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Male infertility : Causes and Solutions

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Fertility is not always as simple & straightforward as it appears. The natural process of conception is very dynamic and well-regulated by nature for males & Females. The gametes (sperm and eggs) of both partners are equally responsiblet for conception & Male fertility has assumed equal status to female infertility.

In this blog, we will address the key points related to male infertility. To understand it, let’s go to the basics of male fertility. For a couple to conceive, both male & female reproductive systems should function properly

A male reproductive system has the following functions.

The testes should produce normal functional sperm as well as the hormone testosterone.

The ability to achieve an erection for sexual intercourse.

The sperm that are produced should have proper structure & movement

Sperms should move to the fallopian tubes to fertilise the eggs.

The male reproductive system functions to manufacture, store and transport sperm. FSH (Follicular Stimulating Hormones & testosterone regulate sperm production. Like sperms, testosterone is produced in both testicles.

There are many factors that cause Male infertility, right from production to transport of sperm in the fallopian tubes is a lengthy process & any obstacles in this process can cause male infertility.

It may be due to,

Less production of sperm by testicles.

Genetic factors that create abnormal sperms

Lifestyle impacts sperm production (smoking, alcohol, drugs)

Long-term illnesses, Hormonal imbalances

All these issues affect the number & quality of sperms.

There are other conditions which cause male infertility like,

1. Azoospermia: chances of fathering a child are non-existent when there are no sperms in the ejaculate.10 to 15% of cases of male infertility are due to this. Azoospermia means the absence of sperms in ejaculate. It may be due to obstruction when there is a blockage which prevents sperm entry in the ejaculate. “nonobstructive simple means lesser sperm production.

Azoospermia may be caused by many factors like hormonal deficiencies and infections. One such example is vasectomy. This is the condition caused by cutting and sealing the vas deference. Due to this, sperms are blocked and prevent pregnancy. Vasectomies can often be reversed (In 70% of cases, sperms do reappear), but in most of the cases, sperm antibodies are seen which reduce the ability of sperms.

Low success rates with reversal of vasectomy are due to high antibodies, time length of vasectomy and amount of vas removal. These all factors contribute to male infertility to some extent.

2. Erectile Dysfunction: this is the condition where a penis is unable to keep or sustain an erection during sexual intercourse. There are situations where the semen sample for Assisted Reproductive Technology treatment could not be produced.

Occasional erectile dysfunction does happen. This may be due to stress or nutritional or lifestyle change. Frequent erectile dysfunction can be a sign of health problems which need prompt attention. It may be due to a relationship or emotional concern which may require professional help.

Incidences of erectile dysfunction increase with age, which contribute to male infertility.

3. Retrograde Ejaculation: In this situation, sperm & semen content may be normal but instead of leaving the penis, it flows back into the bladder.

There are many such situations mentioned above, sperms need to be retrieved with surgery. Such sperms may be immature or not developed fully to fertilize the eggs, the Procedure called Intra Cytoplasmic Sperm Injection (ICSI) or Intra cytoplasmic morphologically selected sperm injection (IMSI) treatment is used.

Recent finding about sperm is an eye-opener. Till date, it was thought that the best swimmer sperm is ideal for making a baby. The 1st sperm to meet the egg must be of the best quality. Now we are aware, that having a good count and motility of sperms does not conform to the best quality sperms.

The sperm factory never closes but the quality of sperm goes down. The process of manufacturing sperms happens over 3 months and happens in cycles. They are the smallest cells of the body. The composition of sperm is dependent upon, the food we eat, drinks we consume & health conditions, much before the issue of fertility treatment sets in.

Do you know, which factors affect the quality of sperm?

Diet we consume, Lifestyle choices of individuals (like smoking, alcohol, drugs etc.) Medical health conditions like obesity, diabetes, hypertension etc. Environmental factors (e.g. exposure to chemicals, toxins, heat) Recent illness (prior, during or after 3 months of treatment) which cause high fevers, Body Mass Index (BMI) Age Genetics

All these factors can have negative effects on sperm health due to hormonal imbalances in the testes and put additional stress on the body. The continuous process of production of these cells & recycling the same creates free radicals. In a limited manner, these free radicals protect the cells & human health. Excess of these free radicals, however, can cause damage to the sperms.

Science has understood the importance of a healthy lifestyle to minimize the overproduction of free radicals.

Poor health of sperms results in Poor fertilization, Poor development of embryos, birth defects, and miscarriages.

The very obvious question is how to improve sperm health.

1. By eating right with balanced, easy-to-digest food

2. Maintaining the Ideal body weight.

3. Keeping away from direct exposure to heat & Sedentary lifestyle.

4. Use of proven nutritional supplements like Zinc, selenium, magnesium-rich substances or fortified supplements

In a nutshell, sperm health is equally as important as female health; a healthy diet and lifestyle changes along with nutritional supplements are of great help in improving sperm health. However, these changes must be started at least three months before conception or fertility treatment.

These simple measures will ensure, that the best quality DNA is generated and passed on to the next generations to come.

As science is evolving & a lot of diagnostic tests are in place for early detection. Simple non-invasive blood tests can be of immense help in overcoming male infertility.

Pearl women’s hospital & Yash IVF has designed the screening & treatment protocol for Azoospermia & other causes of  Male infertility.  We have specially designed Guidelines for modern fertility  techniques like ICSI, IMSI, TESA, and PESA. 

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