Treatment Options - Male Infertility

Male infertility is mainly due to factors such as low sperm production, abnormal sperm function or blockages that prevent the delivery of sperm. Illnesses, injuries, chronic health problems, lifestyle choices and other factors play a role in cause of male infertility factors.

Symptoms

The main sign of male infertility is the prolonged inability to conceive a child. In some cases, however, underlying problems such as an inherited disorders, hormonal imbalances, dilated veins around the testicles, or conditions that blocks the passage of sperm are causes signs and symptoms of male infertility factor.

Although most men with male infertility do not notice symptoms other than inability to conceive a child, signs and symptoms associated with male infertility include:

  • Problems with sexual functionslike difficulty with ejaculation or small volumes of fluid ejaculated, reduced sexual desire or difficulty in maintaining an erection (erectile dysfunction)
  • Pain, swelling or a lump in the testicle area
  • Recurrent respiratory infections
  • Abnormal growth of breast (gynecomastia)
  • Decreased facial or body hair or other such signs of a chromosomal or hormonal abnormality
  • Having a lower than normal sperm count

Causes

Male fertility is a complex process.
For a female to get pregnant a male must be able to:

Produce Healthy Sperm

In initial stages, this involves the growth and formation of the male reproductive organs during puberty stage. One of your testicles must be functioning correctly, and your body should produce testosterone and other hormones to trigger and maintain sperm production.

Sperm has to be carried into the semen

Once sperms are produced in testicles, delicate tubes transport them until they mix with semen and are ejaculated out of penis.

There needs to be enough sperm in the semen

If the count of sperm in your semen (ideally known as sperm count) is low, it decreases the odds of fertilization offemale’s egg. A low sperm count is a count lower than 15 million sperms per milliliter of semen or lower than 39 million per ejaculate.

Sperm Motility or ability of sperm to move

If the movement (motility) or function of your sperm is abnormal, the sperm may not be able to reach or penetrate your partner’s egg.

Medical causes

Problems in male fertility are caused by a number of health issues and medical treatments. Some of these include:

Varicocele

A varicocele is a swelling of the veins that drain the testicles. It’s the most common reversible cause of male infertility. Although the exact reason for that varicoceles causes infertility is unknown, it may be related to abnormal regulation of testicular temperature. Varicocelesdeplete the quality of the sperm.

Treating the varicocele can improve sperm quantity and quality, and drastically improves outcomes when using ART techniques such as IVF.

Infection

Some infections interfere with sperm production or sperm health or can cause scars that block the passage of sperm. These include inflammation of the epididymis (epididymitis) or testicles (orchitis) and some sexually transmitted infections, including Gonorrhea or HIV. Although certain infections result in permanent testicular damage, most often sperms can still be retrieved.

Ejaculation issues

Retrograde ejaculation occurs when semen enters the bladder during orgasm instead of emerging out the tip of the penis. Various health conditions can cause retrograde ejaculation, including diabetes, spinal injuries, medications, and surgery of the bladder, prostate or urethra.

Some men with spinal cord injuries or certain diseases can’t ejaculate semen, even though they still produce sperm. Often in these cases sperm can still be retrieved for use in ART techniques.

Antibodies that attack sperm

Anti-sperm antibodies are immune system cells that mistakenly identify sperm as harmful invaders and try to eliminate them.

Tumors

Cancers and non-malignant tumors affect male reproductive organs directly, through the glands that release hormones related to reproduction, such as the pituitary gland, or through unknown causes. In cases, treatments such as surgery, radiation or chemotherapy to treat tumors can affect male fertility.

Undescended testicles

In some male’s, during fetal development one or both testicles fail to descend from the abdomen into the sac that normally contains the testicles (scrotum). Occurrence of Male Infertility Factor is more likely in men who have had this condition.

Hormone imbalances

Infertility can result from disorders of the testicles themselves or an abnormality affecting other hormone systems including the hypothalamus, pituitary, thyroid and adrenal glands. Low testosterone levels and other hormonal problems have a number of possible underlying causes in Male Infertility Factor.

Defects of tubules that transport sperm

Sperm travels through many different miniscule tubes. These can be blocked due to various causes, including resulting injury from a surgery, prior infections, trauma or abnormal development, such as with cystic fibrosis or similar inherited conditions.

Such blockages occur at any level, including within the testicles, in the tubes that drain the testicles, in the epididymis, in the vas deferens, near the ejaculatory ducts or in the urethra.

Chromosome defects

Disorders such as Klinefelter’s syndrome — in which a male is born with two X chromosomes and one Y chromosome (instead of one X and one Y) — cause abnormal development of the male reproductive organs. Other genetic syndromes associated with infertility include cystic fibrosis, Kallmann’s syndrome and Kartagener’s syndrome.

Problems with sexual intercourse

These include trouble keeping or maintaining an erection during sex (erectile dysfunction), premature ejaculation, pain during intercourse, anatomical abnormalities such as having a urethral opening beneath the penis (hypospadias), or psychological or relationship problems that interfere with sex.

Celiac disease

A digestive disorder caused by sensitivity to gluten, celiac disease can be a cause of male infertility factor. In such cases, fertility improves after adopting a gluten-free diet.

Certain medications

Testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), certain antifungal medications, some ulcer drugs and certain other medications can harm sperm production and hence causes decreased male fertility.

Prior surgeries

Certain surgeries may prevent you from having sperm in your ejaculate, including vasectomy, inguinal hernia repairs, scrotal or testicular surgeries, prostate surgeries, and large abdominal surgeries performed for testicular and rectal cancers, among others. In most cases, surgery can be performed to either reverse these blockage or to retrieve sperm directly from the epididymis and testicles.

Overexposure to environmental elements such as heat, toxins and chemicals can also cause reduces sperm production or decreased sperm function. Specific causes include:

  • Exposure to Industrial chemicals such as benzenes, toluene, xylene, pesticides, herbicides, organic solvents, painting materials and lead may contribute to low sperm counts.
  • Exposure to lead or other heavy metals also may cause infertility.
  • Prolonged Exposure to radiation can cause reduced sperm production, though it will often eventually return to normal. Prolonged radiation in high doses,can cause sperm production to be permanently reduced.
  • Overheating in the testicle area or increasedtemperatures adversely impact sperm production and function. Sitting for long periods, wearing tight clothing or working on a laptop computer for long stretches of time also may increase the temperature in your scrotum and may slightly reduce sperm production.

Health, lifestyle and other causes

Some other causes of male infertility include:

  • Steroids used to stimulate muscle strength and growth can cause the testicles to shrink and sperm production to decrease.
  • Use of cocaine or marijuana may temporarily reduce the number and quality of your sperm as well.
  • Drinking alcohol can lower testosterone levels, cause erectile dysfunction and decrease sperm production. Liver disease caused by excessive drinking also may lead to fertility problems.
  • Men who smoke have a lower sperm count than do those who don't smoke.
  • Stress interferes with certain hormones needed to produce sperm. Severe or prolonged emotional stress, including problems with fertility, affects your sperm count.
  • Obesity impairs fertility in several ways, including a direct impact on sperm themselves as well as by causing hormonal changes that causes reduction in male fertility.

Certain occupations including welding or those involving prolonged sitting, such as truck driving, may be associated with a risk of infertility. However, the research to support these links is mixed.

Major Risk factors to watch for Male Infertility Factor

  • Smoking
  • Alcohol or Tobacco Consumption
  • Consumption of certain illicit drugs
  • Obesity
  • Prolonged history of infection or frequent occurances
  • Exposure to toxins
  • Overheating in the testicle area
  • Having experienced trauma around the testicles
  • Having a prior vasectomy or major abdominal or pelvic surgery
  • History of undescended testicles
  • Born with a fertility disorder or having a blood relative with a fertility disorder
  • Having medical conditions, including tumors and chronic illnesses, such as sickle cell disease
  • Consuming certain medications or undergoing medical treatments, such as surgery or radiation used for treating cancer.

Prevention

Many underlying causes of male infertility aren’t preventable. However, one can avoid some known causes of male infertility such as:

  • Don't smoke.
  • Limit or abstain from alcohol.
  • Steer clear of illicit drugs.
  • Keep the weight off.
  • Don't get a vasectomy.
  • Avoid things that lead to prolonged heat for the testicles.
  • Reduce stress.
  • Avoid exposure to pesticides, heavy metals and other toxins