Definition of Male Infertility
About one out of every six couples who desire children has an infertility problem. This means that infertility is almost as common as diabetes in America. The most generalized definition of infertility may be said to be the inability to beget a child after a year of regular intercourse without any kind of contraception. It generally takes one year to consider a couple or either of the party infertile. Infertility can be a problem for both men and women.
Historically, infertility has been considered a women's disease. It is only within the last fifty years that the importance of the male factor contribution to infertility has been recognized. The mistaken notion that infertility is associated with impotence or decreased masculinity may contribute to this fear. The good news is that the rapid research advances in the area of male reproduction have brought about dramatic changes in the ability to both diagnose and treat male infertility. The majority of couples suffering from infertility can now be helped to conceive a child on their own.
Male infertility is quite common these days and may be caused due to various reasons. When a man is investigated for infertility, his semen is taken as sample and sent to the pathological laboratory for medical tests. It takes a few days to bring about the result of the test. Male infertility is detected from the sperm count. If a man’s sperm count is less than twenty million per milliliter then he is considered to be at a risk of being infertile, on the other hand and if a man’s sperm count is less than five million per milliliter then he is considered to be sterile.
Symptoms of Male Infertility
The most important symptom of male infertility is that if the female partner is unable to conceive even after regular intercourse for a whole year without using any contraception. If a couple discovers that they are unable to conceive even after a whole year of regular intercourse, they must consider checking up with a medical practitioner. Men are tested on their sperm count. A low sperm count can be a serious symptom for male infertility.
Some other major symptoms which can lead to testifying for male infertility are a decrease in sperm motility and the abnormal shape of the sperm. Statistics show that forty percent of those couples who face infertility problems suffer from these symptoms. When the sample of men’s semen is sent to the laboratory for infertility test, the volume, quality and consistency of the semen is also checked along with the sperm count. Some of the common symptoms which are tested while investigating for male infertility are:
- Any childhood problem or problems occurring while growing up
- Serious illness like cancer, respiratory diseases, diabetes or some surgeries
- Previous fertility event, if any
- If the person has suffered from sexually transmitted disease
- Sexual history
- Timing of sexual intercourse
- Frequency of sexual intercourse
- Exposure to any kind of toxins like radiation or chemicals
- If the person has suffered from allergies from medication
- If there is a hereditary problem of sterility
All these factors contribute to being serious symptoms of male infertility. Men who are investigated for infertility may have one or more of these symptoms present in them.
Causes of Male Infertility
While we generally consider the low sperm count in a man’s semen to be the most important cause of male infertility. The most common identifiable cause of infertility in men is varicocele. This is a condition of enlarged veins in the scrotum that causes abnormalities in the temperature regulation of the testis. Enzymes that are responsible for both sperm and hormone (testosterone) production have an optimal temperature at which they operate most effectively. If this temperature is elevated by even one degree, sperm and testosterone production are adversely effected.
There may be a number of other factors which can be equally responsible for male infertility. Some such factors which pose a big threat to male infertility are:
- Varicoceles – Varicoceles are the dilated veins which are found in the scrotum. Since the blood does not get drained from these veins, they are dilated. And as a matter of fact these dilated veins permit blood to settle in the scrotum and thus it has a negative effect on the sperm production leading to male infertility.
- Problems in the Ductal system – Sometimes it happens that the duct which carries the sperm gets blocked or is even found missing. A man may also be born with bilateral congenital with the nonexistence of vas deferens.
- Abnormalities in seminal fluid – Sometimes it is found that the seminal fluid in a man is very thick. This condition restricts the sperms to move easily through this fluid and reach the woman’s reproductive tract.
- Immunologic Infertility – Sometimes men develop antibodies or immunologic response within their sperm. Some of the basic causes behind this abnormality include testicular infection, testicular trauma, testicular surgery and large varicoceles. This immunologic response is an important cause for male infertility.
- Testicular Failure – When the sperm producing part of the testicles becomes unable to produce mature sperms in sufficient numbers then it is called a testicle failure in male infertility. Testicular failure may occur due to various reasons and at any stage of sperm production.
- Facing difficulties in erection and ejaculation – A major reason for male infertility can be caused due to erectile problem and premature ejaculation. The patient who is facing problems like obtaining and holding on to erection, lack of ejaculation, premature ejaculation, retrograde and excessive masturbation may be investigated for sterility.
- Cryptorchidism – This is a physiological disorder which occurs when a male baby is born without the testicles. Since the testicles are quite sensitive to temperature, then they may quit producing sperm, if they do not move down into the scrotum before adolescence. And the fact remains that they have a very high rate of malignancy.
- Hormonal imbalance – The pituitary gland needs to get stimulated properly so that the testicles can produce adequate number of sperms. If somehow this hormonal secretion is decreased or absent in a man then it may cause male infertility.
Risk Factors of Male Infertility
Many factors, both environmental and biological, can be risk factors for male infertility. Physiological conditions, lifestyle factors and some diseases can cause infertility in men. Some causes are temporary and can be reversed and treated; others are permanent.
Some risk factors for male infertility include:
- Age - Studies show that men older than 35 may begin a gradual decline in fertility.
- Drugs - Drug abuse causes a drop in fertility.
- Smoking - Studies show that when men quit smoking tobacco their fertility improves.
- Alcohol - Heavy alcohol use can cause a drop in testosterone levels, can cause erectile dysfunction, decrease sperm production and affect fertility.
- Weight - Being extremely overweight or underweight can cause a drop in sperm count, resulting in infertility.
- Pollution, Radiation and Exposure to Toxins - An exposure to heavy metals, industrial chemicals, radioactivity and other dangerous toxins can cause infertility.
- Disease - Men with diabetes, cancer, cystic fibrosis, sickle cell anemia, sexually transmitted disease and other diseases may suffer infertility.
Conventional Treatments of Male Infertility
The conventional medical treatments for male infertility include drug therapy as well as surgery. However if the person is facing a problem of low sperm count or lack of sperm count in his semen then he is treated with artificial insemination and in-vitro fertilization. Sometimes treatments like gamete intra-fallopian or intrauterine insemination is done to make the partner pregnant.
Treatment of male infertility is difficult and sometimes frustrating. Immediate results are hard to produce and persistence with therapy is required.
The following modalities of treatment are generally employed.
- Medical treatment - This consists of the administration of certain drugs to improve seminal quality. Clomiphene citrate, mesterolone, tamoxifen, gonadotropin injections, antibiotics, steroids etc. are commonly used.
- Surgical treatment - Microsurgery in progressObstructions in the sperm conduction pathway, varicoceles, undescended testes etc. can be treated by operation. Modern microsurgical techniques are of great help. 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 cases, neither medicines nor operations are of help. 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. This includes sperm washing/capacitation, intra-uterine insemination (IUI), gamete intra-fallopian transfer (GIFT), in vitro fertilisation (IVF), and micro-manipulation (ICSI).
Despite the availability of so many treatment modalities, some patients remain incurable and no treatment, cheap or expensive, can improve their fertility prospects. One then has no alternative but to recommend an AID (donor insemination) or adoption.
Patients Medical’s Treatment of Male Infertility
At Patientsmedical male infertility is treatable; we try to understand the exact nature of the problem, whereby tests are done in order to make a correct diagnosis after which our expert team of holistic healers will prescribe the mode of treatment best suited for you.
The first test in the evaluation of the infertile male is the semen analysis. This test is inexpensive, easy to perform and gives valuable information.
- A perfectly normal semen analysis report generally precludes a significant male factor component and investigation and treatment should be more appropriately targeted at the wife. In fact, in many countries, the first test in the evaluation of an infertile couple is the semen analysis. This is generally performed before any tests are conducted on the wife.
- Often, in the case of male infertility, the semen analysis is abnormal. Either the count is low (oligospermia) or sperms are altogether absent in the ejaculate (azoospermia).
- Sometimes, sperm motility is seriously affected (asthenospermia) and sometimes the sperms are totally immobile or dead (necrospermia). There are many other anomalies that one may find on semen analysis.
When one finds anomalies in the semen analysis, the next step is to try and find a cause for it. To do this, one must perform additional investigations. Some of the other tests that may need to be performed are a semen culture, anti-sperm antibody estimation, scrotal ultrasound, hormonal assays, karyotyping, vasography etc.
When a holistic approach is taken in the evaluation of the case at hand in conjunction with a systemic approach to evaluation and functional diagnosis, these subtle etiologies become evident and can be addressed appropriately with botanical and nutritional medicine.
Most importantly, our holistic practitioners review the case as a totality, not simply a reproductive issue. Infertility is much more than just a female- and male-reproductive systems issue; it’s a whole-health concern.
Fertility challenges should be seen as an opportunity for couples to engage in an active naturopathic treatment plan to improve their overall health, allowing their bodies to produce vital, healthy DNA for reproduction. It is often overlooked that when the DNA of the sperm and ova combine at conception, the health of the child has been genetically determined at this point in time.
Couples should be encouraged to participate in a period of preconception care, in which their overall health can be improved with the use of herbs, nutrition, and dietary and lifestyle modifications. This way, not only will they improve their chances of natural conception, but they also will be more likely to have a healthy, complication-free pregnancy and a healthy child.
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