MALE INFERTILITY, ITS DIAGNOSIS & TREATMENT AT JFC
For most couples, reproduction or making of a baby is a simple and natural process but for others, it’s not so for they have problems in conceiving a baby. This problem is attributed to fertility problems which could be that of the man or the woman.
When it comes to the man’s fertility, it relies in the general sense on the quantity and quality of the man’s sperm. Where the number and quality of the sperm is poor or low, then it makes such a man’s sperm unfit for causing a pregnancy. This problem is called Male Infertility.
Today, Male infertility is as common a problem as a woman’s infertility and a widespread problem. About one in five infertile couples are said to suffer from the problem and in that the problem solely lies with the male partner. Further it’s said that one in 20 men suffers from some kind of fertility problem with low numbers of sperm in their ejaculate AND one in every 100 men are said to have no sperm in their ejaculate.
MALE INFERTILITY – CAUSES & SYMPTOMS
In general in most cases, no obvious signs of infertility exist. Thus in such a scenario, intercourse, errections and ejaculation will usually happen without difficulty. Further the quantity and appearance of the ejaculated semen generally appears normal to a human’s naked eye.
Thus, medical tests are the only alternative to find out the cause of the man’s infertility and mask out whether the man is infertile or not.
As per medical experts, more than 90% of Male Infertility cases happen due to low sperm counts or poor quality of the sperm or both.
The remaining 10% are said to be caused by a range of conditions from Anatomical problems to Hormonal imbalances, and Genetic defects. Furthermore, other causes of infertility include:
- Sexual problems that affects whether semen is able to enter the woman’s vagina for fertilisation to take place. It is said to affect 1 in 100 infertile couples.
- Low levels of hormones made in the Pituitary glands that act on the man’s testes. It said to occur in 1 in 100 infertile men.
- Sperm antibodies, found in one in 16 infertile men. However, in most men, sperm antibodies will not affect the chance of a pregnancy but in some men sperm antibodies will reduce fertility.
Though Male Infertility is caused by problems that affect either sperm production or perm transport, medical testing is required to find the cause of the problem.
SPERM TRANSPORT: It’s a problem that is found in about one in every five infertile men including men who have had a Vasectomy but now wish to have more children OR Blockages in the tubes leading sperm away from the man’s testes to the penis. These can cause a complete lack of sperm in the ejaculated semen.
MEDICAL CAUSES :
- VARICOCELE: It refers to the swelling of the veins that drain the man’s testicle; said to be the most common reversible cause of male infertility.
- INFECTION: These include inflammation of the Epididymis (Epididymitis) or Testicles (Orchitis) and some sexually transmitted infections, including Gonorrhea or HIV.
- EJACULATION ISSUES: It occurs when the man’s semen enters the bladder during orgasm instead of emerging out the tip of the penis. The problem can occur due to diabetes, spinal injuries, medications, and surgery of the bladder, prostate or urethra.
ANTIBODIES: They are immune system cells that mistakenly identify sperm as harmful invaders and attempt to eliminate them.
- TUMORS: Cancer and non-malignant tumours can affect the male reproductive organs directly, through the glands that release hormones related to reproduction, such as the pituitary gland, or through unknown causes.
- UNDESCENDED TESTICLES: It occurs when during fetal development, one or both testicles fail to descend from the abdomen into the sac that normally contains the testicles (scrotum).
- HORMONE IMBALANCES: It can result from disorders of the testicles themselves or an abnormality affecting other hormonal systems including the hypothalamus, pituitary, thyroid and adrenal glands.
- DEFECTS OF TUBULES THAT TRANSPORT SPERM: There are many different tubes that carry sperm which could get blocked due to various causes, including inadvertent injury from surgery, prior infections, trauma or abnormal development, such as with cystic fibrosis or similar inherited conditions.
CHROMOSOME DEFECTS: They refer to inherited disorders such as Klinefelter’s syndrome — in which a male is born with two X chromosomes and one Y chromosome (instead of one X and one Y) — cause abnormal development of the male reproductive organs. Other genetic syndromes associated with infertility include cystic fibrosis, Kallmann’s syndrome and Kartagener’s syndrome.
- PROBLEMS WITH SEXUAL INTERCOURSE: They include trouble keeping or maintaining an erection sufficient for sex (erectile dysfunction), premature ejaculation, painful intercourse, anatomical abnormalities such as having a urethral opening beneath the penis (hypospadias), or psychological or relationship problems that interfere with sex.
- CELIAC DISEASE: It is a digestive disorder caused by sensitivity to gluten.
- EFFECTS OF SOME MEDICATIONS: Some medications like Testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), certain antifungal medications, some ulcer drugs and certain other medications can impair sperm production and decrease male fertility.
- PRIOR SURGERIES: Some surgeries can prevent from having sperm in your ejaculate, including vasectomy, inguinal hernia repairs, scrotal or testicular surgeries, prostate surgeries, and large abdominal surgeries performed for testicular and rectal cancers, among others.
DIAGNOSIS / TREATMENTS AT JUHI FERTILITY CENTRE
- GENERAL PHYSICAL EXAMINATION: It includes examination of the man’s genitals and details of any kind of inherited conditions or chronic health problems or injuries or surgeries that could all affect fertility. It could also include insight into sexual habits and about sexual development during puberty.
- SEMEN ANALYSIS: It requires providing a semen sample by masturbating and ejaculating into a special container or the usage of a special condom to collect semen during intercourse.
- SCROTAL ULTRASOUND: It uses high-frequency sound waves to produce images inside the man’s body. This will help to see if there is a varicocele or other problems in the testicles and supporting structures.
- HORMONE TESTING: Hormones produced by the Pituitary gland, Hypothalamus and Testicles play a key role in sexual development and sperm production. Abnormalities in them cause infertility. For male infertility treatment in hyderabad, A blood test is taken to assess the level of testosterone and other hormones by our male infertility doctors.
- POST-EJACULATION URIANALYSIS: It gives an insight as to whether the sperm in the man’s urine are travelling backward into the bladder instead of out of the man’s penis during ejaculation.
- GENETIC TESTS: It comes into effect when the sperm concentration is extremely low. A blood test can reveal whether there have been subtle changes in the Y chromosome – a sign of genetic abnormality.
- SURGERY: It’s resorted to surgically correct a Varicocele or an obstructed vas deferens.
- TREATMENT OF INFECTIONS: Antibiotic treatment is recommended to cure an infection of the reproductive tract. But in most cases, they don’t always restore back fertility.
- TREATMENT FOR SEXUAL INTERCOURSE ISSUES: Medications or counseling is resorted to help improve fertility in conditions like erectile dysfunction or premature ejaculation.
- HORMONE TREATMENT: Either hormone replacement or medications is recommended, wherein infertility is caused by high or low levels of certain hormones or problems with the way the body uses the hormones.
- ASSISTED REPRODUCTIVE TECHNOLOGY (ART): They involve obtaining of sperm through normal ejaculation OR surgical extraction or from donor individuals, based on the specific case of the patient. Later the sperm is inserted into the female genital tract or used to perform In-Vitro fertilization or Intracytoplasmic Sperm Injection.