Whenever the issue of infertility comes into light, all the major problems associated with it that quickly follow the thought are related to female infertility. Male infertility hardly gets the concern. This thing is so common that whenever a couple is trying to conceive a child for a long time but getting unsuccessful, woman is the one to blame. Nobody cares about male fertility. That is why it becomes really necessary to understand everything about male infertility and be aware of it.
What Is Male Infertility?
The lack of ability of a man to get a woman pregnant or to produce a baby is called ‘male infertility’. The major causes of male infertility are abnormal sperm count, abnormal shape of the sperm called sperm morphology, low sperm motility i.e. inability to swim normally, hormonal imbalances in the body or some other physical aberrations in the sperm duct or in the organs. A problem in any one of these areas can cause infertility in men.
How Is Semen Tested For Its Quality?
A man is tested if he is fertile or not with the help of a Semen Analysis Test. This test measures the semen on various parameters after which the cause of infertility can come out. The main parameters that are seen in a semen analysis test are:
- Ejaculate volume (> 1.5 mL)
- Sperm concentration (> 15 million/mL)
- Total sperm motility (> 40%)
- Progressive motility (>= 32%)
- Sperm morphology (> 4%)
- pH level (from 7.2 to 7.8)
Many think that male fertility is all about sperm count. But it is more than that. These major factors along with a few others determine the quality of semen in a male and state whether the man is fertile or not. Thus it brings out the cause of infertility. These parameters are important not only for natural conception but also in ART methods (Assistive Reproductive Technique) cause they help determine which course of action should be taken for a successful treatment.
The most important criterion is the sperm count. A semen sample contains sperms in millions, which is why the sperm count is measured in concentration. A sperm count of 15 million/mL or more is considered normal and there’s no problem with sperm count if the test value is this. According to the test values, sperm concentration can be said to have 4 major categories. If the sperm count is normal, it is called Normozoospermia. If it is a little less than the normal value, it is called Oligospermia. When the sperm count is critically low, it is called Cryptozoospermia. If the sperm concentration is almost zero or nil, then this condition is called Azoospermia. A detailed classification is as follows:
- Normozoospermia (>15 million sperm/ml)
- Mild Oligospermia (10 to 15 million sperm/mL)
- Moderate Oligospermia (5 to 10 million sperm/mL)
- Severe Oligospermia (1 to 5 million sperm/mL)
- Cryptozoospermia (0 to rare sperm, hidden sperms found after centrifugation)
- Azoospermia (0 sperm)
How The Sperm Morphology And Motility Affect Male Fertility?
While sperm count is an important factor in testing male fertility, sperm morphology and sperm motility are also equally important. Sperm morphology refers to the shape of the sperm. Ideally, the sperms should have a round, fairly sized head that makes easier to penetrate the egg. The sperm tail should be even, long and fairly shaped to help it swim easily. If a large portion of sperms doesn’t have the shape is not as it supposed to be, fertility is affected and it becomes difficult to impregnate a woman.
Similarly, sperm motility is also crucial. Sperm motility means the ability of the sperm to swim inside the female reproductive system to reach the eggs. If you have a fairly good sperm count but the motility is low, that means there are very less sperms which are motile, and then it is likely that you will need treatment to overcome this problem. It is the concentration of swimming sperms which is important in successful conception.
What Are The Major Causes Behind These Male Infertility Issues?
One of the major reasons behind infertility in men is found to be varicocele. Varicocele is a condition in which the blood vessels around the testicles get swollen or dilated. It results from abnormal closure of the valves in the blood vessels, which then leads to blood accumulating around the testicles. This also makes the temperature of the testicles rise affecting the sperm production. This condition is so common that more than one-fourth of men having infertility issues suffer from this condition. Thus it calls for greater attention from every one of us.
Another major cause that comes out in such cases is the hormonal imbalance in the body. Testosterone is the primary male hormone. An imbalance in the testosterone level in the male body can affect sperm production. If a man is not making enough of his own testosterone, then the sperm production gets compromised and it leads to low sperm count. On the other hand, if a man takes testosterone injections to boost up the testosterone level in the body, the normal hormone production in the body gets docile leading to a shutdown of sperm production in the body. Very intense workout can also affect sperm production.
Other causes include:
- Genital infections that may cause scarring
- Sexual dysfunction (like loss of libido)
- Some medications like chemotherapy or hair loss medication
- Poor overall health
- Some genetic disorders that prevent sperms from coming out
- Some environmental factors
- Other unexplained fertility issues
How Can These Issues Be Traced And Treated?
When male fertility is being checked, the primary step in this process is the semen analysis. The semen analysis, as stated earlier, checks for the sperm count, sperm morphology, sperm motility, pH level of semen and other things to find the cause of male infertility.
After semen analysis, blood tests are done to check for other things like testosterone level in the blood. Low testosterone levels in the body can be treated with medicines like Clomid. It can help drive a man’s sperm production to a better level. Varicocele is also checked and if present, it affects the sperm production. A surgery can be implemented in such a case to treat this problem.
After that, the patient’s history is checked. If at any time in the past, the patient has undergone some surgical procedure involving the male organs then it is noted. Other things like the work conditions are also asked because some environmental factors affect sperm production.
Any problems that are detected in the male body are tried to counter with medication. If medication is not helpful, a surgery may be performed.
In case of azoospermia, a surgical procedure is done to extract sperms from the testicles and then injected into the female egg as part of the IVF procedure. It is called ICSI or Intracytoplasmic Sperm Injection.
If in a case the sperm count is good but sperm motility is not, a procedure called Intrauterine Insemination (IUI) is implemented in which sperms are placed inside the woman’s uterus, overcoming the need for the sperm to swim through the vagina and cervix.
How Common Is Male Infertility?
Male infertility is more common than you think. An estimate says that around 40 to 50% of couples who are struggling with infertility, there is a male issue involved. This is much more serious than we can see. With female infertility getting all the attention and blame, male infertility gets neglected. Especially in India, where most people still think that it is the woman who is responsible for giving birth to a child and if any issue occurs, it is with the woman, not the man. This thought should be eradicated from our society and a message should be spread among the people that this thing can happen with anyone – male or female, rich or poor, rural or urban, fit or unfit. People should come up with their issues and consult with fertility specialists if they are facing any problem in conceiving a child.
Aveya IVF has experienced fertility specialists who can test you for your fertility and suggest the best course of action to take in case of any fertility issue found. We can take care of the needs a couple has while trying for a baby.