Male Fertility
Male factor infertility causes roughly 40% of cases, yet it is still the half of the picture that gets tested last. Dr. Charmila Ayyavoo at Aditi Pluro, Tiruchirapalli provides comprehensive care.
Male infertility usually comes down to sperm production, sperm quality, or the passage sperm travel through. The commonest causes are:
In some men no single cause is found. Treatment is then guided by the semen parameters themselves.
For most men there are none. More rarely, swelling or aching in the testicle, decreased facial or body hair, change in breast tissue, a loss of sex drive or erectile problems are obvious. If such things occur, include their presence; also note if there has been surgery or trauma of the testicles or infection within them. Almost the only complaint for those seeking help after one year's unsuccessful effort is the failure to achieve pregnancy.
Semen analysis comes first; it includes assessment of the sperm count, motility, and morphology. Decreased sperm counts, known as oligozoospermia, decreased sperm motility (asthenozoospermia) or abnormal sperm morphology (teratozoospermia) may significantly decrease your chances of conceiving. If there are no sperm at all in the analysis, then a more detailed examination should be performed to distinguish obstructive azoospermia (sperm are produced but obstructed somehow) from non-obstructive azoospermia (the testes fail to produce sperm).
One practical note: home sperm test kits measure count only, not motility or morphology a normal home result does not rule out a male factor.
Dr. Charmila Ayyavoo ensures your male factor assessment is thorough. Various tests may be required including semen analysis, a hormone test for male infertility covering FSH, LH, testosterone and prolactin, or an ultrasound of the testicles. The point here is to find out if there are any treatable factors involved and suggest the best course of action possible. An abnormal result is usually repeated after a few weeks, because samples vary.
Treatments vary depending on the cause. Sperm count or motility problems can be managed through lifestyle modifications, use of supplements, and medical treatments. Any infection is managed using antibiotics. Surgical intervention is considered where it involves surgical sperm extraction, or correction of a varicocele or blockage. This can be effective especially among those who have no sperm or low-quality sperm, by combining surgical sperm aspiration with ICSI explained further in TESA and PESA for azoospermia.
Where sperm parameters are only mildly affected, IUI may be enough; where they are not, IVF with ICSI gives the best results see how eggs are fertilised in the IVF laboratory.
Male factor infertility matters just as much the second time around, and is routinely overlooked.
Often, yes. Infections clear with antibiotics, varicocele and obstruction can be corrected surgically, and hormonal problems respond to medication. Lifestyle changes take about three months to show in a semen analysis, because that is how long sperm production takes. There is generally no sperm or egg source that is not conducive to ICSI if no natural production is possible- this therapy can usually fix any form of male factor infertility.
Q: Does a low sperm count always mean IVF is needed?
A: Not necessarily. If count is low but motility and morphology are good, IUI or natural pregnancy can still occur. If counts are very low or multiple parameters are abnormal, IVF with ICSI offers the best success rates.
Q: Can diet and supplements improve sperm health?
A: Yes definitely have been shown to be helpful, antioxidant diets, exercise, avoiding stress, stopping smoking, reducing alcohol have all shown to be useful and as supplementary nutrients CO Q10, Zinc, carnitine has been shown to be of some use. The process takes three months since it takes three months to produce sperm.
Q: What if no sperm can be found in the ejaculate?
A: The absence of sperms does not imply azoospermia. Dr. Charmila will carry out hormone tests and do a testicular ultrasound scan. Provided that there are sperms in the testicles, TESA and ICSI would work to obtain the sperms for IVF.
Not necessarily. If count is low but motility and morphology are good, IUI or natural pregnancy can still occur. If counts are very low or multiple parameters are abnormal, IVF with ICSI offers the best success rates.
Yes, indeed. Antioxidant-based diets, exercise, stress management, quitting smoking, and consuming less alcohol have all been found to be beneficial. Coenzyme Q10, zinc, and carnitine are examples of supplemental nutrients that seem to have some impact. The process takes three months since it takes three months to produce sperm.
The absence of sperms does not imply azoospermia. Dr. Charmila will carry out hormone tests and do a testicular ultrasound scan. Provided that there are sperms in the testicles, TESA and ICSI would work to obtain the sperms for IVF.
