Hello, I am Dr. Srisailesh Vitthala. I am one of the infertility specialist today. Today I am going to talk about male infertility. Male infertility is very frustrating, both to the childless father as well as clinician because no specific cause can be found or no specific treatment can be found in many of the men, after all the tests. In childless couples, around 30% of them are contributed either solely by the husband or a male partner or at least he contributes if it’s not by himself only. Around 5-10% of the men in their reproductive age group are incapable of fathering a child. It is very unfortunate that it is always the woman will be blamed for infertility. Most of the problems in the men will only come into the light after they have completed their semen analysis test, which is a fundamental test for male infertility. The common disorders found in the semen analysis are up there count, which we call as sperm concentration and their movement which we call as motility and their shape which we call as morphology.
So, what is normal semen analysis? As per WHO 2010 guidelines, a semen analysis report after 3 days of abstinence should be like this – a volume of 1.5 ml, sperm concentration of 15 million, total concentration of sperm ejaculate around 39-40 million, motility which means the sperm which moves forward are around 40% out of which progressive motility, which means the sperm which moves forward are around 32% and their shape which we call as morphology are at least 5%. And then, the live sperms or vitality is around 40 – 50%. If the above mentioned criteria is met in a semen analysis after 3 days of abstinence, then we call that semen analysis is normal or that semen analysis from that male partner or husband is capable of fathering a child. So, what happens after semen analysis? If the semen analysis is normal, we do not need to do any further testing in the male partner or husband. However, if the semen analysis is abnormal, we usually ask to repeat semen analysis once again. Even the repeat semen analysis is abnormal, then we would suggest the man should undergo few tests like hormonal blood test, like FSH, LH, testosterone, prolactin and thyroid. And also to have ultrasound of the testiscles, which we call as a Doppler. If these tests are abnormal, then we might request for an advanced blood test.
So, what are the causes of male infertility? The main causes of male infertility are divided as following –Primary testicular failure in around 10-15%, secondary testicular failure in around 2% and obstructive that means after sperm production, coming out is a problem in another 10-15% and rest, where there could be genetic problems or seminiferous tubules problems or any other problems are another whatever is left over.
So, what is the treatment for male infertility? Majority of male infertility treatment would lead into assisted reproductive techniques, like IUI, IVF, ICSI, donor insemination and other. If there are mild sperm count abnormalities, antioxidants treatment for 3 months might help. The supportive treatment will help to improve the count are lifestyle modification, like quitting smoking, avoiding alcohol, avoiding tight undergarments, avoiding hot baths or saunas Jacuzzi. But majority of them, if they do not improve on that will lead to assistant reproductive techniques. Another thing which might improve in small number of male patients are surgery for varicocele or induction of sperm production.
Ovum Hospital Team