The contribution of male to couple infertility or subfertility is about 50% which puts men on the same front as women. Male infertility or Subfertility as we now call it, is clearly reflected by semen analysis and in this page we will discuss the various abnormalities of the semen parameters, their causes and their treatment.
Here are some important terms that you should know when dealing with male factor subfertility.
Aspermia is the lack of semen
Azoospemia is the lack of sperms in the semen
Reduced Number of Sperms
Weak sperms with poor motility
Odd shaped sperms with poor morphology
Problems with amount and liquefaction
Many of these problems occur in combination or keep varying from sample to sample. Oligospermia, asthenospermia and teratospermia often co-exist in many cases. Let’s learn about the causes of these problems in men.
What causes issues in Semen
Semen Problems are Complicated. A large part of male subfertility problems is due to unidentified and genetic causes that are either too insignificant to detect or rare. Our science is still progressing and evolving to identify more and more causes of male subfertility. By far stress and poor lifestyle are the other controllable and leading causes of commonly found semen problems. The above chart describes the common causes of male subfertility.
Lifestyle Changes for Male Infertility
Have more of fermented nuts and seeds, Citrus fruits , Bananas, Broccoli , Green Leafy Vegetables, Walnuts, Turmeric, Dark Chocolate, Ginserg, Garlic, Vitamin D, Folate, Zinc30 minutes of exercise, 15 minutes of meditation/breathing exercises, | Avoid saunas/steam baths, laptop use. Avoid junk meals, smoking and limit alcohol. These diet and lifestyle changes have some part to play in patients with oligospermia, asthenospermia and teratozoospermia.
What else can we do to Help ?
The first and foremost thing that you need to deal with subfertility is a proper assessment of possible factors and examination of your genitals. Many times we are able to rule out infections, varicocele and other conditions like absence of Vas deferens also get an idea about you hormones through a personal meeting.
For many conditions such as infections and low grade Varicocele medications can be useful and correct the problems. Even for mild semen abnormalities causing infertility medications called neutraceuticals can be helpful if not curative. Hormones can also be corrected through medications
Certain problems such as varicocele, Phimosis, Ejaculatory duct blockage and identifiable blockage in the passage of sperms such as a prior vasectomy may be corrected with minor surgical procedures to restore optimum fertility. Many of these surgeries are microscopic and require high degree of skill and training for best outcomes.
Other options for managing Male Sub fertility
In Intrauterine Insemination semen is collected by masturbation and processed or pooled to get the best semen parameters and then injected in the uterus of female partner to make a baby. This is a very simple and cost effective way to make a baby with assistance but chances of success are about 15% only. It requires a semen count of about 10 million or more and results worsen as the count and quality of sperms worsens
In Vitro Fertilization (IVF)
When the number of sperms in very low or when prior attempts with IUI have failed, sperms can be directly exposed to the egg by surgically retrieving the egg and putting them together in a test tube. The chances of pregnancy with this technique are as high as 40% but this procedure requires a lot of manipulation of the female partner in terms of hormones and testing.
Surgical Sperm Retrieval (SSR) and Intra-cytoplasmic Sperm Injection (ICSI)
Even in patients where we can’t find a sperm in the semen, we can make and attempt to extract sperms using PESA, TESA or Micro-TESE and fuse them with the egg. The chances may reduce a bit compared to IVF but they are still better than IUI. ICSI is the last resort to having your own baby for many couples.
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