In couples, infertility has become a common problem. And not only women but men too suffer from infertility issues. Infertility issue in men is known as male infertility. Approximately 30 to 50% of couples are struggling with male infertility.
Table of Contents
What is Male Infertility?
Male infertility is a health issue caused due to problems in the male reproductive system. A male faces a problem in either sperm production or sperm deposition into the female reproductive tract, lowering the chances of his female partner getting pregnant.
Approx 13 out of 100 couples can’t get pregnant even though they’ve had frequent, unprotected sexual intercourse for a year or longer. Injuries, illness, chronic health problems, lifestyle choices and other factors may contribute to male infertility.
What Happens under Normal Conditions?
Usually, sperms are produced in the testicles that are in the scrotum, stored in a sac called the epididymis, and transported via a tube called the Vas Deferens. During ejaculation, the sperm mixes with fluid from the prostate and seminal vesicles, which form semen. This semen travels via the urethra (male urine tube) and is ejaculated out of the penis.
Male fertility depends upon your body making normal sperm and delivering them into your female partner’s vagina. These sperms travel through the female partner’s cervix into the uterus and her fallopian tubes. And when a sperm and egg meet, fertilization happens.
Symptoms and Causes of Male Infertility
Making healthy mature sperm that can travel and fertilize the egg depends on several things. Problems with erection and ejaculation may mean you have infertility. And even the temperature of the scrotum may also affect fertility. Below are the leading causes of male infertility:
1. Sperm Disorder
The most common cause of male infertility is sperm disorder. It may be abnormally shaped, immature, unable to swim, or you may not have enough sperm or may not make any sperm.
Lifestyle choices play an essential role in the quality and quantity of sperm, such as smoking, drinking alcohol, and taking certain medications. It also affects sperm production, function and delivery. Medications to treat health problems like arthritis, depression, anxiety or depression, infection, cancer, etc., can lower sperm count.
There can also be other causes of low sperm numbers such as long-term sickness such as kidney failure, childhood infection such as mumps and chromosome or hormone problems such as low testosterone.
2. Structural Problem
Sometimes the tube through which sperm travels are blocked, which stops the flow of semen. This could be because of repeated infections or inflammation from a sexually transmitted disease, swelling, surgery, genetic or congenital disability.
3. Hormonal Imbalance
Hormonal imbalances such as thyroid disorder, low testosterone levels, pituitary or adrenal disorders etc., can affect sperm production and deposition. Very low hormone levels also cause poor sperm growth.
4. Environmental Factors
Exposure to harmful chemicals or radiation affects sperm count and motility when working in high temperatures.
5. Other Factors
Other factors may include erectile dysfunction or premature ejaculation, liver or kidney disease, or treatment for seizure disorders, which are examples of problems that can also cause infertility.
Diagnostic and Test for Male Infertility
Diagnosis of male infertility starts with reviewing a complete history and physical examination. The problem is usually with sperm production or delivery. Following are the other tests for male infertility: –
1. Semen Analysis
Semen analysis is done to know the level of sperm production and its functioning. It tells how much sperm you make, how well they move, and their shape. Two semen analysis is done on separate days. It tells about one’s ability to conceive.
If your test shows a low number of sperm or no sperm, it does not mean you are permanently infertile. It shows that there may be a problem with the growth and delivery of sperm.
2. Testicular Biopsy
Suppose semen analysis shows a meagre number of sperm or no sperm. You may be told for a testicular biopsy. In this, a small piece of tissue is removed from each testicle and studied under a microscope. This helps find the cause of infertility and can collect sperm for use in assisted reproduction, such as IVF.
3. Transrectal Ultrasound
Your health care provider may tell you for a transrectal ultrasound. In this ultrasound, sound waves bouncing off an organ are used to get a picture of the organ. In the rectum, a probe is placed, which beams the sound waves to the nearby ejaculatory ducts. It helps doctors to see if structures such as the ejaculatory duct or seminal vesicles are blocked or poorly formed.
4. Blood Test
Your health care provider may use blood tests to check hormone levels and rule out other major health problems.
Treatment Options for Male Infertility
The treatment of male infertility varies from person to person, depending on the cause of infertility. Most male infertility can be treated without surgery. There are three categories of male infertility:
1. Treatment with Assisted Reproductive Techniques (ART)
Health care provider usually suggests this technique in case infertility treatment fails or there is no treatment.
(A) Intrauterine Insemination (IUI)
This treatment is used for patients having low sperm count, movement problems, retrograde ejaculation or any other cause of infertility. In this method, the health care provider puts much healthy sperm at the entrance of the cervix or into the female partner’s uterus. And sperm make their way to the fallopian tube.
(B) In Vitro Fertilization (IVF)
In IVF, the female egg and sperm are met in a laboratory, and after 3 to 5 days of growth, it is placed in the uterus. This is generally used where the male partner has very severe and untreatable oligospermia, low sperm count, and for women with blocked tubes or unexplained infertility.
(C) Intracytoplasmic Sperm Injection (ICSI)
It is a treatment used for severe male infertility. A single sperm is implanted into the egg with the help of a tiny needle. And as the egg is fertilized, it is put in the female partner’s uterus.
Sperm Retrieval Process for Assisted Reproductive Techniques (ART)
Following are the different methods of sperm retrieval for ART. These methods are used to get the best quality and quantity of sperm.
(a) Testicular Sperm Extraction (TESE): – This technique is used to diagnose the cause of azoospermia (no sperm). A small portion of the tissue is removed from the testicles, and sperm cells are extracted for further procedure.
(b) Testicular Fine Needle Aspiration (TFNA): -It is sometimes used to collect sperm from the testicles.
(c) Percutaneous Epididymal Sperm Aspiration (PESA): – It is performed under general anaesthesia. The urologist attaches a needle to a syringe into the epididymis. Then they gently withdraw fluid. It is not always possible to get sperm. So, they may tell you about surgery.
(d) Microsurgical Epididymal Sperm Aspiration (MESA): -In this process, sperm are recovered from the epididymal tubes using a surgical microscope. It yields a high quantity of motile sperm, which can be frozen and thawed later for IVF treatments.
2. Treatment with Medicines
If you have a hormone disorder causing your infertility, hormone treatment may help you. Hormone imbalances can affect how sperm develop. Treatment may include antibiotics or gonadotropin therapy.
3. Treatment with Surgery
Much male infertility is treated without surgery. However, if it is required to fix the problems, your health care provider will inform you. Surgery is done to remove twisted, swollen veins in the scrotum, etc.
Prevention of Male Infertility
Infertility is a significant health concern and equally affects men. Approx 40 to 50% of infertile couples, the problem lies in men. But no visible symptoms of the disorder result in male infertility. And can only be identified after unsuccessful attempts by the couples to conceive a child.
However, the problems related to lifestyle that causes male infertility can be prevented by taking proper care and living healthier lives.So here are some tips for preventing male infertility:-
Avoid Being Overweight
Sperm production problems are often associated with excess weight. This happens due to the distortion in the balance of androgens/ estrogens. So to prevent this, maintain a healthy weight as per your body type.
Overcome Addictions & Addictive Substances
Addictive substances like tobacco may harm male infertility. It impairs the reproductive sperm capacity. The effect is even more harmful in men whose semen parameters are abnormal because smoking aggravates sperm count, motility, and morphology. Similarly, marihuana and cannabis have a tremendously detrimental effect. So one must monitor their intake because anything in excess can become an addiction.
Maintain an Optimum Testicular Temperature
The testicular temperature should be lower than the temperature of the rest of the body for them to be functional. Thus, anything misstating this temperature assortment may harm male fertility. So one should avoid wearing tight clothes; prolonged use of a laptop on their lap can affect the circulation of blood in the genital region and can raise the temperature of the testicles.
Avoid Mobile Phones and Other Types of Radiation
Prolonged use of mobile phones or other electronic gadgets emits low radiation, which can affect sperm production. This is why the medical community has adopted the practice of Sperm Cryopreservation in men who have cancer before starting radiotherapy/chemotherapy, as well as in men who are not yet in the stage of trying conception or pregnancy but whose sperm quality has already started dropping. So it is advised to keep your mobile phone in your shirt pockets instead of pants and not sit with the laptop directly on your lap for an extended period.
Have Nutritious Food
Always have a nutritious food rich in antioxidants because these are highly beneficial for male reproductive conditions. Have a healthy and balanced diet such as food rich in vitamins A, C, vitamin E, Zinc, folic acid, etc. And if the food does not provide proper nutrition, take supplements only after the physician’s recommendation.
Exercise to Maintain High Immunity
Exercise regularly to ensure a healthy immune system, as inflammation and infections may stop the production of healthy sperm.
Testicular injuries must be treated without delay because they may have long-term consequences on fertility. So great caution should be taken while playing specific sports where testes are not adequately protected.