Male Infertility

Introduction

Male infertility

India, the second largest populated country in world, is also suffering from a high rise of male infertility rate. One would imagine that in country like India, which already has a population in excess of 980 million, child-bearing should be an effortless endeavour for human beings. This, however, is not true. The figure of prevalence of infertility is quite shocking if we measure it parallel to the growth of rising population. Approximately 15-20 percent of all cohabiting couples are infertile. Of these, in up to 50 percent of cases it is the male factor or the husband who is responsible for the infertility.

To give birth to a child, both the male and the female have to be healthy and fertile. Unfortunately, due to may be lack of education, it is the women who are always blamed for not being able to conceive. For women it is the xx chromosome and for male it is xy chromosome, so, that makes the male responsible for the birth of either a male or a female. This aspect of conception is rarely known to people. Genetic defects of the Y chromosome often lead to male infertility in

 India.

Difference between Infertility and Impotent

There is a huge difference between Infertility and impotency. Failure to distinguish between the two may lead to social embarrassment

Male infertility refers to the inability of a male to make a fertile female pregnant. It is usually due to semen deficiencies. Most infertile men are perfectly normal in terms of potency and have very satisfactory sexual relations with their partners.On the other hand, Impotence means an inability to attain or sustain erections for satisfactory sexual intercourse. It is thus possible for a totally impotent man to be potentially fertile and it will be possible for him to produce pregnancy in his wife by insemination of his semen.

Causes

Male infertility Causes

Fertility reflects a man’s overall health. Men who live an unhealthy lifestyle are more likely to produce unhealthy sperm. Certain problems which cause male infertility are highlighted below:






Hormonal problems:

Sometimes hormonal imbalance targets infertility in men. The hypothalamus-pituitary endocrine system regulates the chain of hormonal events that enables testes to produce and effectively disseminate sperm. Certain things can go wrong with it, like-

  • Failure in releasing gonadotropin hormone (GnRH) properly. It stimulates the hormonal pathway that causes testosterone synthesis and sperm production.  A disruption in GnRH release leads to a lack of testosterone and a cessation in sperm production
  • The pituitary can fail to produce enough luteinizing hormone (LH) and follicle stimulating hormone (FSH). These are the intermediates in the hormonal pathway responsible for testosterone and sperm production.
  • A male may produce other hormones and chemical compounds which interfere with the sex-hormone balance.

Following are the list of hormonal disorders which can trigger male infertility:

  • Hyperprolactinemia

    greater production of this hormone reduces sperm production, libido and may cause impotency.
  • Hypothyroidism

    This is a rare condition where infertility is caused due to high intake of iodine. Low thyroid hormone levels--can cause poor semen quality, poor testicular function and may disturb libido.
  • Panhypopituitafism

    It occurs due to complete failure of pituitary gland.

Physical problems:

There are many physical problems that may cause infertility in men. These problems either interfere with the sperm production process or disrupt the pathway down which sperm travel from the testes to the tip of the penis. It is usually characterized by a low sperm count and/or abnormal sperm morphology.

  • Variocoele

    A varicocele is an enlargement of the internal spermatic veins that drain blood from the testicle to the abdomen (back to the heart
  • Damaged Sperm Ducts

    It is a situation where the male cannot transport sperm from their testicles to out of their penis.
  • Torsion

    It is caused by a supportive tissue abnormality which allows the testes to twist inside the scrotum which is characterized by extreme swelling.
  • Infection and diseases

    A low sperm count and low sperm motility are indicators of this condition.
  • Klinefelter’s Syndrome

    An additional X chromosome in the human body- men with Klinefelter’s Syndrome has one Y and two X, causes problem in fertility.
  • Retrograde Ejaculation

    Is a condition in which semen is ejaculated into the bladder rather than out through the urethra because the bladder sphincter does not close during ejaculation

Psychological problems:

Some of the reasons for male infertility treatment relates to psychological problems as well.

  • Erectile Disfunction (ED)

    It is the result of a single, or more commonly a combination of multiple factors. Before it was treated as a psychological problem but new researchers have found out that it is organic in nature. Most men who suffer from ED have a secondary psychological problem that can worsen the situation like performance anxiety, guilt, and low self-esteem. Many of the common causes of impotence include:  diabetes, high blood pressure, heart and vascular disease, stress, hormone problems, pelvic surgery, trauma etc.
  • Premature Ejaculation

    It is an inability to control ejaculatory response for at least thirty seconds following penetration. It may become a fertility problem as the man ejaculates before completing the penetration process.
  • Ejaculatory Incompetence

    This rare psychological condition prevents men from ejaculating during sexual intercourse even though they can ejaculate normally through masturbation.

Other Common Problems

Male infertility treatment
  • Tobacco smoking and heavy drinking
  • Prolonged use of marijuana and other recreational drugs
  • Chronic alcohol abuse
  • Anabolic steroid use--causes testicular shrinkage and infertility
  • Overly intense exercise
  • Inadequate diet
  • Tight underwear--increases scrotal temperature which results in decreased sperm production
  • Exposure to environmental hazards and toxins such as pesticides, lead, paint, radiation, radioactive substances, mercury,  benzene, boron, and heavy metals
  • Malnutrition and anemia

Diagnosis

Male infertility treatment

The diagnosis of infertility begins with a medical history and physical exam by a physician, preferably a specialist with experience or who specializes in male infertility. Typically two separate semen analyses will be required. The provider may order blood tests to look for hormone imbalances, medical conditions, or genetic issues. If a couple has been trying to get pregnant without success, they should go to their local doctor, family planning or women’s health clinic where initial tests can be performed. Both partners should be tested, even if one has already had a child in another relationship. Sometimes genetic investigations and testicular biopsies are also done.

Types of Treatment

Male infertility

Treatment

Despite medicine’s limited ability to treat male infertility, many successful treatment options are available for its many Male infertility causes. Sometimes it may be frustrating for the male to go through such operations and treatment because the result is not reflected immediately. A lot of persistence is required to undergo such treatments. Some of it are listed below:

  • Medical Treatment

    Intake of certain medicines and drugs may improve the seminal quality. Clomiphene citrate, mesterolone, tamoxifen, gonadotropin injections, antibiotics, steroids etc. are commonly used.
  • Surgical Treatment

    Surgical treatment eliminates the obstructions in the sperm conduction pathway, varicoceles, undescended testes etc. Due to the advancement of the technologies, even patients who have undergone a vasectomy in the past can have their vasectomy reversed and the tubes recanalised successfully using microsurgery.
  • Assisted Reproduction

    In many unfortunate cases, neither operation nor medical treatment helps the patient. In such cases, an attempt is made in the reproductive laboratory to improve semen quality and facilitate the penetration of the sperm into the ovum.

Fertility problem is faced by both male and female. Awareness about this problem may help couples and individuals to get it cured before it gets chronic and lead a normal, fertile and happy life.