Male infertility is very common, affecting about one in twenty men.

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Male Infertility

Barbados Fertility Center specializes in Male Infertility with up to 90% of cases that we see requiring ICSI. Male infertility is very common, affecting about one in twenty men. Male factor is present in almost half of all infertile couples and about one third of all IVF procedures are performed for male factor infertility. For most men the discovery that they are infertile comes as a total surprise.

It must be remembered that the testis have two distinct roles.

The first is to produce the male sex hormone, testosterone, which is important for providing sex drive, erections, strong muscles and basically giving a man a general feeling of well being. All these things can be described as virility.

The second function of the testis is to produce millions of sperm everyday, a process that occurs inside each testis. For most infertile men it is only this process that is at fault and a reduced number or poor quality of sperm are produced.

Most infertile men produce low numbers of sperm, which may also show both poor swimming ability (called motility) and be abnormally shaped (morphology). In such men, only a small number of normally shaped motile sperm are likely to swim up the woman’s fallopian tube into the vicinity of the egg and even then may be unable to fertilise the egg.

Why does this problem develop? We now believe that most cases are genetic. In other words, these men are born without the genetic information that would allow sperm production to occur normally. No treatment for men to improve sperm counts is likely to become available. IVF techniques offer hope though, as they require fewer normal sperm than nature.

In the remaining one third of infertile men, we can find a likely cause for their infertility including:

Obstruction to the passage of sperm from the back of the testis to the outside can result from blockage or absence of the vas deferens. Common causes include, obviously, vasectomy, but any history of injury, and other surgery or sexually transmitted disease may be important.
Men produce antibodies in their sperm following vasectomy or other trauma or infection. These antibodies are a common cause of infertility and prevent sperm swimming or sticking to the egg. Such antibodies can only be found using a special test on fresh sperm and are available Barbados Fertility Center.
The testis can be damaged by a wide number of treatments including chemotherapy or repeated X-Ray therapy.
Some men have difficulties obtaining an erection, or ejaculating due to a wide range of problems such as diabetes, MS, or previous prostate surgery. In these cases sperm can be found and used for IVF.
Rarely, a deficiency in the brain pituitary hormones may result in low sperm counts. Its detection is important as it is readily treated with hormone injections.

Finally studies have shown that sperm counts have declined worldwide. The alleged change is quite small (about 15%) and no cause has been confidently identified, however it is believed to be an environmental factor.

In conclusion while the causes of infertility are uncertain in many men, certain conditions can be identified and treated. Given these facts, it is essential that all men suffering with infertility undergo extensive tests to determine the cause and the best course of treatment.

June 13, 2022

Barbados Fertility
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Father’s Day is here again and June is Men’s Health Month, so we wanted to share knowledge about male infertility and help you to not only cope with it but also fight it!

Epidemiology and definition
Approximately 15 % of couples are infertile. This means they aren’t able to conceive a child even though they’ve had frequent, unprotected sexual intercourse for a year or longer. In about half of these couples, male infertility plays a role.

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

Not being able to conceive a child can be stressful and frustrating, but a number of male infertility treatments are available.

A little help with medical terms:
Oligospermia: low number of spermatozoa in the ejaculate
Asthenospermia: low motility of spermatozoa in the ejaculate
Teratospermia: high abnormal morphology of spermatozoa in the ejaculate

If all these issues are present at the same time, we call it Oligo-Astheno-Teratospermia.

Azoospermia: absence of spermatozoa in the ejaculate.

Approximately 20 % of these men have Obstructive Azoospermia (OA). Their testes produce sperm but a blockage or absence of either the vas deferens or the epididymal tubules prevents the transport of sperm and an adequate sperm. The remaining 80% of our azoospermic patients have Non-Obstructive Azoospermia (NOA). Their vas deferens and tubules are clear and open, but the ability of their testes to produce sperm is impaired.

Symptoms
The main sign of male infertility is the inability to conceive a child. There may be no other obvious signs or symptoms. In some cases, however, an underlying problem such as an inherited disorder, hormonal imbalance, dilated veins around the testicle, or a condition that blocks the passage of sperm may cause male infertility.

When to see a doctor

See a doctor if you:
– Are unable to conceive a child after a year of regular, unprotected sexual intercourse
– Have erection or ejaculation problems, low sex drive, or other problems with sexual function
– Have pain, discomfort, a lump or swelling in the testicle area
– Have a history of testicle, prostate or sexual problems
– Have had groin, testicle, penis or scrotum surgery

Causes
Problems with male fertility can be caused by a number of health issues and medical treatments. Some of these include: varicocoele, infection, ejaculation issues, antibodies that attack sperm, tumours, undescendent testicles, hormone imbalance, sperm duct defects, genetic defects, sexual dysfunction, certain medications, prior surgeries etc.

Overexposure to certain environmental elements such as heat, toxins and chemicals can reduce sperm production or sperm function.

Health and lifestyle can also cause infertility or affect quality and count of spermatocytes as use of anabolic steroids, cocaine or marijuana, alcohol abuse, tobacco smoking, emotional stresses, obesity, prolonged bicycling etc

Test and diagnosis
Many infertile couples have more than one cause of infertility, so it’s likely you will both need to see a doctor. It may take a number of tests to determine the cause of infertility. In some cases, a cause is never identified. Infertility tests can be expensive and may not be covered by insurance — find out what your medical plan covers ahead of time.

Diagnosing male infertility problems usually involves: General physical examination and medical history and semen analysis.

Your doctor may recommend additional tests to help identify the cause of your infertility. These can include scrotal and/or transrectal ultrasound, Hormone testing, post-ejaculation urinalysis, genetic tests, testicular biopsy, specialized sperm function tests, etc.

Treatments and drugs
Your doctor will try to improve your fertility by either correcting an underlying problem (if one is found) or trying treatments that seem like they may be helpful. Often, an exact cause of infertility can’t be identified. Even if an exact cause isn’t clear, your doctor may be able to recommend treatments that work. In many cases of infertility, the female partner also will need to be checked and may need treatment.

Treatments for male infertility include surgery, surgical retrieval of sperm, treating infections, treatments of sexual dysfunction, hormone treatments and assisted reproductive tecniques (ART) as ICSI.

Until recently, men with Non Obstructive Azoospermia (NOA) were considered “sterile”, and donor sperm insemination or adoption recommended as the only means of having a family. Several observations have changed the approach to this condition. Direct evaluation of testis biopsy specimens often demonstrates sperm in men with non-obstructive azoospermia, but not at high enough levels to yield sperm in the ejaculate. With advances in sperm retrieval techniques, sperm can be found in more than half of men with NOA.

Microdissection testicular sperm retrieval is a cutting edge procedure for male infertility and probably the most important advance in treatment of NOA offering new hope.

Alternative medicine
Evidence is still limited on whether — or how much — herbs or supplements might help increase male fertility. Some supplements may help only if you have a deficiency.

Supplements with studies showing potential benefits on improving sperm count or quality include: Alpha-lipoic acid, Anthocyanins, L-arginine, Astaxanthin, Beta-carotene, Biotin, L-acetyl carnitine, Cobalamin, Co-enzyme Q10, Ethylcysteine, Folic acid, Glutathione, Inositol, Lycopene, Magnesium, N-acetyl cysteine, Pentoxyfylline, Polyunsaturated fatty acids, Selenium, Vitamins A, C, D, and E, Zinc.

Talk with your doctor before taking dietary supplements to review the risks and benefits of this therapy, as some supplements taken in high doses (mega doses) or for extended periods of time may be harmful.

Coping and support
Coping with infertility can be difficult. It’s an issue of the unknown — you can’t predict how long it will last or what the outcome will be. Infertility isn’t necessarily solved with hard work. The emotional burden on a couple is considerable, and plans for coping can help.

Managing emotional stress during treatment may be very useful like practicing stress-reduction techniques (i.e. acupuncture, yoga, meditation and massage therapy), consider going to counselling, express yourself and stay in touch with loved ones.

If you suffering with male infertility and need more information, then you will find this link helpful or you can email your questions to contact@barbadosivf.com and we can arrange a free phone consultation for you.