Treatments For Male Infertility

Infertility can be due to problems in either the male or the female. While female infertility is more commonly known, there is often very little awareness about the various causes of male infertility and possible recourse of action in such cases. To be able to face such a situation effectively and in an informative way, it may be useful to know more about it....
Treatments for Male Infertility
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Understanding Male Infertility

Male Infertility refers to inability of the couple to conceive in spite of unprotected intercourse over a period of one year due to a cause in the male partner.

Approximately 15% couples present with infertility as per the above definition. About one third of these result from a cause in the male partner, while another one third are likely to have problems in both the partners. Thus, male infertility contributes to overall incidence of infertility almost as much as the causes in the female partner, a factor which is not always remembered.

Identifying the Cause of Male Infertility

Investigation for male

infertility is important to identify the cause. Thus once the couple seek medical advice, a complete history and the medical examination of both partners needs to be done. In case of male, one needs to look for factors that could be highly innocuous, like tight underwear, excessive smoking, and high temperature in the place of work that may provide an opportunity for correcting the problem. Sometimes a history of recurrent illnesses during the last year may be the clue, as spermatogenesis or the production of sperms, after an episode of illness could remain affected up to 74 days after the remission of illness, thereby indicating the need for rest and recovery as a solution for infertility.

Medical examination can provide the diagnosis in many cases like varicocele or dilation of veins in the scrotum (the sack holding the testis), and indicate surgery as an effective treatment. Several other conditions are also likely to get diagnosed during medical examination, and can be treated depending on the cause.

In many cases, history and medical examination do not indicate a diagnosis, and then semen analysis is required, which may show a reduction in the number or mobility of sperms as the reason for infertility. Sometimes diagnosis may require hormonal or genetic analysis.

Causes of Male Infertility & Treatment

Treatment of male infertility depends on the cause.

Erectile Dysfunction

Causes of infertility can be related to erectile dysfunction itself, and in such cases appropriate psychological counselling or occasional medicinal intervention may suffice.

Defects in Ejaculation

The next group of causes relate to defects in ejaculation. Retrograde ejaculation can be a culprit, and may require treatment with IMIPRAMINE and / or PSEUDOEPHEDRINE, which improve ejaculation. Sometimes this retrograde ejaculation may be a result of diabetes that may require control of diabetes.

Systemic Diseases as a Cause of Male Infertility

Sometimes, the cause of male infertility is systemic in nature, like excessive exercise, smoking or alcohol, and better control of these conditions can lead to conception. Hormonal causes like Hypogonadism may require treatment with appropriate GONADOTROPHIC hormone.

Local Diseases of Reproductive Organs

Diseases of the testicles and scrotum like varicocele and hydrocele will require surgery. Sometimes there could be obstruction to the flow of sperms in the duct that carries the sperms from the testis to the urethra, the vas deferens and the epididymis. In such cases too the treatment is usually surgery, though in some cases, the obstruction may be too severe to be treated by surgery. Similarly, male infertility, in rare cases, can also result from tumors of the testes, which will also require surgery.

Infections

Infections, of the genitor-urinary tract can sometimes be a cause. Tuberculosis is one of the causes in countries where it is prevalent. Another infection which can frequently lead to male infertility is Mumps. Unfortunately, there is no treatment for infertility induced by Mumps.

Azoospermia & Oligospermia

These are conditions in which the defect lies in the sperm count and quality.

Azoopermia is a condition where there are no sperms in the semen. It can result from many of the causes stated earlier, and the treatment would


depend on the medical condition leading to azoopermia.

Oligospermia is a condition where the sperm count in semen is less than 20 million per ml. In case of oligospermia, the couple has some chances of conception, and improving the overall health of the male, taking care of factors like smoking, excessive exercise, hot water baths, tight underwear, treating infections and recurrent sicknesses etc may help. Cases of oligospermia can also be considered for procedures like In-vitro fertilisation.

Another group of causes pertain to lack of healthy mobility in sperms, as in case of immobile sperms.

Rarely the infertility can also be due to excessive thickness of seminal fluid of semen, which restricts the mobility of sperms. In such cases, direct injection of sperms into the uterus by intrauterine insemination is an option.

Lastly, immunological reaction to own sperms can also lead to infertility in some males. In such cases, corticosteroids (steroids) can help, but they also have their own side effects and hence cannot be used for indefinite periods without risks of side effects like infection and gastric ulcer.

Special Procedures as Treatment for Male Fertility

In cases where sperm count is below normal or their mobility is inadequate, there is the option of intrauterine insemination, in-vitro fertilization and the intracytoplasmic sperm injection. Where the sperms are totally absent, sperm donation is an option.

INTRA UTERINE INSEMINATION: This involves direct injection of sperms into the uterus, thereby taking care of the problem of inadequate mobility or seminal fluid thickness. It can also be an effective measure in cases of oligospermia, as it increases the probability of conception many fold.

IN VITRO FERTILIZATION: This involves fertilization of the female ovum outside the body, commonly known as test tube fertilization. This is an option in cases of oligospermia or defective mobility etc.

INTRA CYTOPLASMIC SPERM INJECTION (ICSI): This is one of the latest techniques which have made it possible to achieve artificial conception with very few sperms. It involves taking the sperm directly from the testis and then directly injecting it into female ovum outside the body using micro equipments. It is an option that may work even in a case of azoopermia provided the testes still contains viable sperm cells. It is an effective alternative to donor sperms.

SPERM DONATION: This is practically the last resort, where sperms donated by an unknown healthy donor are used to fertilize the ovum of the female by artificial insemination or intrauterine insemination.

Thus, male infertility is a condition that can be contributed by a number of causes. Treating it effectively requires the determination of the cause as the first step. However, often the cause remains unidentified. In such cases, appropriate measures like intrauterine insemination, in-vitro fertilization or ICSI can be attempted. Sperm donation is the last resort.
 



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