It is a fact that infertility for both men and women is a condition that extends over the years. Male infertility rates are also on the rise, making science an ally for men who have the strength and determination to undergo the proper treatment to experience the happiness that fatherhood brings.

What is male infertility

Male infertility is a condition in which a man is unable to achieve a pregnancy with his partner. In the case, of course, that it has been clinically proven that his partner does not have an infertility problem and after 12 months of timed intercourse no pregnancy has been achieved.  As infertility affects one in seven couples, it is estimated that at least half of the cases are related to male infertility. This is a good reason why men should be evaluated earlier if the following infertility risks are present:

• Problems related to low sex drive, erection or ejaculation, or other sexual function problems.
• Swelling in the testicle area, pain, discomfort, a lump
• Sexual problems, testicular or prostate history
• A surgery on the groin, testicles, penis or scrotum
• A partner over 35 years of age

What are the causes of male infertility

Although it is believed that the causes of female infertility may be more, the list of male infertility causes shows that it is also long. Let’s look at the causes that affect male fertility.

• Frequency of intercourse. Very frequent contacts lead to a decrease in sperm volume, long-term abstinence, up to 5 days, leads to a decrease in motility.
• Fertility declines after age 35 and continues to decline every year after 40.
• Obesity affects sperm quality.
• High levels of stress can change sperm or reduce its motility.
• Problem with the production of sperm from the testicles.
• Azoospermia, a condition caused by dysfunction of the testicles or blockage in the reproductive tract resulting in the absence of sperm.
• Obstruction or absence of the duct for sperm (spermatic duct) from the testicles or obstruction due to prostatitis and epididymitis.
• Varicose veins, a malfunction in the testicular veins located in the scrotum, the sac of skin that holds the testicles, makes it difficult for blood to pass through.
• Genetic diseases associated with myotonic dystrophy, klinefelter syndrome and microdeletion.
• Two of the most dangerous inflammations, chlamydia and gonorrhea.
• Orchitis caused by the mumps virus which can also cause a bacterial infection from a sexually transmitted infection.
• The production of low- or poor-quality sperm, known as oligospermia.
• Malformed sperm that cannot live long enough to fertilize the egg.
• Injury or inflammation of the testicles.
• Cryptorchidism, a condition in which one or both testicles are not in their normal position, at the bottom of the scrotum.
• Lack of sperm motility.
• Serious illnesses and treatments for cancer, chemotherapy, radiation or surgery that removes the testicle.
• Unhealthy habits, heavy alcohol use, smoking, illegal drug use and anabolic steroids.
• Environmental impacts.

What tests are done to determine male infertility?

Diagnosis begins with a complete physical examination to determine general health and identify any physical problems that may affect fertility, including a comprehensive sperm analysis, as well as specialized tests required on a case-by-case basis.

• Sperm volume: Amount of sperm per ejaculation.
• pH: Measurement of acidity or basicity.
• Sperm concentration: Number of sperm per milliliter of semen.
• Total sperm count: Number of sperm in the entire ejaculation.
• Speed: How fast the sperm travels.
• Motility: The movement of sperm.
• Morphology: Sperm size and shape.
• Viscosity: How quickly the semen liquefies.

What are the treatment options?

Not all male infertility cases are permanent or untreatable. With advanced modern technology and methods, the number of treatment options for male infertility has expanded giving hope and successful results, too.

Medicines:

Hormone therapy can help increase sperm count. Also, the doctor may prescribe antibiotics to correct a temporary sperm abnormality if an infection is diagnosed.

ART – Assisted Reproduction Therapy.

The wife or female partner is often going to undergo intrauterine insemination (IUI) or in vitro fertilization (IVF) for some types of male infertility treatment. The procedures include:

• ICSI – Intracytoplasmic Sperm Injection

When the sperm is not sufficient or because of their abnormal shape it prevents their penetration into the egg. It involves selecting a single healthy sperm and inserting it into the egg.

• In vitro fertilization with donor sperm

Donor sperm from various sperm banks is an alternative approach to male infertility.

Testicular biopsy Testicular Sperm Extraction (TESE):  This technique is recommended in cases of men having obstructive and non-obstructive azoospermia and includes testicular biopsy which is required to find sperm.

Microsurgical Epididymal Sperm Aspiration (MESA): For men with vasal or epididymal obstruction, for cases of obstructive azoospermia with normal spermatogenesis.

This method is done as a scheduled procedure or it can be coordinated with their partner’s egg retrieval.

Percutaneous Epididymal Sperm Aspiration (PESA): A procedure recommended for men who are having infertility problems such as obstructive azoospermia from either a prior vasectomy or infection but with normal spermatogenesis. Sperm is retrieved for either IVF or ICSI.

Testicular sperm aspiration (TESA): This procedure is performed with local anesthesia, in which a sample of sperm cells and tissue are removed from the testicle through a small needle attached to a syringe. The sperm is separated from the tissue and looked at under a microscope in the laboratory in order to be used for IVF/ICSI or it can also be used right away to fertilize eggs or get frozen for future infertility treatment.

Fine Needle Aspiration (FNA): An option for men who have a normal sperm production, but they have no sperm in their ejaculate due to obstructive azoospermia. The procedure is minimally invasive and incision-free, with very little pain. Sperm obtained by this method is prepared for subsequent evaluation or for fertilization of the egg using ICSI technique. This procedure can be done under local anesthesia.

How can male infertility be prevented?

Male infertility cannot always be prevented. There are common and well-known practices that help men support their fertility:

• Abstaining from smoking
• Limiting or abstaining from alcohol
• Avoiding illegal drugs
• Maintaining a healthy BMI
• Avoiding habits or things that create prolonged heat in the testicles
• Reducing stress levels
• Avoid exposure to pesticides, heavy metals and other toxins
• Replacing tight underwear and pants with looser and more comfortable ones

Infertility has no gender. This is something every couple should know. Regardless of which of the two has an infertility problem, both should realize that the family begins and ends first and foremost, with each other.