Male Infertility
Potential Causes of Male Infertility:
- Environmental Factors:
Toxins and Chemical Exposure
Radiation - Lifestyle Factors:
Smoking and Alcohol
Drug Use - Medical Conditions:
Varicocele
Infections
Hormonal Imbalances - Genetic Factors:
Genetic Abnormalities - Lifestyle and Psychological Factors:
Stress
Obesity
Seeking Help from an Andrologist:
When facing infertility due to male factors, it's crucial to consult with a specialist, such as an Andrologist or a reproductive endocrinologist with expertise in male infertility. They can perform a comprehensive evaluation to determine the specific cause and recommend appropriate treatment options. These may include:Lifestyle Changes: Advising on diet, exercise, and habits to improve sperm health.
Medications: Prescribing medications to address hormonal imbalances or infections.
Surgical Interventions: Such as Varicocele repair or sperm retrieval techniques for assisted reproductive technologies (ART) like in vitro fertilization (IVF).
Assisted Reproductive Technologies (ART): In cases where natural conception is not possible, ART procedures can help achieve pregnancy.
Diagnosis:
The diagnosis of infertility typically involves a comprehensive evaluation of both male and female partners.
- General Physical Examination:
This includes an examination of the scrotum and penis to check for any anatomical abnormalities or physical conditions that might affect fertility. - Basic Blood Hormone Profile:
Hormonal levels play a crucial role in sperm production. The basic hormone profile usually includes:
Testosterone: Important for sperm production and male sexual characteristics.
FSH (Follicle-stimulating hormone): Stimulates sperm production in the testes.
LH (Luteinizing hormone): Stimulates testosterone production and plays a role in sperm production. - Semen Analysis:
Semen analysis is a key test to assess the quantity and quality of sperm produced by the male partner. - It involves examining:
Sperm count (number of sperm per milliliter of semen).
Sperm motility (ability of sperm to move properly).
Sperm morphology (shape and size of sperm).
Other factors such as pH and volume of semen. - Semen Collection:
For accurate semen analysis, it's important to collect the sample properly. Typically, a dedicated room with privacy is provided to ensure comfort and ease of collection.
If the male partner has difficulty ejaculating or cannot do so through conventional means, methods such as the use of a penile vibrator for stimulation may be suggested to facilitate ejaculation.
Surgical sperm retrieval techniques are chosen based on various factors affecting sperm production and retrieval feasibility. Depending on several factors such as testicular size, previous scrotal surgery and hormone levels, the Andrologist will decide which would be the best option.
- PESA (Percutaneous Epididymal Sperm Aspiration): This is a minimally invasive procedure where sperm is aspirated directly from the epididymis (a coiled tube where sperm matures).
- TESE (Testicular Sperm Extraction): This involves the extraction of a small amount of testicular tissue (biopsy) through a surgical procedure from the testis itself.
- Micro-TESE (Microscopic Testicular Sperm Extraction): This is a specialized form of TESE where a surgical microscope is used to identify and extract sperm-producing tissue (seminiferous tubules) with high precision.
What other options are available if no sperms are found with surgery?
- Donor insemination (DI): Donor semen is carefully screened for infections and a donor selected to have similar attributes to you. This is the only viable option if you have no sperms at all and you do not have obstruction which can be relieved surgically.
- Adoption: If you are unfortunate and do not to have any success with other treatments, you may wish to consider adopting a child.
If surgery to find sperm is unsuccessful, and donor insemination or adoption are not viable options for you, there are still some alternatives to consider:
- Sperm Retrieval from Other Sources: If there is a possibility of sperm production but they are not found during initial surgery, further specialized procedures such as testicular mapping or micro dissection sperm retrieval (MDR) may be attempted by a specialist in reproductive medicine.
- Use of Donated Sperm with IVF: If using your own sperm is not possible, using donor sperm in conjunction with in vitro fertilization (IVF) might be an option. This involves fertilizing eggs with donor sperm in a laboratory setting, and then transferring resulting embryos to the uterus.
- Embryo Adoption: If you and your partner are open to adopting embryos, this could be an alternative. Some couples who have undergone IVF may have remaining embryos that they choose to donate to others.
- Surrogacy: If the issue is related to carrying a pregnancy to term rather than sperm production, surrogacy could be considered. This involves using your own or donor sperm and the egg of a surrogate mother who carries the pregnancy to term.
- Childfree Living: While not a treatment per se, some individuals and couples ultimately decide to live childfree by choice, focusing on other aspects of their lives.