Male infertility: A Comprehensive Guide To Causes Of Infertility In Men

What Is Infertility?

Infertility is clinically interpreted as the inability to conceive after 12 months of regular unprotected sex. It is not affected by the patient’s gender and prevails both in female as well as male patients. Studies suggest that an estimated 15 percent of couples fall under this criterion (approximately 35% due to male factors).

Types of Infertility

1. Primary infertility: Refers to those unable to conceive after at least 12 months of having regular intercourse without any contraceptives.
2. Secondary infertility: Refers to those who had conceived once but are now unable.

Male Infertility Tests

• General physical and medical history: This involves a thorough evaluation of your medical history; infertility duration, previous tests, and procedures, inherited medical conditions, sexual habits, drug usage, illnesses and examining your genitals.
• Semen analysis: Here, a sample of your semen is obtained in a special container which is then examined by the lab technician to evaluate the shape, sperm count, and look for any abnormalities. If the sperm count is low, blood and hormone tests are conducted. The lab will also check for any possible signs of infection.

If the tests are found to be normal, the female partner will be given attention before performing any further laboratory test on the male.

Additional tests involved to determinants of fertility problems in men are as follows:

• Testicular biopsy: This involves the removal of a small tissue from the testicles. It helps to determine if a block is affecting semen formulation.
• Scrotal ultrasound: Images of the scrotum are generated using high-frequency sound waves. It helps doctors in finding any signs of injury and varicocele.
• Urinalysis: This test examines urine to detect any presence of semen; indicating signs of ejaculatory problems (retrograde ejaculation).
• Ultrasonography: Blockages in the male reproductive system and prostate are detected using ultrasonography.
• Specialized-sperm function tests: Rarely performed, it involves multiple tests to determine if your sperm can survive after ejaculation, if it can enter an egg or if there’s any problem with the egg.

Nearly 70% of conditions that causes infertility in men can be diagnosed with such tests alone.

Causes of Male Infertility

Male infertility is caused by multiple factors such as health, medical, environmental, and lifestyle issues.

1. Retrograde Ejaculation

Semen is normally released from the penis during ejaculation. Retrograde ejaculation can make the semen travel back to the bladder.

During normal ejaculation, the semen (aka ejaculate) is forced out of a man’s penis through the urethra. The semen is able to come out of the penis due to a muscle called bladder sphincter, which closes the bladder’s opening and prevents the semen from going back into the bladder.

If the bladder sphincter fails to work correctly, the bladder may fail to close, causing the semen to go back into the bladder instead of exiting the penis.

What Is Retrograde Ejaculation?

Retrograde ejaculation happens when semen flows back into the bladder, rather than ejaculating. This occurs due to the lack of nerve contractions and open bladder neck during ejaculation. It can be caused due to various health issues like diabetes, bladder or prostate surgeries, spinal injury, and medications.

It is also known as a dry orgasm. Retrograde ejaculation patients can still experience an orgasm but ejaculate fewer fluids than what they normally do. When very few or no semen exits from a man’s body, it often causes infertility(0.3-2%) in men as the chances of impregnating is greatly reduced from low to 0.

Most men with this condition don’t even realize that they have it as it doesn’t cause any physical pain. Although some men have reported signs of cloudy urine post-orgasm, this occurs when semen mixes with the urine.

Some Facts on Retrograde Ejaculation

• Men commonly ejaculate over 1.5 milliliters (ml) of semen
• Men suffering from retrograde ejaculation may not ejaculate any semen at all
• Retrograde ejaculation is not a diagnosis, it’s a symptom
• Unless a man is trying for a baby, it is not necessary to treat retrograde ejaculation

What Causes Retrograde Ejaculation?

Retrograde ejaculation might arise due to various factors, such as:

• Diabetes: Most male diabetic patients have chances of suffering retrograde ejaculation due to faulty blood sugar control for a long time. This is because it damages the nerves of the bladder.
• Injuries: Spinal injury can cause damage to the nerves and sphincter of the bladder.
• Surgery: Prior-surgeries on the urethra or prostate, bladder, or surgery on the lower spine can induce retrograde ejaculation. About 10-15% of men who undergo prostate surgery have chances of suffering retrograde ejaculation.
• Medications: certain medications used for treating HBP, depression, enlarged prostate, and spinal injury can lead to retrograde ejaculation.

Treatment for Retrograde Ejaculation

Although retrograde ejaculation does not have any serious underlying cause, some men may seek treatment for the condition simply because it affects their experience of sex.

There are also options for men looking to get their partner pregnant. Usually, the treatment will begin by removing the sperm following ejaculation; It may involve separating the sperm from the bladder.

There are certain medications that attempt to trigger antegrade (forward) ejaculation. If it does not work, a doctor may attempt to extract the sperm without ejaculation. Following are some surgical procedures to remove the sperm:

• Testicular sperm aspiration (TESA): It is a procedure conducted under local anesthesia. The sperm is extracted from the testicles using a needle.
• Testicular sperm extraction (TESE): TESE is similar to TESA as it extracts the sperm directly from the testicles after sedating the patient. But unlike TESA, this procedure makes an incision right in the testicle.
• Percutaneous epididymal sperm aspiration (PESA): In this procedure, sperm is collected from the epididymis (duct connected to the testes) with the help of a needle. It is performed under local anesthesia.

Once the semen has been successfully collected, the doctor can help to get the patient’s partner pregnant through one of two ways:

• Intrauterine Insemination (IUI): The procedure involves directly injecting the semen into the uterus of the woman during ovulation.
• In Vitro Fertilization (IVF): In this procedure, an egg is removed from the woman and then fertilized in a petri dish. Once the embryo grows, the doctor then implants it inside the uterus of the woman.

There are different types of treating retrograde ejaculation, and it depends on what caused the problem in the first place. If it is due to medication, usually stopping the medication or changing it resolves the issue. When it is caused by nerve damage, it is usually not reversible.

Retrograde Ejaculation and Prostate Removal

A common cause of retrograde ejaculation is the surgical removal of a part of the prostate. Around 10 – 15% of men who have undergone this surgery is said to suffer from retrograde ejaculation due to the fact that surgery may cause nerve and muscle damage in the bladder.

It is also possible not to ejaculate at all after undergoing radical prostatectomy (prostate removal.)

When to consult a doctor?

Retrograde ejaculation does not cause any pain, neither is it dangerous, and hence, treatment is not always necessary. However, it can be triggered by certain medical conditions.

You can consult a doctor regarding the condition when:

• You have a dry orgasm
• You ejaculate less semen consistently
• When you can’t impregnate your partner even after trying for a year.

A study conducted in 2017 showed a case where retrograde ejaculation showed to be the only and first symptom experienced by men suffering from type 1 diabetes. So if you are experiencing retrograde ejaculation, it is recommended to consult a doctor.

How to Prevent Retrograde Ejaculation

Retrograde ejaculation cannot always be prevented.

If you need medical treatment for your enlarged prostate, opt for less invasive surgeries like transurethral needle oblation aka TUNA or transurethral microwave thermotherapy aka TUMT. The possibility of causing muscle and nerve damage is less in these surgeries.

Prevention for retrograde ejaculation can also be done by simply keeping a check on the medical conditions that damage the nerve. If you have diabetes, regularly take your medications prescribed by your doctors and make healthy lifestyle changes.

Takeaway on retrograde ejaculation

In most cases, you cannot reverse the damage leading to retrograde ejaculation. However, you can treat the infertility that it causes. Even if you fail to ejaculate at all, you can get help from a fertility specialist.

If you have retrograde ejaculation, there is a chance you may have other symptoms as a result of diabetes, prostate surgery, or an enlarged prostate. It is recommended to report symptoms like erectile dysfunction, frequent urination, blood in semen or painful ejaculation to your doctor. These are symptoms that might be a result of another diagnosis.

Most men are under the assumption that ejaculation and orgasm are one and the same, but normal orgasm is possible even without ejaculation. Some men may find it uncomfortable to have dry orgasm, but it is not always a serious medical condition. Change your expectation so that you can lead a normal life with retrograde ejaculation.

2. Varicoceles causing Male Infertility

Varicoceles are like varicose veins only, it appears around the testicles instead of the legs. These may not cause serious issues, but it can cause male infertility.

Varicoceles occur as a result of enlargement of veins in the scrotum as a result of malfunctions in some blood pumping blood valves. It is a condition that affects around 15% of the male population and has a tendency to occur in men between 15 – 25 years of age.

Normally, varicoceles only affect the left side of the testicles.

Some Facts on Varicoceles

• Varicoceles are just like varicose veins but occurring in the area around the male testicles.
• It normally affects 15% of the male population, between 15-25 years.
• It is not exactly known as to what causes this but is thought to be similar to varicose veins.
• Usually does not cause any pain.
• Varicoceles are not a serious condition but may cause complications like infertility.
• If you face complications, surgery is an option.

What Is Varicoceles?

Varicoceles are one of the most treatable causes of male infertility and the most common cause of acquired infertility (75-85%). It is the swelling of the veins in the scrotum.

It leads to reduced sperm quality by impairing proper blood circulation and abnormal testicular temperature. It usually affects the left testicle, but it affects the production of sperm on both sides. Varicocele doesn’t usually cause pain.

Varicocele affects the pampiniform plexus, a type of nerve which is responsible for regulating( acts as a heat exchanger) the temperature of the testes and cooling the arterial blood. Varicocele interrupts the cooling system, which in turn stops the testes from producing good quality semen.

Treatment for varicoceles

Treatment for varicocele isn’t really required, but individuals must consult a doctor if they experience a reduced sperm count, pain, or feel uncomfortable or have been trying to conceive for more than a years with no success.

Your doctor might suggest having surgery in such cases.

Types of Varicocele Surgeries Available

There are three types of surgery available:

1. Percutaneous embolization: This procedure is minimally invasive, a tube is inserted through the groin or neck by a radiologist, and then instruments are allowed to pass through the tube. Next, the surgeon tries to block the veins by scaring it using chemicals or coils. The surgery can be performed as an outpatient procedure, and patients can expect a quick recovery.
2. Laparoscopic surgery: In this procedure, the surgeon inserts a laparoscope in the abdomen area by making a small incision.
3. Varicocelectomy: The surgeon performs an open surgery under general or local anesthesia. The goal is to enter the area either through the groin or the upper thigh or abdomen.

The surgeon then corrects the swollen veins using surgical microscopes or ultrasound. The affected veins are closed, and the blood flow is rerouted through healthier veins. Patients may feel minimal pain post surgery and can expect a short recovery time.

If the condition isn’t serious or doesn’t require surgery, wearing supportive briefs might prevent discomfort and ease the pain.

Surgery Risks

Although these surgeries are normally safe, there may be some risks involved:

• Damage to the artery
• Atrophy of the testicles
• Abdominal pain
• Infection, or
• Chances of swelling, bruising, or fluids building up in the treated area.

Although very rare, renal vein thrombosis may also develop affecting the kidney. There are also cases where even after surgery, the new veins also enlarge. More treatments are required to address the problem.

Symptoms of Varicoceles

It is very rare for men with varicoceles to experience pain. If pain occurs, it will probably:

• Worsen during physical exertion or in standing position
• Range from dull to sharp pain
• Ease when lying on back
• Increase as the day goes on

Varicoceles are often not noticed except by a physician during a medical examination.

It is recommended to see a physician if you notice:

• Changes in the appearance, size or shape of your testes
• Abnormal lump
• Fertility issues
• Swollen scrotum
• Twisted or unusually large veins

Possible Complications

Varicoceles can sometimes cause complications.

• Infertility

Possibly the most serious complication that may arise is infertility. It happens probably as a result of increased blood accumulation in the area, which causes a rise in the testicular temperature.

Studies show that 35 – 44% of men experiencing primary infertility are diagnosed with varicoceles. When a man fails to impregnate his partner for 12 months, it is called primary infertility.

Varicoceles are also found in 45 – 81% of men experiencing secondary infertility. Secondary infertility is when a man has been able to impregnate his partner at least once but is no longer successful.

According to a research that was published in 2016, 15.7% of 7,035 young, healthy men who were monitored between 1996 and 2010 had varicoceles. The same people also had lower quality semen.

Sperm production is shown to be more efficient when the temperature is said to be lower than the body.

• Shrinkage of Testicles

Varicoceles also cause testicular shrinkage or atrophy. Sperm-producing tubules form a major portion of the testicles. The testicles become softer or smaller when there is damage to the tubules.

• Hormonal imbalance

Changes in the hormones can occur when the cells are subjected to an increase in the pressure. It can lead to a higher level of the luteinizing hormone (LH.) It is a hormone found both in the male and female body. The testosterone levels may also vary between normal to subnormal.

Causes

Reports suggest that the swelling of the veins may be because the valves present in the spermatic cord stops functioning normally, it helps in carrying the blood to and from the testes. Although the precise cause for this is unknown, it is somehow similar to the varicose veins that occur in the legs.

The valves are responsible for the smooth flow of blood from the testicles towards the heart and ensure that the blood does not flow backward. But when the valves stop functioning correctly, the blood pools in the lower parts of the veins and forms a varicocele.

Classification of Varicoceles

1. Pressure type (grade I varicocele, which occurs when the blood fills up the spermatic vein).
2. Shunt type (a grade II/ III varicocele, which is caused by a severe build-up of blood that damages the spermatic vein).

When a patient with varicocele is above 40 years, it might be due to an obstruction in the larger veins in the abdomen area, which indicates the presence of a kidney tumor.

Risk Factors for varicoceles

There are no known risks involved with varicoceles. However, it commonly occurs during puberty. The risk of getting varicoceles is lower when an individual is overweight, while taller people have a higher risk.

Previously, it was considered that a man is less likely to become infertile once he has succeeded in fathering a child. However, a research conducted in 1993 has concluded that this is not the case. Instead, the research claims that the risk of a man becoming infertile increases with time.

If a man above 40 years of age develops varicoceles, it is most probably caused by larger vein blockage around the abdomen, possibly caused by a kidney tumor.

Natural Treatments for Varicoceles

If the condition is not serious enough, you can wear supportive underwear to reduce any pain.

You can find a wide variety of alternative therapies to treat low sperm count but always consult a physician first.

Diagnosis for Varicoceles

Varicoceles are present in 3 grades:

Grade I: It is very small and not visible. A physician can feel it using a Valsalva maneuver.

Grade II: This is also not visible but is big enough to be felt even without using a Valsalva maneuver.

Grade III: Here, the varicocele is visible. Large growths can feel soft to the touch, like a “bag of worms.”

“Subclinical Varicoceles” can be detected only with imaging tests. The tests used in this type of imaging can either be Doppler reflux test or scrotal thermography, which are both types of ultrasound.

By conducting an ultrasound test, your doctor will rule out any possibilities of a tumor near or on the spermatic vein.

Other test options include analysis of the semen and hormone tests for detecting low testosterone and high follicle stimulating hormone (FSH.) These tests may be recommended if your physician suspects a dysfunction in your testicles.

Typically, varicoceles do not pose any risk, but if you notice changes in the consistency, shape, or size of your genitals, it is recommended to consult a physician.

3. Drugs causing Male Infertility

Consuming certain drugs, both legal and illegal, can negatively affect male fertility (the ability of a man to impregnate his partner.) Men who want to father a child must first consult a physician before undergoing treatments or taking a new medication. Taking fertility supplements that are not FDA approved and scientifically evaluated may cause more harm than good.

Men who find it difficult to father a child should consult a physician about their medications and any possible tests for semen quality. Certain medications can cause side effects to some men, which can cause infertility problems. If your physicians tell you it could be the case, it is a good idea to try a different medication. Always discuss the issue with the physician who prescribed the medication for you.

Here are some common substances that cause infertility in men.

• Testosterone

Supplemental testosterone or replacement testosterone can negatively impact your sperm production. When you take testosterone supplements, it blocks the hormonal signals that trigger the testicles to produce sperm and testosterone. This leads to a sharp drop in the testosterone levels in the testicles. A common outcome is a considerable decrease in sperm concentration or a total absence of sperm in the semen.

In most cases, you can reverse this effect although it will take time – 6 to 12 months or more – to normalize the sperm production. It is safer to stay away from any kind of testosterone supplements if you are trying to impregnate your partner.

• Anabolic steroids

Anabolic androgenic steroids or anabolic steroids are drugs that can help in muscle mass enhancement and/or body fat elimination. Testosterone is also an anabolic steroid. It has become increasingly popular among non-athletes and non-competitive athletes to use this drug.

Low-quality muscle-building and fitness dietary supplements sometimes contain anabolic steroids. These steroids can provide the same level of harm to a man’s fertility as testosterone. Both disrupt the hormone signals required for sperm production.

The level of damage caused will depend on the dose, drug, and how long it was consumed. Typically, a man’s sperm production will increase in 3 to 13 months after stopping the medication. It is recommended to avoid taking drugs of this nature because the negative impact of taking anabolic steroids on male fertility is very high.

• Alcohol

Male fertility will not be affected by light to moderate alcohol consumption. The problem lies with heavy alcohol consumption (over 14 mixed drinks per week), which can decrease the testosterone production, rapidly clear the existing testosterone from the bloodstream and increase the estrogen levels. The resultant effect will be a decrease in the testosterone level, harming the production of sperm.

• Tobacco

Using or smoking tobacco causes serious health issues. Infants and toddlers living in households with adult smokers have a higher risk of developing serious respiratory conditions such as pneumonia, severe asthma, and frequent ear infection. SIDS (Sudden Infant Death Syndrome is also a condition frequently linked to households with smokers.

Children whose parents smoke are also more likely to smoke as they grow older. Regular smoking negatively impacts your sperm movement and sperm production. Couples trying to conceive are recommended to stop smoking.

• Marijuana

The active ingredient in marijuana is THC, and it is known to decrease the production or sperm and weaken a man’s sex drive by disrupting the testosterone production. THC also directly harms the sperm movement. Marijuana also contains heavy metals like lead, which increases its weight and other illicit addictive drugs like cocaine.

Due to the negative effects of using marijuana on the fertility of a man, couples trying to conceive should avoid using marijuana altogether.

• Opiates

Opiates or narcotics refer to both illegal street drugs and prescription medication. Long-term opiate consumption interferes with the signals that control the production of testosterone, which lowers testosterone and decreases the sperm quality and quantity. The level of impact will depend on what is used, how long and the dose.

If you have been prescribed opiates to treat your addiction, consult your addiction counsellor, and talk about your fertility concerns because some treatments can be less harmful than others.

Short-term opiate consumption does not have a negative impact on the fertility of a man. Therefore, it is safe to take opiates prescribed by your physician for a short time to control pain after a broken bone or surgery. If you are prescribed or is taking opiates for several weeks or months, consult your physician and ask for suggestion to cut back on your intake.

Recreational (illegal) opiate use is strongly discouraged.

• 5-alpha reductase inhibitors (Propecia, dustasteride, and finasteride)

These are medications for treating hair loss and prostate enlargement. Taking these medications has a very mild impact, and reverses once stopped. If you are taking these drugs for treating prostate enlargement, you will notice a decreased semen volume and the quantity of sperm in your semen, making it harder for you to impregnate your partner.

When this medication is taken to treat hair loss, the change in sperm quantity is negligible. However, about 5% of people consuming this medication for either of the reasons will see a visible reduction in their sperm count. It is recommended to stop taking the medication if you are struggling to impregnate your partner. Taking these medications will also decrease a man’s sex drive, although it will go back to normal once the medication is discontinued.

• Alpha-blockers (Alfuzosin, Tamsulosin, Silodosin, Cardura®, Hytrin®)

Alpha blockers are prescribed for treating urinary symptoms as a result of an enlarged prostate. Taking these medications can cause male infertility. Both Tamsulosin and Silodosin can either decrease the ejaculation volume or completely inhibit the ejaculation altogether.

If you have been prescribed an alpha-blocker and experiencing urinary symptoms, consult an urologist and ask about the possible impact it may have on your fertility and possible treatment alternatives.

• PDE5 inhibitors (Cialis®, Levitra®, and Viagra®)

PDE5 inhibitors are commonly used for treating erectile dysfunction. The medications, however, does not seem to negatively impact male fertility.

• Selective serotonin reuptake inhibitors(SSRIs)

It is commonly used for treating anxiety and depression, especially in the United States. Continued intake of the medication can harm the sperm or even inhibit sperm movement through the reproductive tract.

If you are taking SSRIs and is finding it difficult to impregnate your partner, consult an urologist, and have your semen tested. You can also discuss with your mental health provider for alternative medications.

• Ketoconazole

It is a medication for treating fungal infections. It is a topical treatment and is applied to the skin as powder, cream, or ointment. Topical application of Ketoconazole shows no evidence of harming male fertility. However, when taken as a pill, it decreases the production of sperm and hurts the production of testosterone.

• Chemotherapy

Any type of chemotherapy medication for treating cancer inhibits the production of sperm. Your sperm production will return in a matter of 2 years, depending on the type and duration of chemotherapy.

On rare occasions, the production of sperm may never return, leaving the man infertile. It is recommended to consult a doctor about sperm freezing before undergoing chemotherapy.

• Other medications

These medications can lead to male infertility issues: colchicines, sulfasalazine, nifedipine, cimetidine, spironolactone, and some antibiotics. If you are struggling to impregnate your partner while taking these medications, discuss your concerns with your doctor and consult an urologist to test your semen.

Male infertility is caused by multiple factors such as health, medical, environmental, and lifestyle issues.

4. Immunologic Male Infertility

Sometimes, antibodies or immune system cells produced in a man’s body can mistakenly identify his own sperm as harmful and try to remove it. Antibodies are often produced because of surgery, injury, or infections. They stop the sperm from swimming into the fallopian tube and entering the egg.

Patients with testicular cancer have higher chances of producing antibodies that might impair sperm motility.

Production of antisperm antibodies in men

Causes of immunologic infertility

Immunology infertility in men is triggered by an injury to their testicles or infection in their prostate. This kind of trauma can set off the immune response whenever the blood and sperm come in contact. It can also be caused by testicular surgeries like a vasectomy.

When to get tested?

If you are finding it difficult to impregnate your partner and your doctor has suggested some fertility tests, ask to get tested for antisperm antibodies as well.

An immunobead test can be conducted on the patient’s sperm. You need to provide a sample of your semen by masturbating. You can also opt for an antiglobulin reaction test which is done on the blood.

Treatment for immunologic infertility depends on its underlying cause.

Your doctor might suggest some of these treatments – IUI, IVF, or ICSI.

5. Chromosomes: Genetic Causes of Male Infertility

Changes in chromosomes or inherited disorders such as; Klinefelter’s syndrome (a male born with 2 X- chromosomes and 1Y-chromosome instead of one each) cause abnormality in sperm production and block the sperm flow and can lead to male infertility, Y-chromosome deletion (a condition where a genetic material which is essential for producing sperm is absent in the Y chromosome), down syndrome, and DNA mutations (in a single gene.)

6. Obstructions

Certain infections and prior surgeries, including vasectomy, prostate surgeries, testicular, and abdominal surgeries, can block the male reproductive tract. Such obstructions disrupt the sperm movements and in turn, stops it from leaving the body during an orgasm.

7. Environmental Causes of Male Infertility

Extended contact with certain environmental components can impair sperm production and cause infertility.

Overexposure to radiation or x-rays, industrial chemicals, harmful substances like lead can contribute to lower sperm count. In the same way, elevated temperatures affect sperm production. Sitting for long hours and wearing tight clothes also increases the temperature of the testes and can reduce sperm count.

8. Lifestyle, Health, and Other Causes

Male infertility can also be caused by certain health and lifestyle choices. Some of these are:

• Weight: Obesity causes hormonal changes and accelerates the chances of infertility.
• Depression: Study shows that the chances of pregnancy are reduced if a male partner suffers from depression.
• Smoking tobacco: Men who smoke have reduced sperm production compared to those who don’t.
• Drug use: Using steroids, cocaine, and other sorts of drugs can temporarily reduce the quality of your sperm.

All of these causes can be related to male infertility and impairing sperm production.

What Are The Treatments Available for Male Infertility?

Infertility treatments for men are divided into 3 categories:

Surgical therapy

Varicocele treatments: Varicoceles are swollen veins found in the scrotum. There are three surgical options for treating varicoceles:

• Laparoscopic surgery: To perform this surgery, the surgeon makes a small cut and inserts a laparoscope through the abdomen area.
• Varicocelectomy: An open surgery performed under local anesthetic. The surgeon enters the varicocele area through the groin and corrects the affected veins and allows the blood to pass through healthier vessels.
• Percutaneous embolization: A tube is inserted into the body through the neck by the radiologist, and instruments are passed into the tube. Then the surgeon uses a coil or chemicals to block the veins.

Microsurgical Vasovasostomy: It is used to reverse vasovasostomy. Microsurgical vasovasostomy is done to reattach the vas and allow the sperm to swim through the urethra.

Vasoepididymostomy: It is a common microsurgical procedure to treat epididymal obstruction. This surgery is done to attach the upper end of the vas to the epididymis.

Non-surgical therapy

Non-surgical therapy involves using antibiotics to cure infections of the reproductive tract, medications, and therapy to treat intercourse problems, hormone replacement or drugs in cases where hormone levels affect the semen formulation and lower sperm count.

Treatment for Unknown Causes

Intrauterine Insemination (IUI): The sperm is allowed to pass through a tube and into the uterus. IUI is used to treat lower sperm count, retrograde ejaculation, and other infertility problems.

In Vitro Fertilization (IVF): this method is the most effective among other ARTs. This method involves mixing a woman’s egg with the sperm in a lab dish for fertilization. The embryo is then inserted into the uterus. It is often used to treat blockages in the fallopian tubes and lower sperm count.

Testicular Sperm Extraction (TESE): This method is done to determine the cause of azoospermia. It extracts sperm directly from the testicular tissue.

Intracytoplasmic Sperm Injection (ICSI): In this method, the sperm is injected directly into the egg obtained from IVF. The embryo (fertilized egg) is then inserted into the uterus. It is used in cases of block or testicular failure (when there is no sperm in the semen).

Post-Treatment and Recovery Time

Male infertility is often treated using outpatient procedures. While pain after such treatments is usually mild, their recovery and follow-up may vary. To determine if the varicocele is completely treated, getting a physical evaluation and sperm analysis is recommended every three months for at least a year.

After vasectomy reversal surgery, the pain experienced is mild, but its recovery might take up to 4-7 days. Successful treatment depends on the year gap between your vasectomy and reversal and mostly on the age and fertility of the female partner.

Precautions

A rich diet high in antioxidants like vitamin E and C has been proposed to improve sperm quality by reducing free radicals that damage the membrane. Zinc, fish oil, and selenium are also known to be of benefit.

Limiting the use of abusive substances like cigarettes, marijuana, and steroids. Harmful environmental exposure should be reduced.

Outlook

As new technology is introduced, more options are available for couples experiencing infertility and those who wish to conceive at an older age. Infertility treatments are now accessible to more people, and the success rate and safety of such treatments have increased.

Infertility treatments can be costly, but there are certain programs that can help you financially.

References:

https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/infertility-in-men

http://obgyn.ucla.edu/infertility

http://www.myfertility.ca/testing_and_diagnosis/male_diagnosis/immunological_infertility/

https://www.health.harvard.edu/a-to-z/retrograde-ejaculation-a-to-z

https://www.health.harvard.edu/mens-health/retrograde-ejaculation

http://www.sciencedirect.com/science/article/pii/S2214442016301759

Admin