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Everything About Male Infertility: Causes, Treatment & Diagnosis

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Stress, alcohol and smoking add to male infertility issues.
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With so much focus and burden of stress on female infertility, male infertility is often brushed aside, not acknowledged and often not addressed.

‘’It is a condition in which the male is unable to impregnate the female despite having unprotected sex for a period of 12 months or more. It refers to low sperm production, abnormal sperm function, or blockages that prevent the delivery of sperm,’’ says Dr Rajinder Yadav, Director and HOD, Urology, Fortis Hospital, Shalimar Bagh

According to research, infertility affects an estimated 15% of couples globally, amounting to 48.5 million couples. According to a WHO report infertility in India, of all infertility cases, approximately 50% is due to “male factor” infertility.

What Causes Male Infertility?

According to Dr Ritu S Santwani, Director at Pune Test Tube Baby Centre & Shyam Well Women Clinic, in several cases, enlargement of veins within the scrotum leading to sperm count deterioration is often found to be the cause. Another very important reason is stress.

‘’Hormonal disbalance is also one of the causes of infertility,’’ says Dr Santwani.

She says stress and pandemic have further contributed to increasing cases on male infertility.

“Lifestyle plays a very important role. In the lockdown period, there were 2 scenarios. Sexual contact between partners increased, but on the hand, during the pandemic many faced job losses, loss of income, rising stress levels, and took to smoking and drinking regularly. Smoking and alcohol affect male fertility. Obesity also contributes to infertility.”
Dr Santwani

"Many people are going to the sauna bath in the gym these days, in which the testicles are exposed to a higher temperature for a longer time. Studies have found that higher temperature also leads to a reduction in the sperm count,” she adds.

According to Dr Sowjanya Aggarwal, Principal Consultant, Infertility & IVF, Obstetrics And Gynaecology, Max Hospital, Vaishali, “It could be physical causes, infections, hormones-related problems. There are no common causes as such. Basically, what we can say is that there are 3 main causes – genetics, prior surgery because of cancer or any other major surgery, and medication that can affect semen analysis. Alcohol, drugs, and smoking can also affect this but whether there is a particular limit for that cannot be said. Stress and being overweight can also be the be a cause.’’

‘’Male infertility can be caused by excess heat, drug use, excessive alcohol consumption, exposure to toxins, stress, obesity, dietary deficiencies, prostatitis infection, varicocele, and diseases/surgery of the male genital tract,’’ says Dr Rajinder Yadav, Director and HOD, Urology, Fortis Hospital, Shalimar Bagh

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Diagnosis

Dr Santwani says once someone approaches us, we do a semen analysis. 3 days of no sexual contact is needed for this.

‘’Another test is semen culture which is done to check the existence of microorganism in the sperm. If nothing major emerges from these tests, we may order a sonography,” she adds.

According to Dr Aggarwal, if the semen analysis doesn't help, they order a physical analysis or a hormonal test.

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Treatment Options

Sperm count, mortality, and morphology are the 3 important factors that affect fertility.

  • Oligospermia is the condition where the sperm count is low
  • Necrozoospermia, where dead sperms are present
  • Asthenozoospermia is a parameter of semen analysis where sperm count is there, morphology is there but their mortality is not there

Dr Santwani adds, “If count and mortality of sperm In the patient is low, we start medical treatment. In medical treatment, lifestyle changes and some dietary changes are suggested. In diet, a colour based diet helps boost fertility. Red colour fruits are good for sperm, for eg. pomegranate and watermelon. You should eat a lot of green leafy vegetables. Oranges, amla and walnut are also very good options."

According to Dr Aggarwal says that if the cause linked to alcohol/smoking/weight problems then they can managed with lifestyle changes. To a certain extent, medication can be prescribed.

But if the cause is more medical, due to some obstruction, then we can do surgery, but if surgery doesn’t work as well, then IVF is the answer. "First we have to diagnose whether the problem is treatable or not. If it can be cured by the treatment then it lasts for minimum 3-6 months,’’ she adds.

‘’Treatment is not uncommon and includes permanent and temporary options. Temporary – reducing stress, obesity, eating healthy, increasing male hormone (testosterone), treating testicular and prostate infections. Permanent – testicular atrophy treated, sperm count is less that 15 million per milliliter, genetic syndromes. Treatment takes time, it depends entirely on the patient and his condition on presentation.’’
Dr Rajinder Yadav

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