Male Infertility – Causes, Diagnosis and Treatment
Male Infertility Risk Factors
AGE : With a constant pressure to improve their life style, most of the couples are behind their careers, neglecting or postponing their families resulting in Late marriages, NonConsummation, Infertility etc.,. So, its always good to get FIRST THINGS DONE FIRST or ATLEAST AT THE RIGHT TIME!!
LIFESTYLE : Regarding the changes in the trends of life style… ! The increased prevalence of Smoking, AlcoholConsumption, DrugAbuse, Obesityin the community is also contributing a major threat to the fertility by affecting the sperm quality, Libidoetc., A simple change in the lifestyle, following a balanced diet with a little conscious about fitness and quitting smoking, alcohol and drugs can make them conquer this grave problem of male infertility. The males who smoke, drink or take drugs will be asked to quit that. Apart from the fact that a man is infertile or not, it is a great idea to bring such changes in your style of living prior to having a baby.
STRESS : The need for men to excel in their careers, to reach the targets and the odd work timings put them under lot of stress which can dramatically affect ones health in n number of ways also leading to infertility. Advisable ideas are to relieve from the stress in their own convenient ways and recharge for a better tomorrow.., ofcourse for all the days to be better.
RADIATION : Few occupations have this hazard of exposure to radiation and should be borne in mind to avoid radiation in all possible ways (lead barriers) and the amount of exposed radiation to be monitored always so as not to cross the permissible levels of radiation.
Causes of Male Infertility
Male infertility can be caused from a number of things. Often, men are not checked for infertility till the time their better half are tested and declaredfit and ready to conceive.
Causes for male infertility can be grouped under the following categories:
- SEXUAL PROBLEMS / DYSFUNCTION
- HORMONAL PROBLEMS
- ABNORMALITIES RELATED TO SPERM PRODUCTION / TESTICULAR DYSFUNCTION.
- ABNORMALITIES IN SPERM TRANSPORT (BLOCKAGE…)
- IMMUNITY RELATED PROBLEMS
- Men who are suffering from diseases that are sexually transmitted are more prone to infertility but these issues can be handled through proper diagnosis and medication.
- Some men who have a defect right from their birth that results in a blockage which does not permit sperm to go outof the body within a man’s semen.
- Diabetes could also be one of the reasons and can cause Retrograde ejaculation, which indicates that the semen does not leave the body in the process of intercourse. Instead, it enters the urine of a man.
- Inflamed varicose veins (VARICOCOELE) inscrotrumcould also cause sterilityconcerns in men.
- Erectile dysfunction can also be the reason of infertility. Premature ejaculation can also be the cause. Both the problems could be due to the outside reasons like stress, too much anxiety, lacking confidence. In such case males can cure infertility issues by getting rid of stress, raise their morale or visit a reputed therapist.
- Physical ailments such as hypertension, diabetes,some heart ailment, certain cancers, cholesterol problems, and radiation that has cured certain diseases are also the reasons of infertility.
- Obesity and even if the men are on the heavier side could also be one of the reasons of infertility.
Diagnostic Evaluation of Male Infertility
To pinpoint the cause of infertility, a variety of tests should be performed, differing from individual to individual :
Semen Analysis — To evaluate the Sperm
count, Motility, Progressivemotility, Spermmorphology, Presence of Leukocytospermia.
Semen deficiencies are often labeled as follows:
- Oligospermia or Oligozoospermia – decreased number of spermatozoa in semen
- Aspermia – complete lack of semen
- Hypospermia – reduced seminal volume
- Azoospermia – absence of sperm cells in semen
- Teratospermia – increase in sperm with abnormal morphology
- Asthenozoospermia – reduced sperm motility
There are various combinations of these as well, e.g. Teratoasthenozoospermia, which is reduced sperm morphology and motility.
Low sperm counts are often associated with decreased sperm motility and increased abnormal morphology, thus the terms “oligoasthenoteratozoospermia” or “oligospermia” can be used.
This is done in our most advanced State of the Art Andrology Lab—CASA (Computer Assisted Semen Analysis) to give you the most accurate, reliable, prompt and precise results.
Hormone evaluation — measures blood levels of the hormones involved in sperm production,
abnormal hormonal levels are indicative of the hormonal problems described that cause infertility.
Semen culture — checks for bacteria in the semen which either cause or indicate a genital infection that may cause infertility.
Biochemical analysis of semen — measures various chemical in semen; a chemical imbalance may impair fertility.
Sperm penetration assay (Hamster test)– measures sperm-egg membrane fusion using hamster eggs by a man’s sperm: tests the capability of the sperm to penetrate the egg during IVF.
A thorough physical examination and history can diagnose physical problems such as varicocoeles,
Klienfelter’s Syndrome, retrograde ejaculation, erectile disfunction, and premature ejaculation.
An absence of sperm in the semen sample is indicative of ejaculatory incompetence, retrograde ejaculation, or one of the conditions that block the spermatic ducts.
Scrotal Ultrasound : To rule out the presence of varicocoele, presence, absence or underdevelopment of testis, anyinfections, hydrocele etc.,
Penile Doppler : To determine proper blood flow to the penis which is very important to evaluate the cause of Erectile Dysfunction.
Nocturnal Penile Tumescence monitoring (NPT/Rigi Scan) To evaluate the presence of Erectile Dysfunction.
Few advanced investigations are done at our centre…
DNA Fragmentation Index(DFI): High levels of DFI indicate low chances of fertility.
Reactive Oxygen Species(ROS): This helps to assess the risk of sperm damage based on the availability of free radicals in our body that might cause damage to the plasma membrane of the sperm.
There are few other novel investigations that are done exclusively to evaluate Endothelial Dysfunction which is now considered as Surrogate measure of Erectile Dysfunction viz..,ENDOPAT
- Before the doctor prescribes you any tests the doctor would like to know about your medical history thorough a physical examination. The doctor can also ask about your sexual or personal history. Few of these queries will seem very personal and may feel invasive and disturbing. However, it is vital that you give the answer of these questions very honestly. The doctor would also like to speak to your sexual partner as the partner is in a position to offer an inside reason for the causes that are responsible for the ED.
- After proper examination and interview, your doctor may ask to get the few tests done likeComplete blood count (CBC), Dynamic infusion cavernosometry, Liver and kidney function tests, Penile biothesiometry, Lipid profile, Nocturnal penile tumescence (NPT), Vasoactive injection, Cavernosography, Thyroid function test, Blood hormone studies, Urinalysis, Duplex ultrasound, Arteriography. Tests that are performed in the laboratory are very useful to look for frequent etiologic factors and, when specified, to recognize hypogonadal syndromes. Suitable evaluation of ED leads to perfect advice, organization and recommendation of patients with this particular problem.
Male Infertility Treatment Options
The treatment protocols differ from man to man depending on the diagnosis.