Male Infertility Overview

Male infertility is a medical condition that lowers a male patient’s chances of getting a female partner pregnant. In normal circumstances, a man releases sperm through sexual ejaculation. The sperm then makes it way through the epididymis, a tube behind each testicle, and through the vas deferens going to the ejaculatory duct in the pelvis. Some cases of male infertility originate from sperm production (or the point at which the sperm is produced), while some are related to problems in sperm delivery. Genetic factors, hormone levels, and other factors also come into play.

A male patient is considered infertile when he fails to get a female partner pregnant after a year of unprotected sex.

These patients tend to suffer from the following symptoms:

  • Difficult ejaculations
  • Ejaculating small volumes of fluid
  • Reduced sexual libido
  • Erectile dysfunction, or having difficulty maintaining erections
  • Pain in the testicle area
  • Abnormal lump in the testicle area
  • Swelling in the testicle area
  • Reduced or compromised ability to smell
  • Gynaecomastia or abnormal breast growth
  • Decreased body hair, which may indicate either a chromosomal or a hormonal problem
  • Low sperm count, the normal of which should be 15 million sperm per millilitre of semen or 39 million sperm per ejaculation

The possible causes of male infertility include:

  • Conditions that cause low sperm production, such as varicocele or when the veins that drain in the testicle become swollen. This is the most common but reversible cause of male infertility.
  • Abnormal sperm function or ejaculation issues
  • Retrograde ejaculation, or when the semen enters the bladder instead of coming out from the penis
  • Blockages in the tubes where the sperm pass through
  • Scarring in the tubes
  • Epididymitis or inflamed epididymis
  • Orchitis or inflamed testicles
  • Underlying medical conditions
  • Diabetes
  • Tumours, both malignant and benign, affecting the male reproductive organs
  • Hormone imbalances
  • Celiac disease
  • Hypospadias
  • Certain infections, some of which may cause permanent damage to the testicles

How is the Procedure Performed?

Male infertility treatment begins with several diagnostic tests, including:

  • Physical examination
  • Sperm and semen analysis
  • Hormone evaluation
  • Testicular biopsy
  • Genetic testing

Once the possible causes and contributing factors are determined, a treatment plan is formulated and may include any or a combination of the following:

  • Surgery – Anatomical problems affecting the testicles and the tubes through which sperm passes, as well as obstructions and varicoceles, can be treated with surgery.
  • Hormonal therapy, such as gonadotropin treatment to improve blood testosterone levels or clomiphene treatment
  • Lifestyle changes, such as smoking cessation and reduced consumption of alcohol and other addictive substances
  • Stress relief therapy
  • Antibiotic or antimicrobial therapy for infections
  • Dietary supplements and vitamins