Male Infertility
There are more than one causes of male infertility. As a first step of your fertility investigation, you will be asked to undergo a physical examination and we will evaluate your medical history, taking into account your personal and family background, social and environmental factors that can influence your fertility. A semen analysis may be ordered to measure any abnormalities in the morphology and motility of the sperm. Our infertility specialist will help you diagnose the issue and recommend treatments or procedures that will result in conception.
Below is a small description of treatment options available at Fertility point.
Obstructive Azoospermia
Obstructive Azoospermia means sperm are being produced normally in the testes, but there is a blockage or obstruction in the male reproductive tract that prevents the normal transport of sperm through the post-testicular ductal system. Obstruction occurs mostly in the epididymis, vas deferens and ejaculatory duct. Azoospermia can be caused due to several conditions including sexually transmitted disease, retrograde ejaculation, scrotal trauma/injury, scar tissue, cystic fibrosis, hernia surgery and vasectomy.
There are two treatment options for obstructive azoospermia: surgical correction of the obstruction, or sperm retrieval from the epididymis or testes through testicular sperm extraction (TESA).
Testicular Sperm Extraction (TESE)
Testicular Sperm Extraction (TESE) is a surgical procedure to remove a small amount of testicular tissue or epididymal fluid in the testicle. These tissues are later transported to the laboratory to extract viable sperm from biopsy specimen that can be used for Intracytoplasmic Sperm Injection (ICSI) or In Vitro Fertlisation (IVF). TESE is a minor procedure performed under local anaesthesia. This technique is done in men where there is a blockage in the ducts that are supposed to carry sperm from the testicle and there are no sperm in the ejaculate to succeed with IVF.
Oligospermia
Oligospermia, also commonly referred as low sperm is defined as low sperm concentration in the ejaculate. As per WHO the sperm count in a semen sample should be above 15 million sperm per milliliter, anything below can be diagnosed as oligospermia. Semen with poor sperm quality also show significant abnormalities in sperm morphology and motility. Finding an exact reason behind low sperm count can be complicated, however following are some of the possible causes.
- social and environmental factors such as tobacco and alcohol consumption, exposure to toxic environmental agents, or stress
- hormonal imbalances
- surgery
- chemotherapy
- radiation
- infection
- testicular factors
- genetic abnormalities
Retrograde Ejaculation
Retrograde ejaculation occurs when the semen is redirected to the urinary bladder instead of ejaculating via the urethra. This happens when the bladder sphincter does not function properly, forcing semen to enter the bladder.
Even though retrograde ejaculation is harmless, it can cause male infertility. Men with diabetes are at high risk of developing this condition. Retrograde ejaculation may be also caused due to usage of certain medications, congenital conditions, injury or surgery. In most cases for men with retrograde ejaculation, sperm can be retrieved through urine sample or through Testicular Sperm Aspiration (TESA).
Varicocele
Varicocele is a condition occurs when the veins enlarge within the scrotum. These veins are similar to varicose veins of the legs. These veins also known as pampiniform plexus, drains blood from the testicles. It might cause male infertility. Pooled blood in the enlarged veins affects the temperature in the scrotum to increase than normal, it affects the ability of the testes to produce sperm resulting in decreased sperm count, decreased motility and poor morphology. Varicocelectomy is a treatment option available to treat varicocele. It is a small microsurgical procedure in which all the swollen veins are tied off while preserving the normal blood vessels. In many patients this can result in a dramatic increase in sperm counts and motility.
