Learn about the causes, diagnosis, and treatment options for male infertility. Our experts at AFIC are here to help you on your journey to parenthood.
Understanding the complex process of reproduction and male fertility factors
Reproduction requires both the male and female to contribute in the process. The female produces eggs from her ovaries which is then fertilized by sperms produced by the testes. Before reaching the egg in the uterus, the sperms have to swim through many physical obstacles, so much so that only around a few hundred sperms out of millions, can actually reach the uterus. Thereafter, only one sperm finally makes it to the eggs before others and that's when fertilization occurs. When the sperms present in the semen are sufficiently deficit in their capacity to reach to eggs, fertilization is made impossible and the male is rendered infertile.
Key factors that determine sperm health and male fertility
Semen volume is the total volume of seminal ejaculate produced by a man. Normally, a healthy male ejaculates 2-6 ml of semen per discharge. It is still not impossible to give birth if you have low semen volume.
Viscosity defines the mobility of semen in the vaginal core. A less viscous semen can easily flow through the vaginal layer whereas, if the semen is too viscous, its movement is hindered and therefore may remain stagnant.
Sperm Motility is the capacity of individual sperms to propel itself in forward direction. Generally man is capable of impregnating a woman if he has sufficient progressive motile sperms over non-progressive ones.
Sperm morphology explains the shape, size, and structure of sperm cells. Even if a man has enough motile sperms in his semen, if the morphology is faulty, he most likely loses his capacity to give birth.
In order to fertilize an egg, sperm should be swimming freely and not stuck to each other. Agglutination of sperm occurs when the head or tail of one sperm sticks to another sperm restricting the motility of the sperm.
One of the most important decisive factors for sperm health is how many sperms there are in the total volume of semen of the male. When the total sperm per ejaculate is less than 39 million, it's called low sperm count.
DNA Fragmentation Index roughly describes the percentage of sperms in semen with damaged DNA material. Excessive DNA fragmentation causes embryo factor infertility and therefore needs treatment.
Visualizing the challenges sperm face in reaching the egg
This animation demonstrates how sperm must navigate obstacles to reach the egg. Only a small fraction of the millions of sperm released will complete this journey successfully.
Various factors that can contribute to male infertility
Problems in sperm motility and morphology, low sperm count (oligospermia) and the absence of sperm in ejaculate (azoospermia).
Genetic disorders, including Klinefelter syndrome and myotonic dystrophy can cause congenital factor infertility.
Some medical conditions, such as high blood sugar level and insulin resistance can hinder sperm production and maturation.
Certain autoimmune diseases like Rheumatoid Arthritis, Autoimmune Thyroiditis can cause persistent infertility in men.
Various infections in testicular organs like epididymitis and sexually transmitted infections (STIs), like gonorrhea or HIV can cause infertility.
Swollen veins in your testicles (varicoceles) can restrict blood flow to testes and consequently thwart sperm production.
Cancer treatments, including chemotherapy, radiation therapy can cause physiological problems in sperm production.
Testicular trauma can cause severe infertility by internal injuries and blood clotting in the sperm traversal path.
Hormonal disorders that affect hypothalamus or pituitary glands can cause excessively low levels of Testosterone causing infertility.
Exposure to radiation, harmful industrial chemicals and metal compounds may cause infertility in a lot of men.
Poor lifestyle, bad diet, lack of sleep and excessive intake of nicotine, alcohol and drugs also can cause infertility in some men.
Effective approaches to address male infertility
Advanced methods to identify and understand male fertility issues
Semen Analysis covers almost all the sperm factors. It is performed as the primary infertility diagnosis in men to monitor general infertility.
Semen Culture tests aims to detect bacterial infections in the reproductive system with the help of microbial culture and antibiotic sensitivity test.
Ultrasound test is done to visualize the presence of blockage and clotting in sperm traversal path. It's a very common diagnosis technique.
Blood tests are an essential part of male infertility diagnosis. Blood tests help doctors to evaluate production and utilization of essential hormones.
SCD test is a special technique which allows doctors to inspect the DNA of sperms in greater detail. It's mostly recommended to avoid post-treatment pregnancy failures.
MFSS technique is an advanced infertility diagnosis method which segregates sperms based on biochemical motility and DNA fragmentation factors.
Scrotum USG is done to inspect the testicles and the epididymis. It utilizes sound waves to look into the presence of tumors, blockage, swelling and blood flow.
At AFIC, testicular biopsy is done with the help of minimally invasive procedures, aiming to reduce pain. It is mainly done to check spermatogenesis in the patients.
Urine test is another common infertility test in men. The test helps in identifying possible existence of UTI (Urinary Tract Infection) and diabetes causing infertility.
Karyotyping test on the chromosomes of sperm helps determine the presence of mutations and deformities in DNA, causing certain genetic disorders.