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Pune IVF Centre is one of the best IVF centers in Pune with the largest team of Gynecologists and Embryologists in one place.

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Pune IVF - Male Infertility

Often men face fertility issues and might hesitate to seek help. Finding a solution becomes easier when you reach out to our team.

 

What is male infertility?

Male infertility can be anything from low sperm to no sperm. There are multiple solutions for infertility. But let us first dwell into the cause of male infertility.

Main causes of male infertility are as follows:

 

Sperm Disorders

Varicoceles

Retrograde Ejaculation

Immunonologic Infertility

Obstruction

Hormonal imbalance

Side effects of Medication

Sperm Disorders

The commonest sperms disorders could be mild to moderate reduction in the sperm count, mild to moderate reduction in motility of the sperms and abnormal shaped sperms.

High DNA fragmentation index of the sperms.

Sometimes lifestyle choices lead to lower sperm count. Excessive alcohol consumption, and taking certain medicines can lower your sperm count.
Long term sickness, childhood infections and hormonal issues can lead to drop in sperm count.

Damage of the reproductive system can lower the sperm count or it can result in no sperms.

4 out of 10 men lack sperms (azoospermia) or can have an obstruction (blockage) in the tube. Birth defect or infection can cause blockage.

Schedule an appointment to talk us about Male Infertility.

Varicoceles

When veins in the scrotum swell it’s called Varicoceles. 16 out of 100 men can face this problem. This is common among infertile men and it harms the sperm growth by blocking proper blood drainage.

Varicoceles causes the blood to flow back to your scrotum from the belly. Testicles become too warm to make sperms. This results in low sperm count.

Retrograde Ejaculation

When sperms go back into the bladder instead of the penis it is called retrograde ejaculation. This happens when the nerves and muscles in the bladder come close during climax or orgasm it results in Retrograde Ejaculation. It can be caused by surgery, particular health issues of the nervous system or medications.

Immunologic Infertility

In some cases, a man’s body produces antibodies that harm his own sperm. Antibodies are produced due to some infection, surgery or injury. They stop the sperm from functioning normally. We cannot exactly tell how antibodies lower fertility. But we know they can make it difficult for sperms to swim to the fallopian tube and then later enter an egg. Though this isn’t a common cause for infertility.

Obstruction

At times the tube through which the sperms travel get blocked due to swelling, surgery or some developmental defects. So this blockage can prevent the sperms from the testicles to come into the ejaculation.

Hormonal imbalance

Hormones that are produced by the pituitary gland trigger the testicles to make sperms. When these hormone levels are abnormal they cause poor sperm production.

Genetic causes

Only half of the DNA gets carried to the egg by the sperm. When the number and structure of chromosomes change it can impact fertility. At times the male Y chromosome might be missing.

Side effects of medication

Particular Medicines like anti-hypertensive drugs, cancer drugs, antipsychotic drugs, cholesterol lowering drugs or steroids can impact the sperm production and functionality.

Diagnosis

It can be challenging to find the cause of infertility among men. Most often the challenge is due to problems in sperm production and delivery. Diagnosis begins with a detailed history, physical check-up and examination.

Treatment

Treatment varies as per the causes of infertility. Most fertility issues can be treated with medication or surgery. This would facilitate natural conception.

Treatment options could be

Treatment of underlying cause

Non pharmacological treatments

Medical therapy

Surgical therapy

ART ASSISTED

Treatment of underlying cause

Anejaculation (dry ejaculate)

This is not a common cause and it means that no semen fluid is released during the climax. This is not a common cause and it means that no semen fluid is released during the climax. It can be cause by:

Spinal cord issues

Diabetes

Surgeries

Mental or emotional issues

Abnormalities at birth

Multiple sclerosis

Often diabetes causes low sperm count or high DNA fragmentation index of the sperm. Similarly, hypertension, high cholesterol levels, smoking can impact the sperm count.

Rectal probe electroejaculation

This is done under anesthesia except in men with damaged spinal cord. This method is used to collect sperms but at times sperm movement and shape might still lower fertility.

Genital Tract Infection

This is not the common cause of infertility in 2 percent patients. This issue is diagnosed by a semen test. Infection in semen can lower the chances of the sperm fertilizing the egg.

Often medications can treat this issue. If these treatments fail other options are the Non pharmacologic therapies:

Penile Vibratory Stimulation (PVS)

Rectal probe electroejaculation (RPE) or electroejaculation that induces ejaculation

Penile vibratory stimulation

This vibrates the tip and the shaft of the penis to experience a natural climax. It is noninvasive and works will in certain cases.

Medical therapy

Hypogonadotropic Hypogonadism

(GnRH) is a hormone that is produced by hypothalamus. When testicles lack stimulation by the pituitary hormones it leads to Hypogonadotropic hypogonadism. It is caused by problems in the pituitary or hypothalamus.

It might be present since birth and becomes apparent during puberty.

Congenital form is also known as Kallmann’s syndrome, which is caused by low gonadotropin-releasing hormone (GnRH).

It can be triggered due to health problems like:

  • Head injury
  • Pituitary tumors
  • Anabolic steroid use

Generally, MRI shows a clear picture of the pituitary gland.

Hyperprolactinemia

When pituitary gland makes too much of hormone prolactin it is called Hyperprolactinemia. It causes infertility and erectile dysfunction. Pituitary tumors can be treated through medicines or surgery may be required.

Genetic Conditions

Some men can have genetic conditions that may be denovo or hereditary.

No sperm in the ejaculation or azoospermia can be genetic where the condition affects sperm production. Genetic conditions can impact the development of the male reproductive tract that carries sperm, which results in failure of sperm production.

Treating Male Infertility with Surgery

Varicocele Treatments

Varicoceles can be treated by a minor surgery called varicocelectomy. Swollen veins can be fixed, which may help in improvement of sperm parameters.

Azoospermia Treatments

Azoospermia due to blockages can be treated by surgeries like:

  • Microsurgical Vasovasostomy

Vasovasostomy is used to undo a vasectomy. It joins the 2 cut parts of the vas deferens in the testicles.

  • Vasoepididymostomy

This process joins the upper end of the vas deferens to the epididymis and this treats epididymal blocks.

  • Transurethral Resection of the Ejaculatory Duct (TURED)

Ejaculatory duct blockage is treated with surgery. Ejaculatory duct blockage is treated with surgery by making a small incision in the ejaculated duct and a cystoscope is passed into the urethra. This helps in retaining the sperms into the semen.

Treating Unknown Causes of Male Infertility

Sometimes finding the cause of male infertility is challenging. This is referred to as “idiopathic” male infertility. Doctors generally need to be experienced to find out what works out. This is called “empiric therapy.” Often infertility issues are caused by hormones so empiric therapy might lead to hormonal balance. Each case is different so it’s necessary to individualize the treatment.

Assisted Reproductive Techniques (ART)

Intrauterine Insemination (IUI)

In this procedure the sperms are processed in order to improve the motility of the sperms, remove the dead sperms from the semen so that highly motile sperm concentrate can be placed in the female partner’s uterus with the help of soft flexible catheter at the time of ovulation. This procedure is not at all painful.

In Vitro Fertilization (IVF)

In this process the ovaries are stimulated to produce multiple eggs with the help of medicines and daily hormonal injections. This helps to retrieve the mature eggs, later these eggs are allowed to fertilize with the sperms in the Petri dish in the IVF lab.

When they grow in 3 to 5 days, the fertilized egg (embryo) is placed in the uterus. IVF is used to treat certain hormonal conditions, and blocked fallopian tubes that lead to infertility.

Men with severe and untreatable oligospermia or low sperm count can be treated by using the IVF method.

Intracytoplasmic Sperm Injection (ICSI)

It has brought revolution to the male infertility treatment. A tiny needle is used to inject single sperm into the egg. When the egg fertilizes, it is placed in the female partner’s uterus. If the semen quality is extremely poor then ICSI can be the best bet.

If there are no sperms in the semen due to blockage or testicular failure then sperms can be taken from the testicle or epididymis by one of the following surgical methods and ICSI can be performed.

Sperm Retrieval techniques

In order to retrieve sperms in cases of obstructive or non-obstructive azoospermia many microsurgical methods can be used. These methods aim at getting the best quality sperms directly from the testicles.

Testicular Sperm Extraction (TESE):

A commonest technique used to diagnose cause of azoospermia is TESE. The sperm sourced from the testicle can be used fresh or frozen. At times multiple biopsies may have to be done.

A more advanced form of this method is microTESE. In this method an operating microscope is used to detect small areas of sperm production in the testicles of men who have azoospermia.

Testicular Fine Needle Aspiration (TFNA):

This method is used to diagnose azoospermia. Sometimes it can be used to collect sperm from the testicles.

Percutaneous Epididymal Sperm Aspiration (PESA):

Local or general anesthesia is given during PESA. The fluid is withdrawn by sticking a needle into the epididymis. At times sperm may not be taken out this way. Rather an open surgery might be needed.

Microsurgical Epididymal Sperm Aspiration (MESA):

Sperms are retrieved from the epididymal tubes. A surgical microscope is used in this method and it sources high amounts of motile sperm that can be frozen and thawed to be used for ICSI.

Male Infertility

Frequently Asked Questions

What health issues lead to male infertility?

Often diabetes causes low sperm count or high DNA fragmentation index of the sperm.


Similarly, hypertension, high cholesterol levels, infections and fevers, metabolic disorders, and smoking can impact the sperm count.


Sexually transmitted diseases can block the reproductive tract.


Genetic conditions like cystic fibrosis can cause absences of seminal vesicles that can lead to no sperm in the ejaculate. Certain medical conditions lead to infertility thus its vital that you and your partner disclose family and personal health histories to the doctor you are consulting.

Does consuming body building steroids lead to infertility?

Body building steroids do affect the male’s ability to produce hormones needed to make good quality and quantity of sperms.

Do abnormal semen analyses or sperm cause birth defects among children?

Not necessarily. The risk of conceiving a child with birth defects is the same for everyone, whether it’s a natural conception or IVF conception. Some genetic causes of infertility might lead to birth defects in the offspring. PGS can help us to detect these genetic abnormalities prior to the conception.


Thus, couples should undergo thorough examination and take expert advice before they start any form of ART.

Can cigarette smoking affect sperm count?

Regular smoking impacts sperm count and quality. It harms their DNA. Smoking does impact the sperm quality and quantity drastically and it harms the DNA further affecting the fertilizing capacity of the sperm.

Do cell phone radiations affect male fertility?

Yes, cell phone radiations have been observed to drastically impact male fertility by damaging the DNA in the sperm.

Does obesity affect fertility?

Increased weight in male has been found to impact the testosterone level thereby producing poor quality sperms and perpetually reducing fertility as compared to normal BMI males.

Does Vitamin deficiency cause male infertility?
There is a possibility that Vitamin D, Vitamin B12 and other micronutrients affect sperm motility and fertility potential. Males with optimum Vitamin levels have better fertility potential.

No matter the reason, We can help you.

There are so may ways to start your fertility journey.
Please choose the path that best suits your stage, or give us a call for guidance.

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