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Advanced Centre For Male Infertility at Fortis Hospital Bangalore

All you need to know about Male Infertility

Infertility in males is a concern faced by many couples and proper treatment and counseling is needed to ensure full recovery. A man’s fertility typically depends on the number and quality of his sperms. If the amount of sperms a person ejaculates is low or if the sperms are of a poor quality, it will be not possible for him to cause a pregnancy. Male infertility is usually diagnosed when a couple undergoes testing and reproductive problems are found in the male partner.

Causes

Problems with male fertility can have multiple causes as follows:
 

Medical Causes

  • Varicocele
  • Infection
  • Ejaculation issues
  • Antibodies that attack sperm
  • Tumors
  • Undescended testicles
  • Hormone imbalances
  • Defects of tubules that transport sperm
  • Chromosome defects
  • Problems with sexual intercourse
  • Celiac disease
  • Certain medications
  • Prior surgeries

Environmental Causes

  • Industrial chemicals
  • Heavy metal exposure
  • Radiation or X-rays
  • Overheating the testicles

Health, lifestyle and other causes

  • Illicit drug use
  • Alcohol use
  • Tobacco smoking
  • Emotional stress
  • Weight

Symptoms

Male infertility does not have any obvious symptoms. Inability to conceive a child is considered the main sign. Male infertility may be caused by dilated veins around testicle, an inherited disorder, hormonal imbalance, or a condition that blocks sperm passage.

Symptoms of male infertility are:

  • Sexual problems — such as difficult ejaculation, low volumes of ejaculation, reduced sex drive or erectile dysfunction (difficulty to maintain an erection).
  • Pain or a lump in the testicle area
  • Recurrent respiratory infections
  • Inability to smell
  • Gynecomastia (breast growth) in men
  • Decreased facial or body hair
  • Hormonal abnormality
  • Having low normal sperm count

Diagnosis

Ways to diagnose male infertility problems:

  • Routine physical exam Your doctor examines your reproductive organs and enquiries about any existing chronic health illnesses, inherited disorders, surgeries and injuries, sexual habits & development during puberty that can affect fertility.

  • Semen analysis. You will be asked to undergo a semen analysis by getting a sample of your semen. The doctor will study the shape (morphology) and movement (motility) of the sperm as well as any infections.
Sometimes, the doctor might recommend additional tests that include the following:
  • Hormone testing A blood test to check the level of testosterone. The doctor might also check other hormones that are are important for sperm production and sexual development. Abnormalities found in hormonal glands might also cause infertility.

  • Genetic tests if the sperm concentration is found to be low. Abnormalities in Y chromosome or congenital syndrome may be a contributor to infertility. A blood test is done to determine them.

  • Testicular biopsy involves removing a small tissue sample from the testicle using a needle to check sperm production. If the results are normal, then infertility is likely caused by either a blockage or problems in sperm transport

Treatment

Male fertility treatments are:

  • Surgery. Basis the condition diagnosed, various surgeries can be performed. For example, sperm retrieval techniques can be done to retrieve sperms directly from the testicles or epididymis. A varicocele in the scrotum can be easily corrected by performing a surgery. Prior vasectomies can be tried to reverse.

  • Treating infections Secondary problems affecting fertility like infections can be treated using antibiotics. It might not always restore fertility.

  • Treatments for sexual intercourse problems. Quitting smoking, dealing with stress, anxiety or depression, limiting alcohol intake and proper medication and counselling can help

  • Hormone treatments. Infertility might be the result of certain changes in the level of hormones that are responsible for sexual well-being. Medications containing hormones can be recommended by the doctors to correct this.

  • Assisted reproductive technology (ART). Sperms obtained through normal ejaculation, surgically or from a donor,  are placed in the female uterus (IUI) or IVF or intracytoplasmic sperm injection

Understanding and dealing with infertility can be emotionally challenging. You will not know how long it will take to cure. Professional counselling to manage emotions are a great way to deal with anxiety for both the partners. Discuss and decide on the financial feasibility, procedures and emotional support in advance, which will help make the process less difficult.

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Dr Manisha Singh

Senior Consultant - Gynaecologist & Subspecialist in Reproductive Medicine, Surgery & Infertility

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