Male Infertility: Signs, Symptoms, Causes and Treatment

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Male infertility is a condition that affects people who are assigned male at birth and it interferes with the ability of their reproductive system to impregnate a female person. If you have male infertility, it means that you may have sexual intercourse repeatedly for more than a year but your significant other doesn’t get pregnant.

Infertility affects 186 million individuals globally, and the male partner is the main reason behind half of the reported cases. According to studies, male infertility affects about 10% to 15% of male individuals in the United States who are trying to get pregnant.

Is it easy for the female species to conceive? Human beings are considered species with low reproductive capacity. A fertile young couple having free sex every month, has only about 20-25% chances of conceiving.

Conception is a very complicated process that depends on a couple of factors both in the male and female reproductive system and this includes.

Unblocked oviduct to allow sperms to reach the egg.

Production of both healthy sperms and eggs.

Ability of the embryo / fertilized egg to be implanted in the uterus.

The ability of the sperm to fertilize the egg when they meet.

For pregnancy to happen to full term, the embryo should be healthy and the female’s hormonal environment should be adequate enough for the embryo to develop. Infertility can happen if something affects one of these factors.

Signs and Symptoms of Infertility include:

• Problems associated with sexual function- for instance challenges with ejaculation or ejaculating small volumes of fluid, difficulty maintaining an erection and a reduced libido that is sexual desire.
• Pain, lumps or swelling in the testicle area.
• Recurring respiratory infections.
• Inability to have a sense of smell
• Gynecomastia: Abnormal breast growth
• Decreased body or facial hair or other signs of a chromosomal or hormonal abnormality

A lower than normal sperm count (fewer than 15 million sperm per milliliter of semen or a total sperm count of less than 39 million per ejaculate)

Consult a doctor if you have been unable to conceive a child after a year of regular, unprotected intercourse, or sooner if you experience any of the following:

• Issues with erection or ejaculation, low sex drive, or other sexual function concerns
• Pain, discomfort, lumps, or swelling in the testicle area
• A history of testicle, prostate, or sexual health issues
• Previous surgeries involving the groin, testicles, penis, or scrotum
• A partner who is over the age of 35.
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Many biological and environmental factors can contribute to male infertility. These include:

• Infections

  Infections like epididymitis, orchitis, and sexually transmitted infections (STIs) such as gonorrhea and HIV can affect fertility.

• Swollen Veins

• Varicoceles, or swollen veins in the testicle area, can interfere with sperm production.

• Cancer Treatments

•  Treatments for cancer, such as chemotherapy, radiation therapy, or surgical removal of the testicles (orchiectomy), can impact fertility.

• Testicular Trauma

• Any injury or trauma to the testicles can affect fertility.

• Hormonal Disorders

• Disorders affecting the hypothalamus or pituitary glands, which are responsible for regulating hormones, can impact sperm production and overall fertility.

• Environmental Factors

• Exposure to certain environmental toxins, chemicals, or excessive heat can also negatively affect sperm production and fertility.

• Sperm Issues

• Problems with sperm can include malformed sperm, low sperm count (oligospermia), and the complete absence of sperm in your semen (azoospermia).

• Genetic Disorders

• Conditions such as Klinefelter syndrome and myotonic dystrophy can affect fertility.

• Medical Conditions

• Various health issues, including diabetes, certain autoimmune diseases that target sperm, and cystic fibrosis, can impact fertility.

What tests are used to diagnose male infertility?

A semen analysis is one of the primary tests used to diagnose male infertility. This lab test evaluates a semen sample to assess both the volume and quality of your sperm.

In addition to semen analysis, other tests that a healthcare provider may order to diagnose or rule out the causes of male infertility include:

• Imaging Tests: Non-invasive imaging tests such as ultrasound or magnetic resonance imaging (MRI) can provide detailed views of the reproductive organs. In some cases, invasive tests like a venogram may be used to assess blood flow in the testicles.
• Blood Tests: These tests measure hormone levels and detect potential abnormalities in your genes or chromosomes that could impact fertility.
• Urinalysis: A urine test can help identify sexually transmitted infections (STIs) and conditions like diabetes that may affect fertility.
• Testicular Biopsy: This procedure involves removing a small sample of
• testicular tissue to evaluate how well the testicles are producing sperm.

• Can Male Infertility be Treated?

  Yes, many treatments can help address male infertility. The right approach depends on the cause of the issue. Here are some common treatments:

• Vasectomy Reversal

•  If you had a vasectomy, this surgery can reconnect the tubes to allow sperm to enter your semen again.

• Vasoepididymostomy

•  This surgery removes blockages in the epididymis to allow sperm to pass through.

• Sperm Retrieval

•  A procedure to collect sperm directly from the testicles or epididymis.

• Varicocelectomy

• Surgery to remove varicose veins in the scrotum, which can improve sperm quality.

Assisted Reproductive Technology (ART):

• Intracytoplasmic Sperm Injection (ICSI): A single sperm is injected directly into an egg.
• In Vitro Fertilization (IVF): Eggs are collected from your partner, fertilized with sperm in a lab, and the resulting embryo is then implanted into the uterus.

Lifestyle Changes

Maintain a healthy weight.

Eat more fruits and vegetables.

Exercise regularly (like walking, jogging, or weightlifting).

Manage stress.

Quit smoking, drinking alcohol, and using recreational drugs.

Avoid using sexual lubricants.

Medications

Hormone therapy can balance hormone levels to improve sperm quality.

You might need to stop or find alternatives to certain medications, such as some antidepressants or blood pressure drugs.

You can Lower Your Risk of Male Infertility by:

• Quitting smoking, drinking alcohol, and using nonprescription drugs.
• Reducing exposure to harmful chemicals.
• Keeping up with vaccinations that protect against viruses affecting fertility.
• Avoiding prolonged exposure of your testicles to heat.
• Eating a balanced diet low in fats and maintaining a healthy weight.

Additionally, discuss with a healthcare provider other potential risk factors and ways to reduce them. If you have cancer, consider talking to your provider about storing your sperm before starting treatment.

After Treatment

Male infertility can often be addressed with outpatient procedures, typically performed under general anesthesia or IV sedation. Post-surgery pain is usually mild, but recovery and follow-up care can vary.

Varicocele Repair

After the procedure, your healthcare provider will perform a physical exam to check if the vein has been properly closed off. Often, the veins remain enlarged because they are not completely removed, but rather closed off to stop abnormal blood flow.

Semen tests should be conducted every three months for at least a year or until pregnancy occurs.

If the varicocele returns or infertility persists, discuss further options with your healthcare provider, including assisted reproductive technologies (ARTs).

Vasectomy Reversal

Post-surgery pain is usually mild, with a recovery period of four to seven days away from work. The likelihood of achieving pregnancy depends on several factors, including your partner’s age and fertility, as well as the time elapsed since your vasectomy.

In conclusion, male infertility is a complex issue influenced by a range of biological, environmental, and lifestyle factors. Understanding the diverse causes—from sperm abnormalities and genetic disorders to medical conditions, infections, and lifestyle choices—is crucial for effective management and treatment. Each factor contributes uniquely to infertility, highlighting the need for a comprehensive approach to diagnosis and treatment.

The primary steps in addressing male infertility involve accurate diagnosis and targeted treatment. Diagnostic procedures such as semen analysis, imaging tests, blood tests, and testicular biopsies help identify the underlying causes. Treatments vary based on these causes and can include lifestyle changes, medications, surgical interventions, and assisted reproductive technologies (ART).

Lifestyle adjustments, such as quitting smoking, reducing alcohol consumption, managing stress, and maintaining a healthy weight, can significantly improve sperm quality and overall reproductive health. For hormonal imbalances or specific medical conditions, targeted medications may be necessary. Surgical options like varicocele repair or vasectomy reversal can address physical barriers to fertility, while ART procedures, including intracytoplasmic sperm injection (ICSI) and in vitro fertilization (IVF), offer advanced solutions for overcoming infertility.

Preventing male infertility involves proactive measures such as avoiding harmful substances, minimizing exposure to environmental toxins, and staying up-to-date with relevant vaccinations. For those undergoing cancer treatments, sperm banking prior to therapy is a valuable option to preserve fertility.

Ultimately, successful management of male infertility requires a collaborative effort between patients and healthcare providers. Open communication, thorough diagnostic evaluation, and personalized treatment plans are essential for addressing the challenges of infertility. By understanding the causes and exploring the available treatments, individuals and couples can navigate the path to successful conception and build the family they desire.

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