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Infertility (male): Treatment, symptoms, advice and help

About infertility (male)

The term infertility refers to failure of conception even after one full year of unprotected sexual intercourse. It is a complex problem with diagnostic and treatment challenges. Male infertility mostly arises from absence of adequate number of healthy sperms.

Infertility (male): Incidence, age and sex

About 1 in every 7 couples in the United Kingdom suffers from infertility disorders. The male partner contributes to about 30% of cases which is the same as that of females (30%). Another 10% causes are combined and the remaining 30% are unexplained. The incidence of infertility seems to augment with increasing age.

Signs and symptoms of infertility (male): Diagnosis

The symptoms of infertility usually arise from the underlying causes which may include structural penile deformities, erectile problems, premature or delayed puberty.

The diagnosis of male infertility includes detailed history and comprehensive physical examination (including pelvic examination) of male individual along with his female partner. Semen analysis is the first and foremost investigation wherein both quantitative and qualitative examination of sperm is performed. The quality of sperm bears more significance than the quantity of sperm. Other tests like blood hormone levels may also be required to evaluate the cause of infertility.

Causes and prevention of infertility (male)

Several causes may lead to male infertility which includes generalised disorders or localised reproductive tract disorders. Generalised causes include diabetes, (especially diabetic neuropathy which causes erectile dysfunction and retrograde ejaculation), congenital disorder like Klinefelter’s syndrome, thyroid disorder, adrenal gland disorder, pituitary insufficiency or childhood infection like mumps. Localised causes of male infertility include undescended testes, testicular trauma, structural abnormality of the penis, infections, obstruction in ductal outflow of the sperms or varicocoele (enlarged vein placed above testes). Other causes include toxins like tobacco, alcohol and drugs (spironolactone, sulfasalazine) which may damage the male reproductive cycle.

Avoid wearing tight pants and jeans, sitting in hot bath tub for long periods since heating can damage the sperm production in the testes.

Infertility (male): Complications

Infertility is a disorder which may lead to immense psychological stress and increased anxiety.

Infertility (male): Treatment

The first and foremost step in treatment of male infertility includes evaluation and subsequent management of underlying cause; for example, management of varicocele by a simple surgical procedure. If the couple is not able to get successful results, then other treatment modalities may be tried.

The female partner can be given ovarian stimulation drugs (if needed) like clomiphene, which may be either followed by “intrauterine insemination” (IUI) or “assisted reproductive techniques” (ART). Intrauterine insemination (IUI) is a procedure wherein the sperm is introduced in the female’s uterus during ovulation period for effective fertilization to occur inside the human body. The success rate of this procedure is not very high. However with the advent of assisted reproductive techniques” (ART) which includes in vitro fertilization (IVF), infertility management has not a new hope.

This procedure involves extraction of eggs from ovary (female partner) and sperms from male. This is followed by external fertilization of eggs and sperms in a laboratory setting. Thereafter the fertilized egg (embryo) is reinstated into the uterus of the female partner, for normal pregnancy to ensue. The treatment of infertility should be ideally tailored according to each couple depending upon the cause, health status and economic status of the couple.