Male Infertility Treatment

How is male infertility evaluated and diagnosed?

A delay in a couple’s pregnancy can be due to male infertility problems, female infertility problems, or both. Sometimes, the cause behind a couple’s inability to reproduce can also remain unclear or undetermined. In any case, taking a female or male fertility test can prove highly beneficial in choosing the most appropriate line of treatment.

(a) Physical examination:

The number of tests required for diagnosing fertility problems varies from patient to patient. But generally, doctors start by conducting a general physical examination to identify any visible injuries, surgeries, or any other problems in the reproductive organ that may be the prime cause of infertility.

(b) Medical History:

Next, most doctors analyse the patient’s medical history. Through this, information about any genetic problems, chronic health conditions, medications taken by the patient, etc. is collected. The male and the female partner can also be questioned by the doctor about any past trauma, general sexual habits, etc.

(c) Analysis & Further Tests:

All this patient information is put together to form a strong basis for deciding the treatment for male infertility or female infertility problems. If these details feel insufficient to the doctor, then they can recommend any of the below-mentioned tests to find out about male fertility issues.

What are the common male infertility tests performed?

Fertility test for men is very useful for getting a clearer picture of the problem at hand. It will also help you get the best fertility treatment in a cost-efficient manner. Your doctor may suggest you take any one or more tests listed below. 

(1) Semen Analysis

Semen analysis is one of the most basic tests performed for male fertility testing. It helps to look into the pH level (acidic or basic in nature), sperm concentration (how many sperms are present in every millimetre of semen), sperm volume (quantity of sperm in every ejaculate), total sperm count (the total number of sperms present in an ejaculate), sperm viscosity (the amount of time taken for sperm liquefaction), colour, velocity (the travelling speed of a sperm), morphology (sperm shape and size), linearity, etc.

(2) Sperm Analysis

Sperm analysis is also a crucial male fertility test where a sperm’s motility (any irregularity in the movement of the sperm to fertilize the egg), viability (the ability of the sperm to stay alive in the female’s reproductive system), morphology (the appearance or quality of the sperm), etc. is analyzed. 

(3) Scrotal ultrasound

A scrotal ultrasound conducted in male infertility treatment provides images of any structural abnormalities in vital male reproductive organs like testicles, etc.

(4) Transrectal Ultrasound

Transrectal ultrasound helps to spot any blockages in the tubes or ejaculatory duct and treat them accordingly. 

(5) Hormone Testing

A blood test helps a doctor to check the testosterone levels and other hormones secreted by the testicles, hypothalamus, pituitary gland, etc., and get treatment for male infertility problems arising due to hormonal imbalance.  

(6) Post-ejaculation urinalysis

In retrograde ejaculation, the sperms travel backwards rather than getting discharged through the penis. Due to this, there can be traces of sperm found in the urine. Post-ejaculation urinalysis helps to identify this problem in infertile men.

(7) Genetic tests 

Inherited or genetic syndromes, changes in the Y chromosome, extremely low sperm concentration, etc. can all be a reason for male factor infertility. Such abnormalities can be detected by running a blood test. 

(8) Testicular biopsy  

Testicular biopsy or TESE (Testicular Sperm Extraction), is a procedure where samples are removed from the testicles using a needle. This male fertility test helps to find out whether a healthy sperm is present or not. A testicular biopsy can help when the cause of sperm abnormality is difficult to determine.

(9) Specialized sperm function tests 

In rare cases, an additional fertility test for men may be done to understand if sperm can penetrate well and form a fertilized egg, the ability of the sperm to stay alive post-ejaculation etc.

What treatments are available to treat male infertility? 

Male fertility treatment can range from medical therapies and surgeries to advanced ART (Assisted Reproductive Technology) for infertile men. Get the best treatment at Indira IVF according to your needs for a budget-friendly fertility solution. 

(A) Medication treatment: 

Medicines are normally the first line of treatment administered to patients with less severe infertility issues. This can include prescribing medications for –

• Treatment of Reproductive Tract Infections
• Controlling Sexual Health Problems e.g., premature ejaculation, erectile dysfunction, etc.  
• Restoring Hormonal Balance (for abnormally high or low levels of hormones), etc.
   

Men with fertility issues generally have low sperm counts. Some prescription-based medications stimulate certain hormone-releasing organs in the body, that in turn work to increase sperm production in the male partner. The drugs should be taken in the manner instructed by the doctor.

(B) Assisted Reproductive Technology (ART) for Male Infertility:

ART or Assisted Reproductive Technology provides men and women with pre-existing infertility issues to get additional help to conceive easily. These techniques also come to use when the cause of delayed pregnancy is difficult to identify. Some of them are discussed below: 

1. IVF (In Vitro Fertilization): 

IVF is one of the most popular assisted reproductive techniques. In IVF (In Vitro Fertilization), medications help a female’s eggs to mature. When multiple eggs have matured under the effect of these fertility injections, they are collected through the egg retrieval technique. 

The male partner also submits a specimen of his semen which is then used to fertilize the female’s eggs in a culture dish. Once fertilization is completed, the fertilized egg/embryo develops and then is planted inside a woman’s uterus. If the embryo attaches to the uterus lining and starts growing, then a couple gets pregnant. 

In Vitro Fertilization (IVF) is a highly recommended male infertility treatment, especially when they have a low sperm count or poor sperm motility. This technology can facilitate fertilization by preventing the sperm from ‘getting lost’ in the female’s reproductive path. Also, sperm with poor motility can easily fertilize a female’s egg as they are placed close to each other in a laboratory dish.

2. ICSI (Intracytoplasmic Sperm Injection): 

ICSI provides further assistance with an IVF procedure. In Intracytoplasmic Sperm Injection (ICSI) instead of letting sperms fertilize the female eggs on their own, a laboratory expert selects a healthy sperm and directly injects it into the egg through a needle for fertilization. This type of advanced male infertility treatment can help those with severe reproductive health conditions.

After fertilization happens and an embryo is developed, it is put back into the female’s womb. A few subsequent tests will help to know if the woman is successfully pregnant.

3. IUI (Intrauterine Insemination)

IUI can also be called artificial insemination as the healthy sperm of the male partner is directly placed into the female’s uterus for fusion. IUI starts with the male partner collecting his semen specimen and giving it to the laboratory experts for further processing. The sperm received is washed well to remove compounds like prostaglandin and obtain healthy sperm of high concentration. 

When the female partner is nearing her ovulation, this sample is placed in her uterus. This will increase the chances of fertilization when the female’s eggs are released from her ovaries. Men with infertility complaints like low sperm motility, concentration, movement, or less sperm count can be highly benefitted through this technique.
 

4. Sperm Donation

The Sperm Donation program helps to fertilize a female partner’s eggs with the sperm of a person other than the male partner. For this procedure, healthy sperm can be obtained from any sperm storage facility or sperm bank. They are then used for artificial insemination during an IVF procedure. Men with severe sperm morphology, or low sperm count, or women who want to get pregnant without a male partner can be helped through this technique.

(C) Surgical Treatment for Male Infertility:

Some men with infertility problems may also be suggested to undergo certain surgeries if needed. A few common lines of surgical treatments are mentioned below:

1. Vasectomy reversal

Vasectomy stops the flow of sperm from the testicles to the penis by surgically cutting, blocking, or sealing the ducts in the scrotum that carry them. This results in their semen having no sperm when they ejaculate. In vasectomy reversal, the vas deferens are repaired and reconnected carefully with expert care. 

2. Varicocelectomy 

Varicocele can cause several problems relating to male infertility like poor sperm quality and production. This happens due to swelling of the scrotum varicose veins. A surgical procedure like varicocelectomy treats this condition effectively, thereby reducing discomforts like testicular pain and increasing the chances of fertility.

3. Vasoepididymostomy

In the vasoepididymostomy procedure, any additional blockage in the vas deferens or epididymis that may have formed with time, injuries, infections, etc. is surgically removed. After the blockage is treated through this method, the ends of the vas deferens tubes are connected back again. 

4. Sperm Retrieval

A Sperm Retrieval procedure is performed to extract semen from the testicles. This procedure is helpful to men who are not able to ejaculate or produce any semen/sperm.

(D) Lifestyle changes: 

Bringing healthy changes in the day-to-day lifestyle can help to improve fertility conditions in men. A few highly suggested improvements include:

• Avoiding the use of any recreational substance
• Refraining from consuming alcohol
• Stopping habits like smoking, taking marijuana, etc. 
• Exercising or dietary changes to maintain an optimum body weight