Male Infertility Causes & Treatments

While many men will be celebrating Father’s Day this weekend, for some who are dealing with infertility, it could be very challenging time.
Infertility is (wrongfully) associated as being mainly a female challenge. Although it is true that women are the ones who carry the burden of the pregnancy and are the ones who undergo most of the Assisted Reproductive Technology (ART) procedures and tests, it is also important to acknowledge that men struggle with infertility too. In fact, infertility affects men and women equally, and the emotional impact is as equal. In our previous blog, we listed the common causes of male and female infertility, and we will dedicate this blog to male infertility.

What Are The Common Symptoms:

The most obvious symptom is the inability to conceive a child in 12 months of unprotected intercourse. However, there might be other underlying signs that are associated with male infertility such as problems with sexual function, pain, or swelling in the testicle area.

What are the causes of male infertility?

Alteration in sperm counts, motility, or morphology are the main causes of male infertility. This may be a result of the following conditions:

  • A hypothalamic or pituitary disorder – Male fertility is critically dependent upon a normal hormonal balance. Hormonal imbalance may affect sperm count and/or quality.
  • Testicular disorder – Some of the more common conditions that affect the testicles include testicular trauma, testicular torsion, testicular cancer, epididymitis, and hypogonadism.
  • Sperm transport disorder – this includes blockage in male reproductive organs.
  • Autoimmune disease – anti-sperm antibodies can mistakenly attack sperm cells as foreign cells, which will result in low sperm counts.
  • Infection – These include inflammation of the epididymis or testicles and some STD’s, Urinary tract infections that affect sperm production, health or cause a blockage in sperm passage.
  • Varicocele – A varicocele is a swelling of the veins that drain the testicle which results in reduced quality of the sperm.

Male infertility can also occur when there are problems with sexual function, such as ejaculation problems or erectile dysfunction. Unfortunately, in some cases, male infertility cannot be determined but the good news it can still be treated.
There are other environmental risk factors that can reduce male fertility, such as exposure to excessive heat, radiation, toxins (such as alcohol, cigarettes or cannabis, etc) , heavy metals reduce sperm production or function. Men can help reduce the risks by simple lifestyle changes, such as keeping a healthy diet, avoiding excessive use of saunas and hot baths, as well alcohol, smoking, and stress.

Diagnosis of Male infertility

The initial male fertility examination includes a review of medical history, a general physical exam, blood tests, and semen analysis.
Semen analysis is a useful fundamental tool that allows detection of 9 out of 10 men with a genuine problem of male infertility. The semen analysis will measure the number of sperm cells (quantity), look for any abnormalities sperm’s shape (morphology) and movement (motility). The lab will also check other parameters such as volume, sperm concentration, viscosity, fructose levels, PH levels, and any signs of infection. In most cases, several semen analysis tests are done over a period of time to offset the normal fluctuation in sperm counts.
The fertility specialist may order further tests such as a more comprehensive sperm analysis (CASA – computer assisted sperm analysis, anti sperm antibody screen, DNA fragmentation assay, etc), scrotal ultrasound, genetic testing, and testicular biopsy to complete the diagnosis

What are the treatment options?

Based on the medical history and the diagnostic tests results the fertility specialist will determine the course of treatment. The treatment options may include:

  • Surgery – is offered in the treatment of varicocele (widening of the veins in the scrotum and back flow of warm abdominal venous blood ) or in cases of blockage in the tubes that carry sperm.
  • Antibiotic treatment – is useful in cases of infection of the male reproductive organs.
  • Hormone replacement and medication – is used in the treatment of hormonal imbalance.
  • Medication or counseling – can be useful in the treatment of sexual function problems.
  • Assisted reproductive technology (ART) – Depending on the semen analysis results, the sperm will be collected either from the patient or sperm donor.
  • IUI – Artificial insemination may be effective in some cases of low sperm count and quality. In this procedure, sperm is collected from several ejaculations. Poor quality sperm cells are removed then manually placed in the female’s uterus.
  • IVF – In this procedure, fertilization occurs in the lab by mixing the sperm specimen with the egg. The developing embryo is later inserted to the woman’s uterus.
  • ICSI (IVF)– Intracytoplasmic sperm injection is an in vitro fertilization procedure in which a single sperm cell is injected directly into the cytoplasm of an egg
    Fertility supplement – Sperm production may also improve by taking clinically proven supplements

Male infertility is a complex disease that may be caused by combination of several factors however, the good news is that in many of the cases of male infertility are treatable with the right treatment plan. Juno specialists will conduct comprehensive diagnostics testings that will allow us to tailor a course of treatment that is right for you. Most of these tests are covered by OHIP, so if you have concerns don’t hesitate, ask your family doctor for a referral or contact us. 

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