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Male fertility treatments
It is usually claimed that 40% of all infertile couples have malefactors involved. In a few cases, both the partners suffer from medical conditions limiting them to get pregnant.
Understanding Sperm Production
Before we come to male infertility treatment, it’s important we understand the sperm production cycle. Testes constantly produce new sperms. During spermatogenesis, say 1500 sperms are produced every second. By the end of say 64-day full sperm production cycle, any man produces about 8-10 billion sperms. Every act releases 20-300 million. There is always a fresh supply available for conception.
When to see a Male Fertility Doctor
You should see a Male Fertility Specialist if you are unable to conceive a child. Following conditions need to be evaluated
- Ejaculation problems
- Pain or discomfort in the testes
- Over the age of 35
Common Conditions suggesting IVF/IUI Treatments
Male Infertility comprises of following findings in male partners
- Poor sperm quality
- Low sperm count
- Azoospermia
Azoospermia
Azoospermia is the absence of sperms in a man’s ejaculate and we find this usually in 15 – 20% of male infertility issues.
There are two types of Azoospermia:
- Obstructive causes commonly occur in the vas deferens due to Trauma, Infections, Inflammation, Previous surgeries, cyst, vasectomy, cystic fibrosis
- Non-obstructive causes of azoospermia include Genetic conditions like Klinefelter’s syndrome and Y chromosome deletion
Other Causes of Azoospermia
- Varicocele: A condition in which the veins inside the scrotum are enlarged and engorged, causing the whole testes to look much bigger.
- Drugs: Certain antibiotics and prescription medicines, steroids, marijuana directly affects the sperm production
- Stress: Stress affects every organ of the body including the testes and sperm formation causing male infertility
- Excess heat: Eg truck drivers, welders, or firefighters, or tight clothing or excessive use of the hot tub or keeping laptop for too long on laps, causes habits, affects sperm production
- Toxicants: People working in areas where they are exposed to pesticides, heavy metals, lead, mercury, or paint can over a period of time affects the hormones and sperm production
- Excessive Exercise: Heavy lifting, tight clothing or acts like bicycling can cause injuries in the groin.
- Chronic Diseases: Many conditions like anemia, malnutrition, cancer, or diabetes affect sperm health
- Dietary Deficiencies: It has been noted usually men with infertility issues are suffering from zinc, vitamin C, folic acid deficiency
- Obesity: Obesity directly affects and changes the hormones, causing secondary medical diseases and affects sperm production
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Surgery: Childhood surgeries if not performed correctly on the male genital tract conditions like undescended testicleImproving Sperm Health
- Diseases: Infections, cancer, trauma, or retrograde ejaculation directly affects the fertility potential
How to Diagnose Poor Sperm Motility
Initial Diagnosis for male infertility involves:
- Medical History: History related to any genetic conditions, or chronic health issues, or injuries, or surgeries that may have decreased the fertility quotient.
- Semen Test: A semen sample is taken from the husband /partner and the semen is sent for analysis. This is usually the most commonly done and provides a lot of information on the quality of the semen/sperms. Semen tests determine the shape (morphology), (motility), and count of the sperms.
Advanced Diagnostic Tests for Low Sperm Count
In case the semen test is abnormal, we recommend a few more tests to identify the cause.
* Testes Sonography: Sonography on the scrotum/testes to rule out varicocele or blockages of the tube.
* DNA Fragmentation Test: Sperm DNA fragmentation has become one of the routine tests to rule out male infertility, which helps to identify abnormal genetic composition within the sperm. Poor or bad DNA fragmentation directly leads to multiple IVF / ICSI treatment failures and multiple miscarriages. Embryos which are formed from sperms with high DNA fragmentation level usually have shown blastocyst arrest, increased chance of miscarriage and abnormalities in the children born.
* Hormonal Evaluation: Hormones play an important role in sexual development and sperm production. Any condition affecting the pituitary glands, or other organ systems, will influence infertility. Usually, Testosterone, FSH, LH are done.
* Urine Analysis: Sperm in urine means sperms are going back (retrograde) into the bladder instead of coming out through the penis during ejaculation.
* Genetic Evaluation: At times men may have inherited or genetic causes affecting their poor sperm sample. A simple karyotype will present the picture of the chromosomes.
* Biopsy of Testes: In this procedure, usually a sample wedge is taken from the testicle with a needle. If the results are normal, it means the sperms are getting blocked through the passage tubes.
Treatment
On multiple occasions, we may not be able to ascertain the cause. In such cases, we may recommend treatments or procedures that will increase the chances of conception and pregnancy.
* Surgery: In cases like varicocele, this can be surgically corrected or in cases of obstruction, the vas deferens can be repaired through surgery. If a man had a vasectomy, it can be reversed.
* TESE: TESE is a minor surgical sperm retrieval procedure carried out under local anesthesia, and used in male infertility treatment, for men who have no sperm in their ejaculate. These sperms which are retrieved, are used to do ICSI with the eggs and is the best male fertility treatment option.
* Infections: Antibiotic or antifungal treatments cure an active infection of the reproductive tract.
* Stress or Sexual Intercourse Problems: Usually psychological counseling helps alleviate stress and improve fertility conditions like erectile dysfunction or premature ejaculation.
* Hormonal Therapy: We may suggest you take some HRT (hormone Replacement Therapy) to correct the hormonal variations.
* IVF or Assisted Reproductive Technology (ART): ART or IVF interventions are required when medical therapies did not show results. Sperms once collected through masturbation or surgical intervention, are then used through IUI or IVF procedure to get the female partner pregnant.
* Sperm Donor: In rare cases, when any treatment has not worked in the favor, we do recommend and suggest that you and your partner should consider using donor sperms.
Personalised Opinion for Male Partner
Home Remedies
These are the few methods that you could do at home, to increase your chances to get your wife pregnant.
- Frequency of sex: Having sexual intercourse 5 days before ovulation drastically increases the chances of getting pregnant.
- Lubricants: Do not use condoms or any gelly/lubricants for male or female partners. These usually affect the sperm’s movement and function.
- Healthy Lifestyle: Reduce carbs, lose weight, exercise, eat less, drink more water, eat healthy foods, remove junk food completely, get sleep. These steps invariably have brought changes to the semen or sperm sample.
- Stop: Stop alcohol, quit smoking, and don’t use illicit drugs till you get pregnant.
Supplements
Studies have shown many possible benefits for improving sperm quality.
- Antioxidants, coenzymes
- Folic acid and Zinc combination
- Vitamin C
- Vitamin E
Preparing for your appointment
If you have never been evaluated by a doctor, you might begin by seeing your family doctor. If, however, you have a known condition resulting in infertility or have any abnormalities on your testing by your primary care doctor, then you may be referred to a specialist.
Here’s some information to help you get ready for your appointment, and what to expect from your doctor.
