alcohol lowers the testosterone levels which causes erectile dysfunction and also decrease sperm production.
Usage of Drugs: Intake of Anabolic steroids to increase muscle strength and growth can shrink the testicles and lower sperm production.
Some other causes like the use of cocaine, obesity or overweight, those involved in prolonged sitting also result in infertility.
How To Treat Male Infertility
You may not find the exact cause for the infertility problem. Even though the exact cause is not clear, your doctor might suggest some treatments or procedures which will result in the favor of fertility.
Some of the ideal treatments for male infertility which includes:
ICSI in case of Oligospermia ( low sperm count)/ Atheno teratozospermia (poor morphology) where the embryologist has an option to select ideal sperm and inject in the oocyte (egg).
Sperm can be aspirated with a needle from the testicle or from the vas deferens (a structure right next to the testicle that also contains sperm). The man is given some drugs to sedate him and some local anesthesia is also used to numb the area. Then a small needle is inserted and sperm is aspirated from either the epididymis or the testicle. There should be no severe pain. The procedure generally takes about 30 minutes. The sperms retrieved can be used for IVF-ICSI procedure.
Males with low sperm count
Males with no sperm count ( Azoospermia)
Males with blocked tubes in their testes, or because of a genetic condition that prevents their sperm being released, require some form of surgical sperm retrieval
Treatment for Hypothalamic and pituitary deficiency: In a very few cases male infertility is due to problems in the hypothalamus and pituitary glands. Fertility can be restored by giving certain medications. Treatment is given with human chorionic gonadotropin (hCG), sometimes in combination with recombinant human follicle-stimulating hormone (rhFSH). Treatment provided hCG is called gonadotropin treatment.
Varicocele Treatment: If you have varicoceles (swollen veins in your scrotum) and it can be treated surgically. This treatment is an option for you as there’s no evidence that surgery for varicoceles improves the quality of your sperm.
Azoospermia Treatments: In this case, the semen lacks sperm in the ejaculate because of a blockage somewhere in the path. There were many surgical procedures to identify the blockages and removes them successfully.
Vasovasostomy: It is done to reverse the previous vasectomy surgery. It is quite an effective treatment in reversing the blockage by connecting the two end of vas deferens which allows sperm out during ejaculation.
Epididymovasostomy: This is a microsurgical procedure. It is performed when a blockage is found in the epididymis. Epididymal obstruction may occur due to a history of previous infections or injuries. If the man has had a vasectomy or a cystic fibrosis gene.
Hormonal treatments and medications: In some cases, infertility is caused due to a high or low level of specific hormones. If you consult a doctor he might prefer some medications or hormonal replacement in such cases.
If the above treatments are not quite enough to treat the male infertility problem, we provide high-tech technologies like ART(assisted reproductive technologies) which support conception without intercourse. IUI (Intrauterine insemination) places a sperm directly into the vagina through a catheter; IVF (In vitro fertilization) is where fertilization takes place outside the body in a laboratory; in ICSI (intracytoplasmic sperm injection) a single sperm is injected directly into the egg with a microscopic needle and after fertilization, it is transferred to the female partner’s uterus etc.
People generally think that ART is an alternative to female infertility but it can be just as effective for male infertility as well.
About The Hospital:
At Neelima Hospitals we have been creating miracles every day, for over 20 years. Regardless of your situation, our nationally recognized fertility specialists can work closely with you to develop a personalized fertility treatment plan, including IVF, PGD, egg donation & and other fertility options. As a leading destination for fertility tourism and travel, our Neelima MOM fertility center offers hope to patients around the world. Neelima MOM Fertility Center takes your dreams seriously and is dedicated to providing compassionate care, so why not get to know us better…
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November 23, 2018