CONDITIONS
Male Fertility
What is male fertility?
Male fertility is defined as the capacity of male sperm to successfully fertilize female eggs, resulting in conception. This complex process relies on several factors, such as sperm count, motility (ability to move), morphology (shape and size of sperm), overall health condition. It is important to note that a decreased sperm count, or poor-quality sperm can greatly diminish the chances of achieving successful conception.
What determines sperm health?
Sperm health depends on quantity, movement, and structure.
- Quantity (Sperm count): The quantity of sperm, also known as sperm count, indicates the number of sperm cells found in a specific sample of semen. Generally, a healthy sperm count falls within the range of 15 million to over 200 million sperm/mL of semen. Oligospermia, or low sperm count, can diminish the likelihood of successful conception.
- Movement (Sperm motility): Sperm motility refers to the ability of sperm cells to move effectively. Motility is essential for sperm to reach and fertilize an egg. Healthy sperm should demonstrate progressive motility, meaning they move forward in a straight line. Poor sperm motility, known as asthenozoospermia, can impair fertility.
- Structure (Sperm Morphology): Sperm morphology refers to the size and shape of sperm cells. A normal sperm will have an oval-shaped head, an intact midpiece and an uncoiled single tail. Abnormal sperm morphology (caused by either defect in the head, midpiece and/or tail), known as teratozoospermia can affect fertility because misshapen sperm may have difficulty penetrating the egg.
What are the factors that affect male fertility?
- Unhealthy lifestyle habits like smoking, excessive alcohol consumption, drug abuse, or leading a sedentary lifestyle can have detrimental effects on male fertility and overall health.
- Consuming a well-balanced diet that is rich in vitamins, minerals, antioxidants, and omega-3 fatty acids is essential for promoting optimal sperm production.
- Prolonged stress can disrupt hormone production, leading to potential issues with sperm production.
- As men age, the quality of their sperm typically decreases, which could impact their fertility.
- Exposure to environmental factors such as toxins, radiation, and excessive heat sources like saunas, hot tubs, or laptops placed on the lap can have adverse effects on sperm health.
What cause male fertility problems?
Different medical conditions can lead to male fertility issues, such as:
- Hormonal imbalances can lead to infertility, which can be caused by disorders in the testicles or abnormalities in other hormonal systems such as the hypothalamus, pituitary, thyroid, and adrenal glands. Male hypogonadism, characterized by low testosterone levels, and other hormonal issues can have various underlying causes.
- Testicular disease such as such as undescended testicles, testicular injury, or testicular cancer
- Varicocele, which is a condition characterized by the swelling of veins in the scrotum, which can impair sperm production and quality.
- Disorders related to sperm transport. Blockages or abnormalities in the reproductive tract, such as epididymal blockages, ejaculatory duct obstruction, or congenital absence of the vas deferens can prevent sperm from reaching the semen.
- Ejaculatory disorders such as premature ejaculation or erectile dysfunction.
- Sexually transmitted infections.
- Age can also be a factor. As men get older, the mobility and quantity of sperm tend to decrease, which can impact fertility, particularly after the age of 50.
What is the best way to produce healthy sperms?
To optimize the production of healthy sperm, it is crucial to adhere to these simple steps:
- It is important to maintain a healthy weight, as research suggests that having a higher body mass index (BMI) is linked to a decrease in sperm count and motility.
- Incorporate a nutritious diet that includes plenty of fruits and vegetables, which are known for their antioxidant properties that can potentially improve sperm health.
- Take precautions to prevent sexually transmitted infections (STIs) such as chlamydia and gonorrhea, as these can lead to male infertility. Always using condoms or being in a relationship with only one partner who does not have any infections can provide protection against sexually transmitted infections.
- Effectively manage stress levels, as excessive stress can have a negative impact on sexual function and disrupt the hormonal balance necessary for sperm production.
- Engage in moderate physical activity, as studies indicate that men who engage in regular physical activity tend to have elevated testosterone levels and improved semen quality compared to men who lead sedentary lifestyles.
What is male infertility?
Male infertility is defined as the inability of a man to successfully impregnate a fertile woman, despite engaging in unprotected sexual intercourse for a period of at least one year.
One in every fifteen Indian couples struggles with infertility. The issue is exacerbated by late marriages, demanding lifestyles, obesity, excessive consumption of fast food, smoking, drinking.
About 50% of infertility cases are believed to be caused by issues with the man’s fertility. In some cases, it is the main reason for infertility in 20% of couples, while in 30% of cases, it contributes along with the woman’s fertility issues
How is male infertility diagnosed?
Diagnosing male infertility typically involves a combination of medical history, physical examination, and specialized tests. Here’s an overview of the diagnostic process:
- Semen analysis: It involves collecting a semen sample, usually through masturbation, and analyzing it in a laboratory. The sample is evaluated for sperm count, motility, morphology, and other factors like pH and volume. Abnormalities in any of these parameters can indicate potential fertility issues.
- Hormone testing: Blood tests may be conducted to measure hormone levels, such as testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin. Hormonal imbalances can affect sperm production and fertility.
- Imaging tests: Imaging tests such as scrotal ultrasound may be performed to assess the structure of the testicles and detect any abnormalities such as varicoceles or blockages in the reproductive tract.
- Testicular biopsy: If semen analysis shows that there are only a few sperm or no sperm present, the doctor may perform a biopsy by removing a small piece of tissue from each testicle. The sample will then be examined under a microscope.
How is male infertility treated?
Treatment options for male infertility may vary depending on the underlying cause and severity of the condition. Some common treatments for male infertility include:
- Lifestyle modifications: Making lifestyle changes such as quitting smoking, reducing alcohol consumption, maintaining a healthy weight through diet and exercise, and avoiding exposure to environmental toxins can improve sperm quality and fertility.
- Medications: Depending on the specific cause of infertility, medications may be prescribed to address hormonal imbalances, enhance sperm production, or treat underlying medical conditions. For example, hormone replacement therapy may be used to treat low testosterone levels, while antibiotics may be prescribed to treat infections of the reproductive tract.
- Assisted reproductive techniques (ART): ART procedures consist of surgically extracting eggs from a woman’s ovaries, fertilizing them with sperm in a controlled laboratory setting, and subsequently transferring the resulting embryos back into the woman’s body. Some commonly used methods of ART include:
- In Vitro Fertilization (IVF): IVF involves fertilizing an egg with sperm outside the body in a laboratory setting and then transferring the resulting embryo(s) into the woman’s uterus.
- Intracytoplasmic Sperm Injection (ICSI): ICSI is a specialized form of IVF where a single sperm is injected directly into an egg to facilitate fertilization, particularly in cases of severe male infertility.
- Intrauterine Insemination (IUI): In IUI, sperm are washed and concentrated before being inserted directly into the woman’s uterus during ovulation to improve the chances of fertilization.
- Surgery: Surgical procedures may be recommended to correct anatomical abnormalities that affect sperm production or transport, such as varicoceles, epididymal blockages, or ejaculatory duct obstructions.
In summary, male infertility is a complex condition that can result from various factors affecting sperm production, quality, or the reproductive process. Common causes include hormonal imbalances, genetic factors, anatomical abnormalities, lifestyle factors, and medical conditions. Diagnosis typically involves a combination of medical history, physical examination, semen analysis, hormonal tests, and imaging studies. Treatment options may include lifestyle modifications, medications, assisted reproductive techniques (such as IUI, IVF, or ICSI), or surgery. Due to advancements in fertility treatments and interventions, many couples struggling with male infertility are now able to achieve their dream of starting a family.
References
- Mayo Clinic. Healthy lifestyle Getting Pregnant. Available from: https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/fertility/art-20047584. Accessed on May 16th, 2024
- Mayo Clinic. Male infertility. Available from: https://www.mayoclinic.org/diseases-conditions/male-infertility/symptoms-causes/syc-20374773#:~:text=Male%20fertility%20is%20a%20complex,male%20reproductive%20organs%20during%20puberty. Accessed on May 16th, 2024
- Low Sperm Count. Available from: https://www.nhs.uk/conditions/low-sperm-count/. Accessed on May 16th, 2024
- Johns Hopkins Medicine. Male infertility. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/male-infertility#:~:text=Male%20infertility%20means%20a%20man,blockage%20in%20your%20genital%20tract. Accessed on May 16th, 2024
- Deventhiran et al. Prevalence if male infertility in India: Studies on the effects of gonadotropin releasing hormones. Asian J Pharm Clin Res, Vol 10, Issue 8, 2017, 208-210
- Choy JT, Amory JK. Nonsurgical Management of Oligozoospermia. J Clin Endocrinol Metab. 2020 Dec 1;105(12):e4194–207
