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Overview about Male Infertility
Infertility is more common than most couples perceive. In the present day, as many as one in seven couples trying to have a baby will have fertility-related issues. Studies suggest that by 2025, nearly 10 million couples will experience problems in achieving conception. Infertility affects an estimated 15% of couples globally, accounting for 48.5 million couples worldwide. Male infertility is found to be the sole reason for 20-30% of infertility cases and accounts for 50% of cases overall.
What is male infertility?
When a couple is unable to conceive after 1 year of unprotected sexual intercourse, it may be due to fertility issues. Infertility affects around 15-20% of couples in the reproductive age and may be caused by either male or female factors. Male infertility statistics show that it accounts for about 35% of all infertility cases. Couples facing trouble conceiving should be evaluated for male factor infertility along with female factors.
What causes male infertility?
There may be many different causes of male infertility such as:
- Low sperm count, motility or shape
- Injury to testicles
- Sexual disorders
- Varicocele (enlargement of veins in the scrotum)
- Chronic health conditions (eg: Diabetes, Hypertension etc)
- Previous infections
- Sexually transmitted diseases
- Genetic factors
- Stress
- Environmental factors
One of the most common causes of male infertility is related to problems with the sperm count and motility. Male partners exhibiting certain signs of male infertility are recommended to get evaluated at the earliest. Individuals can consult a male infertility specialist or an Andrologist regarding a proper diagnosis and further treatment for male infertility.
Symptoms of Male Infertility
Male infertility is as common as female infertility and many times goes unnoticed. It is important that individuals get evaluated by infertility specialists as ignoring the problem may have serious emotional and psychological implications.
The most common male infertility symptoms are ejaculation disorders which result in premature ejaculation or low semen volume. Other signs may be:
- Erectile Dysfunction
- Pain in the testicles may be caused due to testicular tension
- Very small and firm testicles
- Kallman’s Disease
- Varicocele
- Low sexual desire
Erectile dysfunction (ED) is a common sign of male infertility wherein the male partner had difficulty in maintaining an erection during intercourse. This may be due to neurological or psychological disorders.
Pain in the testicles may be caused due testicular tension, infection in the testicle, testicular hernia of hydrocoele
Small testicles may produce less testosterone and thus lead to a number of fertility problems. This is commonly seen in genetic conditions such as Klinefelter Syndrome.
It is a genetic disorder which leads to delay or absence of puberty in affected individuals
The enlargement of veins in the scrotum lead to a condition known as varicocele which affects about 15% of male individuals in the reproductive age and is a significant reason for male infertility.
Male partners who have low testosterone or other hormonal imbalances may experience low libido or sex drive.
Diagnosing Male Infertility
Couples facing infertility need to get evaluated at the earliest. Many times, the problems arise due to certain factors in both of the partners. Diagnosing male infertility requires a number of tests and checkup by fertility doctors.
Male fertility Tests:
- Semen Analysis
- Hormone testing
- Scrotal Ultrasound
- Transrectal Ultrasound
- Post-ejaculation Urinalysis
- Genetic test
Male partners may be asked to take a semen analysis test wherein the sperms are checked for quality, motility and structural abnormalities contributing to the infertility
Sperm counts may fluctuate during tests taken at different times. The individual may be asked to get tested a few times over a particular time duration to check for proper counts.
As in female partners, male partners may also be recommended to take tests to evaluate the hormone levels in the body. The elevation or reduction of different hormones also directly contributes to male infertility causes.
The ultrasound is routinely used as an infertility test for male partners wherein high frequency sound waves is used to image the scrotum to check for varicocele or other structural problems in the testicles
This ultrasound test uses sound waves to image the prostate and other tubes known to carry semen. This test uses a specialised ultrasound and is inserted in the rectum for the imaging
This test helps to check for sperms in the urine. The detection of the same in urine means that the sperm are travelling backwards towards the bladder instead of the penis and is also known as retrograde ejaculation.
Fertility tests for men also involve testing to determine the cause of absent and very low sperm count which could be attributed to certain genetic causes. Certain genes in the male individual’s body are responsible for formation and function of sperm and any change or mutation could cause sperm-related anomalies and subsequently infertility. Genetic testing such as karyotype or Y-chromosome microdeletion may be advised to detect such inherent conditions
Male Infertility Treatment
Treatment of male infertility is dependent upon the cause of the infertility problem identified in the male partner. Male infertility doctors may suggest a number of treatments such as:
- Treatment for sexual disorders
- Treatment for infections
- Hormone treatment and medication
- Surgery
- Assisted Reproductive Technology
Disorders such as erectile dysfunction and premature ejaculation can be treated with the proper medication.
Infections in the reproductive tract may contribute to some fertility problems. Antibiotics may be prescribed to such individuals.
When there is an elevation or reduction in levels of certain hormones, fertility specialists may prescribe certain hormone treatments which can help restore fertility.
Male infertility surgery is recommended for conditions such as varicoceles and obstructive vas deferens. Vasectomies done previously can also be reversed and in many cases absence of sperms in semen can be countered by extracting sperms directly from the testis or epididymis
ART procedures such as IVF (in-vitro fertilisation) and ICSI (intracytoplasmic sperm injection) can help couples conceive by directly fertilising a sperm with an ovum to form an embryo. This embryo is then transferred to the uterus of the female partner for implantation.
Risk factors of Male Infertility
There are various risk factors that are associated with male infertility:
- Smoking
- Use of alcohol
- Use of recreational drugs
- Prior infections
- Obesity
- Chronic health conditions
- Overheating of testicles
- Trauma to testicles
- Prior vasectomy or other abdominal surgery
- Undescended testicles
- Undergoing treatments for cancer such as chemotherapy and radiotherapy
- Family history of members with fertility problems
Myths around Male Infertility
- Infertility is a female problem
- Age doesn’t affect men’s reproductive health
Fact: When it comes to infertility and related problems, men are also considered to be responsible for failed conception or pregnancy. Going by the statistics, in around 20% infertility cases, men are solely held responsible because of defects in quantity or quality of sperm and other factors.
Fact: Like women, men’s age is also considered to be an important factor when couples start planning their parenthood. By the time men reach the age of 45 years or above, the quality of sperm begins to decline.
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