Wednesday, January 21, 2015

When the man is shooting blanks - The Ins & Outs of Male infertility

Recent surveys have revealed some alarming facts- 15% of Indian couples in the 31-40 years age group need medical intervention to successfully conceive , as either one or both the partners suffer from fertility issues.

Generally, if a couple has unprotected intercourse for a year and are still unable to conceive, they are said to suffer from infertility. The sad truth is that there are number of misconceptions about infertility floating around. The most popular one of course is that it’s always a problem with the woman. This is one myth that has to be debunked.

The truth is that in almost 40 percent of all infertility cases, the problem lies with the male partner while 40% of infertility issues are attributed to the female. In 10% , we cannot find out the cause; and in another 10%, both have a medical problem.

Semen analysis is the basic test used to determine male fertility. In case any abnormalities show up, your doctor will get you to repeat the test at a later date.  Please make sure you do the test in a reliable lab !

Understanding the Causes

It’s only when there is a persistent abnormality in the  semen analysis that doctors will tag it as male infertility. There are a number of causes for it such as childhood infections, genetic factors, physical abnormalities and hormonal disorders:
•    Men who drink alcohol and smoke tend to have a 13%-17% lesser sperm count compared to teetotalers
•    In some cases, STD’s such as Chlamydia and gonorrhea are the reasons for infertility. These block the sperm-carrying tubes
•    Testicular damage & failure can result from mumps in childhood. At times this can also lead to absence of sperm
•    A boy might also be born without a vas deferens (this is the tube via which the sperm travels from the body to outside it); this is a congenital disorder
•    Undescended testes can be another cause of male infertility. This can result in damage to the testes which is why no sperm will be produced

Treating it Right

•    ICSI: If the man has a very low sperm count Intracytoplasmic Sperm Injection or ICSI is the preferred procedure that doctors use. The woman’s eggs will first be collected during an IVF cycle. Each sperm will then be picked up and injected into the egg utilizing a micromanipulator. Once the eggs have fertilized and divided after 2-3 days, the embryo is then placed inside the womb

•    PESA: In those cases where the semen does not have any sperm, PESA is an option for men with obstructive azoospermia. ICSI is done to inject the sperm into the egg

•    TESA:. For men with non-obstructive azoospermia, TESA can be explored. A tiny needle will be used to remove the sperm directly from the testes. This is a minor procedure and no major surgery or cut is required. The ICSI procedure will then be used to inject the sperm into the egg

IUI is NOT a good treatment option for the infertile man. If the sperm are functionally incompetent, then using these sperm and injecting them into the uterus will not help. It just wastes time and money and creates frustration.

In cases of no sperms, and complete testicular failure, using donor sperm is the only option. These have to be taken from a sperm bank. The success rate of this procedure is quite high, since the woman if fertile. The procedure itself is simple and inexpensive, but can be very hard to come to terms with.

Even a Male can Fail

As you can see, male infertility is not as much a rarity as our male-centric society makes it out to be. So before making any assumptions or embarking upon a blame-game, it’s important that you consult an infertility doctor and confirm the diagnosis.  You will then be able to take a decision about what the further plan of action should be.

The experienced doctors at clinics such as the Malpani Infertility Clinic have the knowledge and expertise to help you with a successful IVF/ ICSI  procedure. Need more information? Get a free second opinion from Dr Malpani by filling in the Free Second Opinion form.

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