How can male infertility be treated?
If a man and a woman have regular unprotected sex for over a year and the woman doesn’t get pregnant then either one, or both of them may have infertility issues. Male infertility is a common issue and the process of conception could be challenging. Fortunately, having infertility problems does not prevent you from having a child of your own. There are procedures and medications that can increase the likelihood of conception.
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How common is male infertility?
One in eight couples experience difficulties conceiving or maintaining a pregnancy. One-third of infertility causes are generally attributed to the female partner, one-third to the male partner, and one-third to a combination of issues affecting both couples.
High amounts of environmental contamination, such as pesticides, herbicides, and water pollutants, are likely to cause male infertility. While infertility has not significantly increased recently, several studies claim that sperm levels have been dropping globally.
What causes male infertility?
- Genetic diseases: For example, Klinefelter’s syndrome, myotonic dystrophy, microdeletion etc.
- Drugs: Including a few prescription medications, anabolic steroids, alcohol, and marijuana, as well as certain antibiotics.
- Chronic Disease: Such as diabetes, cancer, some autoimmune disorders, cystic fibrosis, malnutrition, anemia or history of mumps in childhood.
- Varicocele: A condition where the veins in the scrotum enlarge which may affect the number and motility of sperm.
- Diseases of the male genital tract: Includes cancer, infection, or injury.
- Surgery on the male genital tract: Inguinal hernia or a testicle-removal operation.
- Hormonal disorders: Male infertility may be impacted by conditions that affect your hypothalamus or pituitary gland.
What are the symptoms of male infertility?
Being unable to conceive is the only symptom of male infertility.
How is male infertility diagnosed?
Male infertility issues are typically diagnosed by:
- Medical history and examination: Your doctor will inquire about any hereditary disorders, ongoing health issues, illnesses, injuries, or surgeries that may have an impact on your fertility. Your doctor will examine your genital area to look for any undiagnosed problems. Additionally, your doctor might inquire about your sexual behaviours and how those changed as you approached puberty.
- Semen analysis: There are several techniques to collect samples of semen. You can submit a sample by masturbating and ejaculating into a special container provided at the clinic. In certain circumstances, semen can be obtained by using a unique condom during sexual activity.
After that, the semen sample is examined in a lab to see if their number, motility and morphology are normal. Your semen will also be examined in the laboratory for signs of issues including infections.
Which males are most likely to have infertility?
A male may have a higher chance of being infertile if:
- He is obese or overweight.
- He has been exposed to radiation.
- He has been exposed to toxins found in the environment, such as lead, calcium, pesticides, or mercury.
- He is currently using a number of drugs, such as cyproterone, flutamide, spironolactone, bicalutamide, cimetidine, or ketoconazole.
- He has a history of undescended testicles.
- He has a history of varicoceles, which are widened veins in your scrotum.
- He has been exposed to testosterone.
- He uses tobacco, marijuana or alcohol.
- He has a history of mumps
How is male infertility treated?
There are now more treatment options available for male infertility. Infertility treatments might vary depending on the underlying cause, such as:
Medications:
- Hormone therapy can help to boost sperm production.
Lifestyle changes:
- Keep your weight within a healthy range.
- Give up smoking.
- Give up drinking.
- Abandon marijuana use.
- Stop using drugs recreationally.
Surgeries:
- Sperm Retrieval: If the semen analysis shows no sperm in ejaculate, then sperm must be found through a testicular biopsy. There are various surgeries which can be performed like Percutaneous epididymal sperm aspiration (PESA), Testicular sperm aspiration (TESA), Testicular sperm extraction (TESE), Testicular sperm aspiration (TESA ) and Microsurgical testicular sperm extraction (Microdissection TESE). The sperm found through these methods can be used with the spouse’s egg for fertilization through intracytoplasmic sperm injection (ICSI) or can be frozen for future if conception is not planned immediately.
- Vasectomy reversal: This common surgery is used in patients with a history of vasectomy to undo the procedure. The vas deferens, the scrotal tube through which your sperm travels, is reconnected by the surgeon. The surgeon delicately stitches the ends of the vas deferens back together while using a high-powered surgical microscope to observe it so that the sperm may travel back into ejaculate.
- Vasoepididymostomy: A similar method is used to clear blockages in your epididymis. The blockage is surgically removed, the ends of the tube are rejoined.
Other methods:
- Intrauterine insemination: This method can be used in patients with erectile dysfunction or with below average sperm count or mild motility or morphology issues. In this method semen sample is collected in a sterile container, prepared in the iui lab and transferred into the female partner’s uterus using IUI cannula after her follicle is ready egg is matured and released, which is monitored through ultrasound.
- In vitro fertilization: In vitro fertilisation (IVF) is the treatment of choice for some couples coping with male infertility. Injectable fertility drugs are used during IVF to stimulate the ovaries and enhance the maturation of eggs. When the eggs are ready, a day care oocyte retrieval procedure is carried out to collect them. The eggs are exposed to sperm in a culture plate. After that embryos are grown in the lab for three to five days, then a tiny catheter is inserted through the cervix to transfer the embryo/embryos into the uterus.
- Intracytoplasmic sperm injection: This treatment is known to have helped even the most severe cases of male factor infertility. Similar to IVF procedure the female is prepared using injectable fertility drugs followed by oocyte retrieval. One sperm is directly injected into each mature egg, through a procedure known as intracytoplasmic sperm injection. Then the embryos are grown in the lab for three or five days and transferred to the uterus.
With advancement of medical science there are chances of conception even in patients with severe male factors to have an offspring of their own. If you are facing any difficulties in conception then it is better to approach fertility specialists and discuss your problems as early as possible.