Male Infertility

One third of all infertility cases have been linked solely to issues with the male partner. Male infertility is a condition where the male in a relationship affects the child bearing ability of the woman.

When couples are not able to conceive even after having unprotected sex over a long period of time, it is important that men get screened for fertility as well as women.

Male fertility may be impaired by a number of factors. These include:

  • Sperm production problems: The quality and quantity of sperm are the key factors to male fertility. Any defect such as immature sperm or low sperm count (oligospermia) can lead to infertility

  • Varicoceles: This is a condition characterised by swelling of the veins that supply the testicle

  • Backward ejaculation of semen

  • Blockage of the sperm carrying ducts

  • Development of sperm antibodies (auto-immune disorder)

  • Hormonal/stress problems

  • Infections/tumours of the male reproductive system

  • Genetics (chromosomal disorders)

  • Sexual problems

  • Use of certain medications such as steroids

  • Excessive radiation exposure affects the sperm production

  • Work related causes (e.g. laptop use elevates the temperature of the testes leading to low sperm production)

  • Smoking and alcohol abuse

A diagnosis is often made by your doctor based on the following:

  • Medical history

  • Complete physical examination

  • Semen analysis: This is a laboratory test carried out to assess the sperm count and quality. The test sample is obtained by ejaculating into a sterile bottle

  • Transrectal ultrasound of the prostate: It is an investigation carried out to evaluate the prostate gland and detect any obstruction of the ducts that transport the sperm

  • Scrotal ultrasound: This is an imaging test to diagnose abnormalities of the scrotum or testicles

  • Testicular biopsy: A small piece of tissue is removed from the testicle using a sterile needle and sent for evaluation under a microscope to help determine the cause of infertility

  • Ant-sperm antibody tests to trace the antibodies that attack sperm

With the advancements in medical technology, it is now possible to treat this condition. Treatment options include:

  • Surgery: Surgery is indicated in cases of varicocele and obstruction of the sperm duct to improve the sperm motion

  • Medications: Antibiotics are prescribed to treat infections of the reproductive system

  • Treatment for sexual problems: Counselling about sex and relationships can help boost fertility levels

  • Male hormone replacement therapy may be used to treat hormonal deficiency

  • Assisted Reproductive Technology (ART): These are revolutionary treatment procedures that can help couples with infertility problems to conceive. Some of them include in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) methods

  • Lifestyle modification: These include changing habits such as not smoking, limiting alcohol intake, and using stress reduction techniques

Dr Kokum