Infertility is a disease of the reproductive system that impairs one
of the body's most basic functions: the conception of children. It is
defined in practical terms as a couple's inability to achieve pregnancy
after a year of unprotected intercourse.
Male infertility refers to the inability of a male to contribute to
conception with a fertile female. Infertility has traditionally been
thought of as a woman's problem, but as it turns out, men don't get off
that easily. About one out of every three cases of infertility is due to
the man alone, and men are somehow involved in infertility about half
the time.
A diagnosis of male infertility can be one of the hardest challenges a man can face. For some, it can be devastating.
Not being able to father a child can make a man feel like he’s failing
at one of his most primal responsibilities. Advances in male
infertility treatment offer real help to the males to become fathers.
Among couples with infertility, approximately 55% have a female problem,
about 45% have a male factor problem and a full quarter (25%) have
issues on both sides. The ability to treat female and male infertility
in parallel is, therefore, crucial for modern infertility care.
Understanding What is Male Infertility.
Approximately 15 percent of couples are infertile. This means they
aren't able to conceive a child even though they've had frequent,
unprotected sexual intercourse for a year or longer. In about half of
these couples, male infertility plays a role.
Reproduction (or making a baby) is a simple and natural experience for
most couples. Male infertility is diagnosed when, after testing of both
the partners, reproductive problems have been found in the male partner.
When Should one go for help for Male Infertility?
Unlike female infertility (where irregular periods may hint at a
problem), obvious symptoms are not common with male infertility. Most
infertility doctors suggest waiting a year before seeking infertility
testing. Some health problems may reduce a man’s ability to get a
woman pregnant. A visit to the infertility specialist is necessary if
you have a history of cystic fibrosis, injury or trauma to the scrotum
and testes, problems getting an erection and problems in ejaculating.
The Causes of Male Infertility.
Male infertility has many causes--from hormonal imbalances, to
physical problems, to psychological and/or behavioral problems.
Moreover, fertility reflects a man’s “overall†health. Men who
live a healthy lifestyle are more likely to produce healthy sperm. There
are a variety of conditions that may lead to male infertility. The most
common cause of male infertility is varicoceles. A varicocele is a
varicose vein found in the scrotum. The extra heat caused by the vein
can lead to low sperm count and impaired sperm movement.
Potential causes of male infertility are:
1.Complete absence of sperm (azoospermia)
2.Low sperm count (oligospermia)
3.Abnormal sperm shape (teratozoospermia)
4.Problems with sperm movement (asthenozoospermia)
5.Sperm that is completely immobile (necrozoospermia); the sperm may be alive and not moving, or they may be dead
6.Problems with sperm delivery, due to sexual dysfunction, an obstruction, previous vasectomy, or retrograde ejaculation
7.Problems with erections or other sexual problems
A small percentage of male infertility is caused by hormonal
problems. The hypothalamus-pituitary endocrine system regulates the
chain of hormonal events that enables testes to produce and effectively
disseminate sperm. Several things can go wrong with the
hypothalamus-pituitary endocrine system.
Some of the lifestyle changes that negatively influence male
infertility includes smoking, prolonged use of marijuana and other
recreational drugs, chronic alcohol abuse, anabolic steroid use, overly
intense exercise, inadequate vitamin C and Zinc in the diet, tight
underwear, exposure to environmental hazards and toxins, malnutrition
and anemia and excessive stress.
Diagnosis of male infertility.
Male infertility is usually diagnosed by a semen analysis. This
relatively simple test involves the man providing a semen sample for a
lab to evaluate. The lab uses this sample to measure the amount of semen
and the number of sperm, and to evaluate sperm shape and movement. Most
of the time, basic semen analysis is all that's needed to diagnosis
male infertility. However, further testing may include:
1. A general physical exam by a urologist
2. Specialized semen analysis, including genetic testing of the sperm
(looking for the presence of antibodies) and evaluation of immobile
sperm (to see if they are dead or alive)
3. Blood work to check hormone levels, usually of FSH and testosterone, but sometimes also LH, estradiol, or prolactin
4. Genetic karyotyping, if recurrent miscarriage is a problem
5. Ultrasound
6. Post-ejaculatory urinalysis (urine testing), to check for retrograde ejaculation
7. Testicular biopsy
8. Vasography
Treatment of male infertility.
The treatment for male infertility depends on the specific problem.
In some severe cases, no treatment is available. However, many times
there are a mix of medications, surgical approaches and assisted
reproductive techniques (ART) available to overcome many of the
underlying fertility problems. The options are:
Surgery: Surgical correction is necessary in order to remove a varicocele, reverse a vasectomy, or repair a duct obstruction.
Medication: Treatment with antibiotics, in cases of infection and Medications or fertility drugs to improve sperm production.
If these techniques fail, fertility specialists have a variety of
other high-tech assisted reproductive techniques that promote conception
without intercourse. Depending on your problem your physician may
advise you top go for IUI, IVF or ICSI treatment.
IUI Treatment: Here the sperm are transferred into the uterus via the
cervix directly. IUI is often successful in overcoming sperm count and
movement problems, retrograde ejaculation, immunologic infertility and
other causes of infertility.
IVF Treatment: IVF treatment may be suggested if IUI is not
successful or appropriate, or if female infertility is a contributing
problem. While IVF is employed mostly for women with obstructed
fallopian tubes, it is occasionally used for men with oligospermia.
ICSI Treatment: This procedure has revolutionized treatment of severe
male infertility, permitting couples previously thought infertile to
conceive. It involves injecting a single sperm directly into the egg
with a microscopic needle and then, once it is fertilized, transferring
it to the female partner's uterus. Infertility specialist is likely to
use ICSI if you have very poor semen quality or lack of sperm in the
semen caused by an obstruction or testicular failure. In some cases,
sperm may be surgically extracted from the testicles or epididymis for
this procedure.
However, if none of these options are available, or if they are
unsuccessful, fertility doctor may advise you about using a sperm donor,
to help build your family.
As stated above, given the proportion of infertile couples with
issues on both male and female, the ability to treat female and male
infertility in parallel is essential for modern infertility care. The
Blossom Fertility and IVF Centre aims to reduce the stress and hassle
associated with infertility investigations and treatment, by offering a
one-stop diagnostic and treatment service for infertile couples. Blossom
Fertility Center has the knowledge and experience to help at least 90%
of affected males to become the genetic fathers of their children.
The specialists for Male Fertility at Blossom Fertility and IVF
Centre,understand your concerns from an emotional perspective as well as
the medical one and are here to help. We offer a unique, comprehensive,
team approach to diagnosing and treating male infertility to help you
achieve your personal goals and dreams for the future. Rapid research
advances in the area of male reproduction have brought about dramatic
changes in the ability to both diagnose and treat male infertility. The
majority of couples suffering from infertility can now be helped to
conceive a child on their own.
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