Infertility in men

Infertility in men is defined as a condition wherein a man fails to produce sperm that is capable of fertilizing the female egg. Causes of male infertility vary from one to the other. The causes can be physical, such as genetic abnormalities, hormonal disorders, infections and damage to the reproductive system, or psychological ones, such as stress, anxiety and depression.

Infertility in men is the inability of a man to father a child. Infertility affects an estimated 15% of couples globally. Males are found to be solely responsible for 20-30% of infertility cases and contribute to 50% of cases overall. But you don’t need to get worried as it is completely treatable.

Common Causes of Infertility in Men

Many factors have been associated with infertility in men and some of the following can be a cause of low sperm count or abnormal sperm production in men.

Varicocele: An abnormal collection of bulging veins above the testicles.
Infections in the testicles, the prostate or somewhere in the body, which can lead to fever.
Undescended testicles.
Sometimes, chemotherapy can also be the reason for infertility in men.
Medicines like anabolic steroids or anti-seizure medicines can reduce sperm production.
Serious hormonal imbalance and genetic abnormalities.

Generally, these problems can be resolved but sometimes, men have normal sperm in the testicles but the sperm in the semen is either abnormal or very low in number. This kind of causes include:

Retrograde ejaculation
Obstruction between the testicles and penis.
Absence of main sperm pipeline.
Anti-sperm antibodies, which attack the man’s own sperms.

Treatment for Infertility in Men

There are generally three types of treatment for infertility in men: Surgical, Non-surgical and treatment for unknown causes.

Surgical Treatment for Infertility in Men

Varicocele treatment is done by varicocelectomy where swollen veins are fixed which helps in sperm movement.
Azoospermia is caused due to a blockage that prevents sperm from entering the ejaculate. There are many surgical options available for treating Azoospermia.
Microsurgical vasovasostomy uses microsurgery to join two cut parts of the vas deferens in each testicle.
Vasoepididymostomy treatment is where the upper end of the vas deferens is joined to the epididymis.
Transurethral Resection of the Ejaculatory Duct is the surgical treatment for Ejaculatory duct blockage. A cystoscope is passed into the urethra and a small incision is made in the ejaculatory duct.

Non-Surgical Treatment for Infertility in Men

Anejaculation, also known as dry ejaculation is when a man does not release semen fluid during the climax. It can be caused by injury in the spinal cord, diabetes, mental health problems, multiple sclerosis, etc. Generally, drugs are prescribed to treat this condition but in serious cases, Penile Vibratory Stimulation (PVS) or Rectal Probe Electroejaculation (RPE) may be used to induce ejaculation.
Hyperprolactinemia is when the pituitary gland makes a huge amount of prolactin hormone which causes infertility and erectile dysfunction. It can be treated with drugs or if the pituitary is present, surgery can be used to treat tumours.
Hypogonadotropic Hypogonadism is when the testicles don't produce enough sperms because of pituitary hormones. A specialist may ask the patient to have an MRI or blood test and after evaluating the reports, your health care provider will tell you whether surgery is necessary or not.
Some men are born with abnormal genetic conditions that affect their fertility but these can be treated with proper medication.
Retrograde Ejaculation is when semen flows back to the penis instead of going out from the penis. It can be caused by diabetes, injury in the spinal cord, prostate surgery, etc. It can easily be treated with OTC medicines.

Treatment for Unknown Causes of Infertility in Men

Sometimes it is difficult to find out the exact cause of male infertility, therefore specialists use their experience to figure out what might be best for you.

If other infertility treatments do not work, there are some other techniques that can help you and your partner to get pregnant. These techniques are called Assisted Reproductive Techniques.

One of them is Intrauterine Insemination (IUI). In this method, the doctor will place the sperm inside the uterus through a tube.
IVF, In Vitro Fertilization, is when the egg and sperm of the partners are joined in a lab Petri dish. For this method, ovaries are stimulated to produce multiple eggs. This method is more frequently used in severe and untreatable oligospermia (low sperm count).
Intracytoplasmic Sperm Injection is the severe treatment of infertility in men. In this method, a single sperm is injected into the egg using a tiny needle. When the egg is fertilized, it is attached to the female's uterus.

Take Away

Infertility in men refers to the condition when a man is not able to contribute to conception. This condition may be due to different reasons, but the popular ones are low sperm count and poor sperm motility. Both of them lower the chances of pregnancy and before you come to the conclusion that a man is infertile, it is best to be examined by a urologist.