Defining Male Infertility
Experts define the male infertility as the inability of the man to impregnate a woman even after one year of the unprotected sexual activity. It mostly depends on quality and quantity of his sperm
Causes Of Male Infertility
Hormones can affect the fertility by bringing down the sperm motility and count.
|Physical, psychological and behavioral problems||
Factors That Increase The Risk Of Male Infertility
- The Overweight
- The Prior infections
- The Genital exposure to high temperatures
- The family history of fertility disorders
- The Mumps after puberty
- The Prior vasectomy or pelvic or abdominal surgery
- The Tumors or other chronic illnesses
- Taking certain prescription medications or undergoing The medical procedures
In most cases, inability to conceive is only sign of infertility. However, in some cases, underlying hormonal or physical problems show a few other signs.
Signs Of Male Infertility
Some possible the signs and symptoms could be.
- The Difficulty in erection or ejaculation, ejaculating low fluids and low sexual desire
- The Pain, lump or swelling in the testicle region
- The Abnormal breast growth
- The Decreased body or facial hair
- The Reduced muscle mass
- The Recurrent respiratory infections
- The Lower sperm count
If you are unable to conceive or facing any of above issues, then see the healthcare provider for diagnosis of problem.
How Is Male Infertility Diagnosed?
Both partners may have to get diagnosis done. The initial diagnosis includes the analysis of the medical history, the physical examination, and the common lab tests, and probably a few semen test
- A complete review of the past conditions, medications, and surgeries
- Knowing about family history of infertility or the birth defects
- A review of the social history and exposure to the occupational hazards to understand if they had an impact on fertility
- A review of the sexual habits and practices
Evaluates the genitals including the penis, testes, the scrotum, and prostate.
- Urinalysis to detect presence of infections.
- Semen analysis to evaluate motility (movement), shape (morphology), and maturity of sperm, the volume and liquidity of ejaculation, and actual sperm count. The sperm counts mostly fluctuate from one analysis to other. Therefore, multiple semen evaluations are done over the period to get accurate results.
- Hormonal tests to evaluate levels of testosterone and follicle stimulating hormone (FSH) to understand overall hormonal balance and state of the sperm production. Sometimes, initial hormonal testing indicates need for other hormonal tests such as the serum luteinizing hormone and prolactin.
If the above diagnostic tests are unable to determine condition, further testing is done to identify the cause of the infertility.
- Scrotal ultrasound uses the high-frequency sound waves to detect obstructions or problems in testicles and other supporting structures.
- Transrectal ultrasound is done by inserting tiny and lubricated wand into rectum to check the prostate and tubal blockages (ejaculatory ducts and the seminal vesicles) that they might carry.
- Post-ejaculation urinalysis helps detect sperm in the urine indicating retrograde ejaculation, where th sperm travels backward into the bladder.
- Seminal fructose test checks if the seminal vesicles are producing fructose in semen. The fructose sugar provides energy to sperm.
- Semen leukocyte analysis checks for the white blood cells in the semen.
- Anti-sperm antibodies test looks for presence of antibodies that could cause infertility.
- Sperm penetration assay (SPA)identifies ability of the sperm to fertilize.
- Kruger and World Health Organization (WHO) morphology detects sperm morphology and motility closely.
- Testicular biopsy checks for impairment or a blockage in sperm production.
- Vasography detects structure of the ducts and finds obstructions.
- Genetic testing identifies the mutations in gene regions of Y chromosome and diagnoses various the inherited or congenital syndromes.
Treatment For Male Infertility
Male infertility is treatable with the medications and other options. In some cases, where treatments do not work, the couple may have to go for the sperm donors or adopt a child.
Medications and devices:
- Gonadotropin injections are suggested for the hypogonadism to improve fertility. They trigger the sexual glands to produce testosterone and sperm.
- Pseudoephedrine medications work in treating the retrograde ejaculation. They close opening of the bladder thereby helping sperm to ejaculate through the penis.
- Sildenafil (Viagra) helps treat ejection issue.
- In case of problems with erection, your doctor might suggest you try the vacuum pump. You need to place pump over the penis and pump the air out to create the vacuum. It causes the blood to shift into penis, thus erecting it. A constriction band is placed at base to maintain the erection.
- Variocele (the swollen veins in the scrotum) is corrected through the surgery to improve the quality of your sperm.
- Obstructive azoospermia is surgically treated by removing blockage.
- Vasectomy (surgery that stops the sperm from going into the semen) can also be reversed.
Assisted reproductive technologies (ARTs)
If above treatments have not worked, your doctor would suggest the ARTs. These are powerful and high-technology based options that offer the extra boost to sperm to move into an egg. The sperm is collected from the ejaculated semen or through a needle from testicle. It is then processed and released into eggs through several methods.
- Intrauterine inseminations (IUI): The sperm (yours or donor’s) is directly injected into uterus during ovulation. Your partner would be given the medications to trigger ovaries for increasing the number of eggs. This option is recommended if there is problem with erection, and having sex is difficult.
- In-vitro fertilization (IVF): The sperm is combined with partner’s eggs in a test tube. They are made to fertilize and form the embryos. The embryos are then placed in uterus.
- Intracytoplasmic sperm injection (ICSI): A single sperm is injected into egg through a small needle, and made to fertilize. The fertilized embryo is then transferred into uterus. It is usually recommended when sperm count is low or the sperm is abnormally shaped.
Are There Any Complications Associated With Male Infertility?
Yes, the male infertility increases the risk of:
- Inherited disorders including the Klinefelter syndrome and cystic fibrosis
- The Hormonal abnormalities
- The Cancers, such as melanoma, testicular, colorectal and prostate
- The Stress and difficulty in relationships(source)
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