Male Infertility and Treatment
From a medical point of view, a married couple is considered sterile if there is no pregnancy after a year and a half of unprotected intercourse. For the fertility process to go smoothly, both the man and the woman must have good and normal health. The woman is usually always blamed when a couple is unable to have a child. The infertility investigation begins and ends with the evaluation of the wife alone. In general, this is not true. Approximately 15-20 percent of all cohabiting couples are infertile. In 50 per cent of cases the male reproductive factor or the husband is responsible for infertility. This means that approximately 7.5 to 10 percent of all men of childbearing age are infertile, that is, unable to have a child.
Male infertility is due to low sperm production, abnormal sperm motility or motility, a varicocele, or a blockage that prevents sperm delivery. Diseases, injuries, chronic health problems, erectile and ejaculation problems, hormonal problems, genetic problem, lifestyle choices, and other factors such as environmental toxins and radiation can all play a role in causing male infertility. Unhealthy eating patterns, stress, obesity, being overweight or underweight may also be risk factors.
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| Male Infertility and IVF Treatment |
Some of the factors that play an important role in male infertility are:
Sperm motility: Sperm motility is the ability of the sperm to move towards the egg leading to its fertilization. Sperm that do not swim properly will not reach the egg to fertilize it.
Sperm Count: Sperm count is the amount of sperm or cells, the higher the sperm, the more chances of a normal pregnancy. A total healthy sperm count should be around 20 million sperm per milliliter and a normal semen volume per ejaculate should be 2ml. Azoospermia is a condition in which there is a complete absence of sperm. It can also be congenital. The right causes must be found and addressed. Even when no sperm is present in the semen, sperm can often be harvested and used to achieve fertilization.
Sperm morphology: Sperm morphology refers to the size and shape (shape) of an individual sperm that is evaluated during a semen analysis. According to a 1989 manual, morphology is considered normal if it is about 30% or more.
A deficiency of any of these factors can lead to male infertility.
Male infertility assessment
Fertility in men requires the normal functioning of the hypothalamus, pituitary gland, and testicles. Therefore, a variety of different conditions can lead to infertility. Evaluation of male infertility begins with a visit to a urologist. The urologist will start with a basic interview and exam including
* A complete medical and reproductive history, along with any surgeries you've had and medications you're taking.
* Questions about lifestyle, including exercise, smoking and drug use.
* Physical exam.
* A frank discussion about your sex life, including any previous sex-related issues or STDs.
In any assessment of male infertility, the man will need to provide a semen sample for analysis. The doctor will want the man to give the sample there, or at least nearby, because it is important that the analysis be done quickly.
How is male infertility treated?
Treatment for male infertility depends on the specific problem. In some severe cases, no treatment is available. However, there is often a combination of medications, surgical methods, and assisted reproductive (art) methods available to overcome many of the underlying fertility problems. The options are:
Surgery: A minor outpatient surgery called a varicocele resection is often used to repair the dilated scrotal veins (varicocele). Studies have shown that repairing these dilated veins improves sperm motility, concentration and structure. In some cases, the blockage causing infertility can also be corrected surgically. In the case of a previous vasectomy, surgery with a surgical microscope has been shown to be very successful in reversing the blockage.
Medications: Drugs are essential in correcting retrograde ejaculation and immune infertility. In addition, pituitary hormone deficiency can be corrected with medications such as clomiphene or gonadotropins.
If these techniques fail, fertility specialists use high-tech assisted reproductive techniques that promote pregnancy without intercourse. Depending on the problem your doctor may suggest
Intrauterine insemination (IUI): By placing sperm directly into the uterus via a catheter, the IUI bypasses cervical mucus that may be hostile to sperm and places it near the fallopian tubes where fertilization takes place. IUI is often successful in overcoming problems with sperm count, motility, retrograde ejaculation, immune infertility, and other causes of infertility.
In vitro fertilization (IVF): Refers to fertilization that occurs outside the body in a laboratory petri dish. There, the partner's egg or the donor's sperm is attached. While ICSI is used mostly for women with blocked fallopian tubes, it's sometimes used for men with oligospermia.
Intracytoplasmic sperm injection (ICSI): A different type of in vitro fertilization, this procedure has revolutionized the treatment of severe male infertility, allowing couples who were previously thought to be infertile to get pregnant. It involves injecting a single sperm directly into the egg with a microneedle, and then, once fertilized, it is transferred to the uterus of the female partner. Your doctor will likely use ICSI if you have poor semen quality or a lack of sperm in your semen due to a blockage or testicular failure. In some cases, sperm may be surgically extracted from the testicles or epididymis for this procedure.
Modern scientific techniques such as ART, ICSI and IUI have made male infertility treatment easy. However, this treatment can be very expensive and can cause a hole in your pocket. Inexpensive methods are also available today without any compromise on treatment and methodology. Awareness of the magnitude and importance of the male factor in infertility is relatively recent. Tremendous progress has been made in andrology research over the past few years. If not today, then one can envision for the foreseeable future, a state in which all males (and females) who are infertile can be completely cured.
Always remember that infertility can be treated like any other disease and it does not mean that your manhood is at risk. By being fit, you can fight infertility. It is therefore essential that fertility testing be done for men as well as women. Yes, it can be embarrassing, but detecting male fertility problems early can mean early treatment and a successful pregnancy. Testing for male infertility can also spare women the inconvenience and unnecessary costs.
