Father’s Day is here again and June is Men’s Health Month, so I want to share my 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.
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
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 disfunction, 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.
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 email@example.com and we can arrange a free phone consultation for you.
– Dr Corona
In Conversation with Dr. Juliet Skinner and Anna Hosford: The Story of How Barbados Fertility Centre (BFC) Began
A conversation with Dr. Juliet Skinner and Anna Hosford, co-founders of the JCI...