Treatment of Male Infertility

Dear readers, today let me give you an insight into Male Infertility. If a couple is infertile, almost all the time blame goes to the female partner. But we must understand that of all the infertility problems around 40% belong to the male partner.

Infertility in men can be due to

• Defect in production in semen
• Defect in the path through which semen passes
• Difficulty in ejaculation
• Difficulty in intercourse

So, how to find out if there is any problem with the male partner or not? For that, at the very outset the treating doctor talks to the male partner, ask him some relevant questions, and try to gather the information like the following:

1. Since when he is trying to father a child?
2. Is there any previous history of having a baby of his own either with the same partner or different?
3. Any previous history of injury or surgery in and around the penis and testicles or in the lower abdomen?
4. Is there any difficulty during passing urine or during intercourse?
5. Does he stay with his partner or stay away due to his job?
6. Any knowledge about the fertile period of the female body?
7. What is his job? (does his job carries any type of risk to his fertility? Occupational exposure?)
8. Did he ever suffer from any type of cancer?
9. Is he taking any kind of medicine related to cancer, depression, psychological problem, or any other long-standing disease?
10. Any habit of chewing betel nut/consuming alcohol/smoking or using tobacco? If yes, then since when and the daily amount of consumption?

After getting this information, the doctor may examine the husband & advise him to do “SEMEN ANALYSIS”. A NORMAL semen analysis report gives us the idea that the man has

• No defect in sperm and seminal fluid production,
• No defect in the path through which semen passes
• No difficulty in the ejaculation process.

If the semen analysis report comes to be ABNORMAL, then some other tests may be required e.g some hormonal values, sonography of both the testes, genetic evaluation, etc. But normally the initial evaluation of the male patient is rapid, non-invasive, and cost-effective, as nearly 70% of conditions that cause infertility in men can be diagnosed with history, physical examination, and hormonal and semen analysis alone. More detailed, expensive, and invasive studies are ordered if necessary.

Proceeding for treatment proper:

(a) If there is any psychological issue that exists between husband & wife, then proper counseling helps to achieve the target.
(b) Sometimes the couple doesn’t know the concept of the fertile period of a woman. Proper knowledge of that also helps the needy.
(c) If the husband is habituated to alcohol/smoking/tobacco, that must be stopped immediately.
(d) Hectic stressful life produces some harmful chemicals within the body (reactive oxygen species) which causes damage to the sperms. Here, yoga and exercise are helpful.
(e) If the wife’s parameters are within normal limit, then with the above modifications the couple can be advised to try naturally for few months.
(f) If not conceived then the next fertility options IUI or IVF can be tried.
(g) Even if very low sperm count (oligozoospermia, cryptozoospermia) or absent sperm in seminal fluid (azoospermia) is found, then fertility is possible by techniques like TESA and ICSI.