Male Infertility

What is male infertility?

When a husband cannot impregnate his female partner even though they are having unprotected intercourse for a year or more, it is referred to as male infertility. However, several tests and bodily examinations are conducted in order to establish the fact whether or not a person is having fertility issues.

What are the symptoms of male infertility?

In India almost 4 out of 10 cases of infertility are due to male fertility issues. Following are some situations which indicate there might be existence of fertility problems:

1. Problems in sexual intercourse:
   • Erectile dysfunction: When a person is facing problem in having or maintaining erection during intercourse.
   • Ejaculation difficulties: Dry ejaculation or very low amount of ejaculation fluid during climax.
   • Decreased sexual desire or low sex drive.
2. Pain in testicles or testicular sac.
3. Swelling or lump around testicle area.
4. Hormonal Problems.
5. Hypogonadism.
6. Ejaculatory Duct Obstruction
7. MAGI - Male Accessory Gland Infection
8. Drugs
9. Steroid supplements
10. Varicocele

What causes male infertility?

There can be no conclusive list of factors that cause male infertility, but we can certainly underline numerous situations which may lead to male infertility:

• Metallic exposure: If a person is more exposed to heavy toxic metals like lead, mercury, cadmium, etc. the risk of become infertile increases.
• Heavy radiations: Radiation from x-rays, prolonged radio therapy might cause harm to the fertility hormones and cells.
• Dreadful chemicals: Increased usage of pesticides and other harmful chemicals may impair your fertility capabilities.
• Heating of testicles or testicular sac: Not just the increased temperature of your surroundings but sitting into same position for long hours, wearing body fitted clothes, frequent usage of sauna/ hot tub can heat up your testes area.
• Obesity: Being overweight can impact your fertility heath.
• Alcohol: Regular heavy consumption of alcohol can injure your sexual health.
• Drugs: Addiction of drugs like cocaine, marijuana, etc is highly probable to cause fertility complications.
• Smoking and tobacco: Continued consumption of cigarettes, cigars, tobacco and other harmful smoking contents are injurious to fertility health.

What are the sperm disorders that one might face if they have male infertility?

A person having male infertility may suffer from any or all of the following hardships:

1. Lower sperm count: According to medical science an ideal sperm count is 15 million sperms per millilitre of semen or39 million sperms per ejaculation, however a person having male infertility might have lower amount of sperm discharge, which decreases the probability of sperms being able to fertilize the egg.
2. Morphography of sperm: Your body must secrete appropriate amount of testosterone and other sex hormones in order to ensure production of healthy sperms. Low quality sperms which do not have proper structure will not be able to impregnate the female partner.
3. Motolity of sperm: If the sperm is unable to move or function in the desired pattern, it will not be able to pass through fallopian tubes so as to fertilize the egg.
4. Ejaculation of sperm: Even if the morphography (structure), motility (movement) of sperm is adequate it is of no use until it is discharged through penis into the vagina. Problems like dry ejaculation or retrograde ejaculation can be responsible for male infertility.

Before we get into depth of medical conditions of male infertile patients let us understand meaning of a few important terms which will enhance your ability to grasp this concept even better:

• Epididymis and vas deferens: These are thin tubes which are responsible for transportation of sperm to the ejaculatory duct (in the penis) once it gets produced in the testicles.
• Azoospermia: Inability to make sperms at all.
• Oligospermia: Production of sperm in a very low quantity.
• Vasectomy: A surgical procedure to cut the vas deferens so that sperm cannot reach the ejaculatory duct.

What are the possible medical situations responsible for male infertility?

1. Varicoceles: When the veins around scrotum become swollen, twisted or have a lump like structure, it can obstruct the blood flow into testes which causes the testicles to heat up and produce low amount of sperm.
2. Immune system dysfunction: There might be a situation where the body starts producing anti bodies against the sperms, due to which they detect sperms as intruders and ends up killing them.
3. Blockage: Many a times the veins/ tubes through which sperm flows are blocked due to which it cannot reach to the desired place.
4. Hormonal imbalance: Secretion of low testosterone or low follicle stimulating hormone (FSH) or high prolactin can disrupt the sperm production ability.
5. Genital infections: Infection in epididymis, scrotum, etc may lead to presence of too many white blood cells in seminal fluid which are damaging the sperm’s ability to fertilize the egg.
6. Retrograde ejaculation: Under this condition the semen flows back into the bladder instead of ejaculating through penis.
7. Genetic disorder: Male infertility can sometimes be inherited from the parents.
8. Chromosomes: Existence of Klinefelter syndrome wherein sometimes extra or may be microdeletion of Y chromosome is noticed. There are many other chromosome defects causing harm to the sperm.
9. Past surgeries: If a person has had any testes or prostate surgery, they are more exposed to the risk of infertility.
10. Medication: People who suffer from:
    • Spinal cord injury
    • High blood pressure
    • Depression or anxiety issues
    • Arthritis
    • Cancer; are given medications and treatments which might affect the sperm generation, ejaculation process.

What are the procedures to diagnose male infertility?

1. Blood test: Conducted to determine various hormone levels which impact sperm production and transportation.
2. Physical examination: To diagnose situations like erectile dysfunction, etc.
3. Semen test: To identify the sperm disorders, be it related to morphology or mobility or low quantity of sperm.
4. Hormonal Assay: the doctor would prescribe various hormonal tests to identify whether the hormones functions are at normal level or not.
5. Transrectal ultrasound: A medical practitioner inserts a probe (a medical instrument) in the rectum, wherein using the sound waves he verifies whether the ejaculatory ducts are properly formed and are unblocked.
6. Testicular biopsy/FNAC: This is a surgical procedure where by using a needle a small part of tissue is retrieved from each testicle and used to make critical analysis under microscope.