Male Infertility: What Every Man Should Know

What is Male Infertility?

According to the WHO, around 1 in 7 couples worldwide face infertility , meaning they have been unable to conceive after a year or more of trying.

In India, male infertility is often overlooked, as there is a common misconception that infertility mainly affects women. However, men can also experience this condition. Male infertility can be caused by a range of issues, including problems with sperm production, reduced sperm motility, and blockages that prevent sperm from being released.

In India, factors such as exposure to pollution, smoking, alcohol use, and obesity can negatively impact sperm quality. Additionally, health conditions like diabetes, which affects over 77 million people in India , as well as genital infections, also play a role in male infertility.

Understanding Male Reproduction and Infertility

For natural male reproduction to occur, you must be able to:

• Produce healthy sperm capable of fertilizing the egg.
• Maintain an erection and successfully ejaculate , allowing sperm to reach the egg.

When problems occur in either of these areas, infertility may be the result. Below are some of the main causes of male infertility.

1. Issues with Sperm Production

• Low Sperm Count : When the ejaculate contains fewer sperm than the normal required amount.
• No Sperm Production : Refers to the complete absence of sperm in the ejaculate.
• Poor Sperm Quality :
  • Motility Issues: Sperm that do not swim effectively may fail to reach the egg.
  • Abnormal Shape: Sperm with irregular shapes and sizes may struggle to fertilize the egg.
• Hormonal Imbalances : Issues with hormones like testosterone can adversely affect sperm production.

2. Obstructions Leading to Male Infertility

• Any blockages in the genital tract ( the tubes that transport sperm) can prevent sperm from passing through. These obstructions may be caused by previous surgeries, infections, genetic, or congenital conditions.

3 . Functional Issues Contributing to Infertility

• Impotence:The inability to achieve or maintain an erection sufficient for sexual intercourse.
• Ejaculation Problems:Includes issues like retrograde ejaculation (where semen enters the bladder instead of exiting through the penis) and premature ejaculation.
• Testicular Problems:May result from injury, infection, or chemotherapy.
• Varicocele:Enlargement of the veins within the scrotum, similar to varicose veins in the legs. This condition can increase the temperature in the testicles, affecting sperm production and quality.

4. Health and Lifestyle Factors

• Smoking, Alcohol, and Drug Use:These habits can reduce sperm count and damage sperm DNA.
• Obesity: Excess weight can lead to lower testosterone levels and a higher risk of erectile dysfunction.
• Sedentary Lifestyle: Lack of physical activity and prolonged exposure to heat ( e.g., hot showers) can negatively impact sperm production.

5 . Genetic and Immunological Factors

• Chromosomal Abnormalities : Conditions like Klinefelter syndrome (where males are born with an extra X chromosome) result in very low or no sperm production, affecting fertility.
• Anti-sperm Antibodies: In some cases, the immune system mistakenly targets sperm, reducing their mobility or preventing them from reaching the egg.

By understanding these causes, individuals can seek accurate diagnosis and treatment . Modern medical advancements provide various solutions that can address many of these issues.

Who is at risk for male infertility?

You may be at a higher risk of male infertility if you have experienced:

• Previous inflammation of the prostate or genital infections
• Injury to the testicles or conditions like testicular torsion (twisting of the testicles)
• Early or delayed onset of puberty
• Exposure of the genitals to high temperatures
• Surgery for hernia repair
• Undescended testicles
• Immune disorders that cause the body to produce antibodies against its own sperm
• Genetic conditions, such as cystic fibrosis or hemochromatosis

You may also be at risk if you take certain prescription medications, including those used to treat ulcers, psoriasis, depression, and high blood pressure.

How is Male Infertility Diagnosed?

Male infertility is diagnosed through a combination of reviewing medical history, physical exams, and specialized tests to identify potential issues related to sperm production, function, or ejaculation. Below are the common steps involved in the diagnostic process:

1 . Medical History

The doctor will inquire about:

• Sexual History : Frequency of intercourse, history of sexually transmitted infections (STIs), and any issues with ejaculation or sexual function, such as erectile dysfunction.
• Medical Conditions : History of chronic illnesses (like diabetes or thyroid disorders), previous surgeries (e.g., hernia repairs, testicular or prostate surgeries), and past infections (such as mumps or STIs).
• Lifestyle Factors : Smoking, alcohol use, drug habits, stress, exposure to toxins at work, and dietary and exercise patterns.
• Family History : Any genetic disorders or fertility issues present in the family.

2. Physical Examination

detailed physical exam includes:

• Examination of the testicles and penis : Checking for abnormalities such as varicocele (enlarged veins in the scrotum), testicular lumps, or small testicles, which may indicate underlying problems
• Assessment of secondary sexual characteristics ( e.g., body hair, muscle mass): To evaluate hormonal health, as low testosterone can affect these traits.
• Evaluation for physical signs of hormonal imbalances or genetic conditions.

3. Semen Analysis

The primary diagnostic tool for male infertility is semen analysis, which involves collecting a semen sample for laboratory examination. The test evaluates:

• Sperm Count: The number of sperm present in the sample.
• Sperm Motility : The ability of the sperm to swim efficiently.
• Sperm Morphology : Assessing whether the sperm have normal shape and structure, as abnormalities can affect fertility.
• Sperm Morphology : Assessing whether the sperm have normal shape and structure, as abnormalities can affect fertility.
• Semen Volume : The quantity of semen produced, which can influence sperm transport.
• Sperm DNA Integrity :Advanced tests may analyze the quality of DNA in sperm to detect damage.
• Multiple analyses are often conducted over weeks to account for normal variations in sperm production.

4. Blood Tests

Blood tests help evaluate hormone levels and detect underlying health conditions:

• Testosterone : Low levels can indicate hormonal imbalances affecting sperm production.
• Follicle-Stimulating Hormone (FSH) : Regulates sperm production; abnormal levels can indicate issues with the testicles or pituitary gland.
• Luteinizing Hormone (LH) : Controls testosterone production.
• Prolactin : Elevated levels can interfere with sperm production.
• Thyroid Hormones : Imbalances can impact fertility.

5. Scrotal Ultrasound

non-invasive test that examines the testicles and surrounding structures. It can detect:

• Varicocele ( enlarged veins in the scrotum).
• Cysts, tumors, or other structural abnormalities in the testes.
• Blockages in the vas deferens or epididymis ( the tubes that carry sperm).

6. Genetic Testing

If low or no sperm is detected, genetic testing might be recommended to check for conditions such as:

• Y chromosome microdeletions : Missing genetic material that affects sperm production.
• Klinefelter syndrome : A condition where men have an extra X chromosome, leading to reduced sperm production.
• Cystic fibrosis gene mutations :Often associated with a congenital absence of the vas deferens, impacting sperm transport.

7. Post-Ejaculation Urinalysis

This test identifies retrograde ejaculation, where semen enters the bladder instead of being expelled through the penis. After ejaculation, a urine sample is analyzed for the presence of sperm.

8. Testicular Biopsy

A testicular biopsy involves taking a small sample of testicular tissue for microscopic examination. It is usually performed when:

• ⦁ Sperm production is extremely low or absent, and the cause is unknown.
• Klinefelter syndrome : A condition where men have an extra X chromosome, leading to reduced sperm production.
• The biopsy helps determine if sperm is being produced but not reaching the semen due to blockages or other factors.

9. Advanced Sperm Function Tests

Additional tests may be conducted to assess sperm function more closely, such as:

• Sperm DNA Fragmentation Test : Measures DNA damage in sperm, which can impact fertility even with a normal sperm count.
• Acrosome Reaction Test : Evaluates the sperm’s ability to release enzymes needed to penetrate and fertilize an egg.
• Sperm Penetration Assay : Tests the sperm’s capacity to penetrate an egg.

By using these diagnostic tools, healthcare professionals can identify the underlying causes of male infertility and recommend appropriate treatment options.

How is Male Infertility Treated?

Treatment for male infertility varies depending on the underlying cause, with several options available. Below is an overview of the main treatment methods:

1. Medications

Various drugs can help treat male infertility, especially in cases involving hormonal imbalances or infections:

• Hormone Treatments: When infertility is due to low testosterone or other hormonal issues, hormone replacement therapy or medications that stimulate natural hormone production may be used. Examples include:
  • Clomiphene: Increases hormone levels to stimulate the production of testosterone and sperm.
  • hCG Injections: Stimulate the testes to produce testosterone and boost sperm production.
• Gonadotropin Therapy: Administered to men with pituitary disorders, this therapy can stimulate sperm production.
  • Antibiotics: Used to treat infections such as prostatitis or sexually transmitted infections (STIs) that may cause male infertility.
  • Erectile Dysfunction Medications: Drugs like sildenafil (Viagra) or tadalafil (Cialis) can help men with erectile dysfunction achieve an erection suitable for intercourse.

2. Surgical Interventions

Surgery may be needed if physical abnormalities or blockages are affecting fertility.

Common procedures include:

• Varicocele Repair : Enlarged veins in the scrotum (varicoceles) can be corrected through a procedure called varicocelectomy, which improves sperm production and quality.
• Sperm Retrieval Procedures: When blockages prevent sperm from being present in the ejaculate, sperm can be surgically extracted from the testicles or epididymis:
  • Testicular Sperm Aspiration (TESA) or Microsurgical Testicular Sperm Extraction (TESE).
  • Percutaneous Epididymal Sperm Aspiration (PESA).
• Repair of Obstructions : Surgical correction of blockages in the vas deferens, epididymis, or ejaculatory ducts may be possible.

3. Assisted Reproductive Technology (ART)

ART helps couples conceive when issues with sperm count or quality limit the chances of natural conception. Common ART options include:

• Intrauterine Insemination (IUI) : This procedure involves placing washed and concentrated sperm directly into the woman’s uterus during ovulation to increase the chances of fertilization. IUI is often recommended when sperm motility is low.
• In Vitro Fertilization (IVF): In this process, sperm is combined with eggs outside the body in a lab, and then one or more fertilized embryos are transferred into the uterus. IVF is often used when there are issues with sperm quality, motility, or unexplained infertility.
• Intracytoplasmic Sperm Injection (ICSI):ICSI involves injecting a single sperm directly into an egg. This method is suitable for cases of extremely low sperm count or when sperm cannot naturally penetrate the egg, often used in conjunction with IVF.
• Sperm Donation: When sperm count is very low or absent (azoospermia) and cannot be treated, couples may opt for donor sperm for IUI or IVF.

4. Treating Ejaculation Problems

ART helps couples conceive when issues with sperm count or quality limit the chances of natural conception. Common ART options include:

• Retrograde Ejaculation: Medications like pseudoephedrine or imipramine may be prescribed to treat retrograde ejaculation, a condition where semen enters the bladder instead of being expelled through the penis.

By addressing the specific underlying cause of infertility, these treatment options can significantly improve the chances of conception.

Apart from this simple lifestyle changes can also help to deal with infertility, these include :

• Quit Smoking and Reduce Alcohol Consumption
• Avoid Drugs : Anabolic steroids, recreational drugs ( such as marijuana or cocaine), and certain medications that can impair sperm production.
• Weight Management : Losing excess weight through a healthy diet and regular exercise can help normalize hormone levels and improve sperm production.
• Reduce Heat Exposure : Avoid tight underwear, prolonged hot showers or anything that increases scrotal temperature, which can affect sperm production
• Stress Management : Reducing stress and anxiety can improve overall health and potentially enhance fertility.

Consult With Our Best Male Infertility Doctors In Mumbai:

If you are facing male infertility issues and looking for expert care, consult with our top male infertility specialists in Mumbai. Our experienced doctors specialize in diagnosing and treating various causes of male infertility, from hormonal imbalances and genetic disorders to lifestyle-related factors. With personalized treatment plans, we offer advanced solutions like assisted reproductive technologies (ART), medications, and surgical interventions to help you achieve the dream of parenthood.

Why Choose Us?

• Expert Team : Our team of highly qualified andrologists and urologists has extensive experience in treating male infertility.
• Comprehensive Care :We offer a full range of diagnostic tests, including semen analysis, hormonal evaluations, and advanced genetic testing.
• Cutting-Edge Treatments : Access to the latest treatments such as In Vitro Fertilization (IVF), Intracytoplasmic Sperm Injection (ICSI), and sperm retrieval techniques.
• Personalized Approach : Each patient receives a tailored treatment plan designed to address their specific fertility challenges.
• State-of-the-Art Facilities : We provide care in world-class fertility clinics equipped with the latest technologies.

Get in Touch

Consult with our male infertility experts in Mumbai today. Whether you're just starting your fertility journey or seeking advanced treatments, our dedicated team is here to support you.
Call us now or book your consultation online to take the first step toward overcoming male infertility.