Male Infertility Problems

Abnormalities in sperm due to various reasons can deprive an otherwise happy couple of having a child. Of all infertility cases, approximately 40–50% is due to “male factor” infertility.

A recent international study analysis revealed that there is a significant decline in sperm counts between 1973 and 2011, driven by a 50-60% decline among men from North America, Europe, Australia and New Zealand. The reasons could be multifactorial being birth defects, genetic abnormalities, radiation exposure, lifestyle changes, exposure to various toxins, stress or sometimes unknown.

In such conditions with abnormalities in semen/sperm, one has to approach the Andrologist for possible solutions without much delay because the fertility potential of a couple decreases significantly with advancing age.

Diagnosis:

Both male and female partners have to be simultaneously investigated, to categorise infertility.

Basic evaluation of male infertility involves:

• General physical examination including scrotum and penis
• Basic blood hormone profile such as Testosterone, FSH, LH
• Semen analysis

Semen collection: A dedicated room with adequate privacy would be given. If the male partner is unable to ejaculate, a penile vibrator could be used for stimulation.

Surgical sperm retrieval:

Depending on several factors such as testicular size, previous scrotal surgery and hormone levels, the Andrologist will decide which would be the best option.

Different surgical options to retrieve sperms:

• PESA: Percutaneous Epididymal Sperm Aspiration
• TESE (Testicular Sperm Extraction)
• Micro- TESE: using a surgical microscope

What other options are available if no sperms are found with surgery?

• Donor insemination (DI)
  Donor semen is carefully screened for infections and a donor selected to have similar attributes to you. This is the only viable option if you have no sperms at all and you do not have obstruction which can be relieved surgically.
• Adoption
  If you are unfortunate and do not to have any success with other treatments, you may wish to consider adopting a child.