Male Infertility

Male Infertility

We know that infertility is nowadays very common and male factors make a significant contribution, as high as 40 % of infertility cases. Therefore, it seems logical and cost effective to address male factor first and manage it along with the evaluation of female partner.

Tests to Diagnose Male Infertility –

1. Semen Analysis – It is a very simple test done in laboratory by analysing human sperms directly under the microscope . Various parameters of sperms are assessed like counts, motility and morphology etc. It gives a fair idea about the male factor infertility and the need for further testing will be decided upon this report
2. Hormonal Tests – Blood values of FSH, LH, Testosterone , Prolactin and TSH are done to assess about spermatogenesis.
3. Ultrasound Scrotum – To assess testicular volume and varicocoele ( Dilated veins)
4. DNA Fragmentation– This test is sometimes advised for cases with normal semen sample but still giving negative results . If DNA damage is more than a certain limit , it can lead to poor results despite a normal sperm count, motility and morphology .
5. Routine Blood tests and clinical examination of male partner

Common types of male infertility –

1. Low sperm count ( OLIGOZOOSPERMIA )
2. Low sperm motility ( ASTHENOZOOSPERMIA )
3. Poor sperm morphology ( TERATOZOOSPERMIA)
4. OATS (Oligo Astheno Teratozoo Spermia )-when all three are there!
5. Absence of sperms ( AZOOSPERMIA)
6. Sexual dysfunctions

Management of male infertility

Mild male factor infertility –

When sperm parameters are mildly deranged than the normal cut off values , it can be managed by giving medical treatments consisting of hormonal tablets and supplements for about 3 months . Also IUI i.e. Intrauterine Insemination can be done to make the best motile sperms available for transfer at the time of ovulation . Decision is best taken by your fertility expert after reading your reports .

Severe Male factor infertility –

When there is gross abnormality in sperm parameters , then even IUI may not be helpful .We cannot select the sperm in natural conception cycles where any sperm( good or poor ) can enter and fertilise the egg . Then it seems logical to take help of Assisted Reproductive Techniques like ICSI. By doing ICSI ( Intra Cytoplasmic Sperm Injection ) , under a highly specialised microscope, we first select the best sperm available and then inject it directly into the egg using the ICSI machine in an IVF laboratory. It gives best fertilisation results in male infertility cases.

AZOOSPERMIA –

Sometimes there is no sperm seen in the entire semen sample, then one needs to assess whether sperms are there in the testicles or they are not getting released into the ejaculate due obstruction in male genital tract (Obstructive azoospermia ).This will be diagnosed by your fertility expert by doing certain more tests.

Obstructive Azoospermia –

 Can be treated by doing corrective surgery.

Non Obstructive Azoospermia –

Sperms are sometimes available in semen producing tubules inside the testes. They can be retrieved by doing some minor surgical procedures like –PESA, TESA, TESE, MICRO TESE. Sperms retrieved are used in ICSI for fertilisation of oocyte in laboratory and resulting embryos are transferred into the women to give pregnancy.Of these Microtese technique gives the best outcome.

DONOR SEMEN-

 If the sperms are not present in the testes and we do not get any sperm after doing sperm retrieval procedure ., the last option is to go for sperm donation programme .