Latest statistics reveal that 1 out of 7 couple is unable to conceive naturally. ‘Naturally’ would usually mean post a year of unprotected sexual intercourse. In our country the common tendency in such cases is to point the finger of doubt at the female partner. Yet, again, statistics reveal that in almost 50% of such cases the male partner is responsible. It is a problem that has shown an upward trend over the past years. Though it is difficult to zero in on the exact cause of this, changing lifestyle where stress and pressure of performance are two unignorable facts, is believed to be largely responsible.
Unfortunately, even in this day and age, our country has remained miles behind when it comes to either awareness or acceptance of the problem. The social stigma attached and presence of a strong male ego often prevents the men from going to the doctor and undergoing the relevant tests. This causes an inordinate delay in detection and subsequent treatment of the problem.
What causes male infertility?
Low sperm production and/or poor quality of sperm is the most common reason for male infertility. While even about three decades back sperm count in a normal Indian male was recorded at 60 million/ml, recent studies have revealed that it stands at 20 million/ml now. So, what has brought about this significant change? While factors like family history, chronic illness, and age are responsible, one cannot ignore the large role played by lifestyle factors like smoking, consumption of alcohol, and stress of modern day living. Sometimes, certain medical conditions or abnormalities (blockage) could be the cause.
Signs or symptoms to look out for
While there are no definite symptoms that would suggest infertility in males, inability to conceive is usually the first sign that indicates a fertility problem. Some other signs, however, could be indicative of male infertility. These include:
- Difficulty with ejaculation
- Poor volume of ejaculated fluid
- Low sexual drive
- Erectile dysfunction
- Pain and swelling in the testicular area
- Abnormal breast growth (a condition called gynecomastia)
If you are facing these issues, then it would be advisable to pay a visit to an infertility specialist without delay. Men with infertility issues are also known to be prone to recurrent respiratory infections, problems in the sense of smell and minimal growth of hair on the body.
What role does ‘male factor’ infertility play in conception?
The process of impregnation begins with the health of the sperm.
Are you producing healthy sperm? For this at least one of your testicles has to be functioning properly and your body has to produce the right quantity of hormones (including testosterone) to ensure a steady supply of sperm.
The journey begins: The sperm produced in the testicles are transported through thin tubes to the mix with semen before the final ejaculation.
Sperm count matters! The larger the number of sperm the more is the chance of fertilization of your partner’s egg. Fewer than 15 million sperm per millilitre of semen and less than 39 million per ejaculate is considered as low sperm count.
Sperm motility is important. Abnormal movement of sperm would mean that it is less likely to reach and impregnate the egg, hence motility of sperm plays a big role.
Sometimes certain Health conditions can lead to male infertility. These include:
Varicocele: Swelling of the veins that drain the testicle and reduce sperm quantity and quality
Infections can interfere with sperm production and health, and cause blockage in the pathway
Auto-immune disorders like diabetes: 1 in 4 men with type 2 diabetes are seen to have lower testosterone levels that is likely to lead to low sperm count, erectile dysfunction and low sexual drive.
Certain genetic disorders can lead to male infertility
Non-malignant tumours and treatment for testicular cancer can affect both the quantity and quality of sperm
Undescended testes is a condition where the testicles haven’t moved into their proper position. This increases risk of infertility and other medical conditions
Injury to the testes can be a cause of infertility as it may impact sperm production and motility
How is the condition diagnosed?
Post physical examination and understanding your family and medical history, the infertility specialist would typically advice some tests to check for the anomalies. These would include, semen and sperm analysis to check for the quantity, quality and motility of sperm. Sperm antibody and DNA tests are also recommended.
The role of Assisted Reproduction Techniques (ART)
Depending on the results of the prescribed test, the doctor may recommend hormone therapies and lifestyle modifications as an initial line of treatment, then follow up with choices of artificial reproduction techniques best suited to your condition. These could include:
Intracytoplasmic sperm injection (ICSI): Where a single sperm is injected into each egg to increase chances of fertilization
In Vitro Fertilization (IVF): Selected quality sperm from those donated by the male partner are used to increase chances of fertilization of egg in the laboratory
