Best option to become a Father with Male Factor Infertility?

When a couple is unable to convince, male infertility is often neglected, but statistically, one-third of infertility cases are consequences of male factor infertility.

What is Male Factor Infertility?

Male Factor Infertility is the inability to conceive children naturally due to abnormalities in the male reproductive system. It accounts for low sperm count, low sperm mobility, morphology, lack of sperm or semen production, erectile dysfunction, etc. Male infertility may comprise one or more of these factors.

When a couple couldn’t get pregnant even after continuous attempts, then both male and female partners are subjected to fertility tests. The motive is to find the cause of infertility. If male factor infertility is diagnosed then the treatment specific to the cause of infertility is suggested to the couple.

If you’re one of many suffering from male infertility and dream of becoming a father, there are various treatments available for you.

The first step of the treatment plan is to find the cause of infertility. Here are some of the many male factor infertility causes:

  • Congenital Absence of the Vas Deferens,
  • Cystic Fibrosis,
  • Retrograde ejaculation, Erectile dysfunction,
  • Varicocele,
  • Sperm disorders; azoospermia, oligospermia, etc.,
  • Male anatomic abnormalities, Genetic abnormalities,
  • Hormonal disorders,
  • Certain medications; antibiotics, chemotherapy medicines,
  • Unhealthy lifestyle; smoking, drinking alcohol, substance abuse, overweight, stress, other illnesses like diabetes, etc.,
  • Infections,
  • Radiation, toxins, heavy metals, heat,
  • Genetic factors,

To find the cause of infertility Your fertility expert may recommend the following tests:

  • Semen Analysis and Sperm Assessment Tests; To analyze the quality and quantity of sperms,
  • Scrotal and Transrectal ultrasound; In case of very low or no sperm count,
  • Hormone Testing,
  • Genetic Screening,
  • Biopsy of Testicles,
  • Sperm DNA Assessment, etc.

After these tests, the doctor will find out one or other infertility causes. Having said that, sometimes it is hard to find the actual cause of male factor infertility.

Depending upon the genesis of infertility, different treatment options are available. Your fertility specialist will suggest the best suitable treatment specific to you.

Some male infertility treatments are surgical and non-surgical, whilst others are more advanced Assisted Reproductive Technology (ART) treatments. Following are the best treatment options available depending upon the infertility cause;

How can ICSI help Childless Couples with Failed IVF?

Non-surgical Treatments

  • Lifestyle Modification:

At times fertility can be improved with help of some lifestyle alterations. As smoking, alcohol, and drug abuse can lower sperm count and mobility – breaking off these habits abet fertility. Also building healthier habits like exercise, a better diet, and losing weight can reduce infertility factors like Erectile dysfunction caused by being overweight, stress, etc.

  • Medication:
  • Oftentimes, infertility can be aided with medication like in the case of anejaculation, rectal probe ejaculation, or retrograde ejaculation; which can be caused by numerous factors.
  • Infections: Antibiotics or non-steroidal anti-inflammatories are prescribed in epididymal and testicular infections to aid with low sperm count and mobility.
  • Hormonal Disorders: Anomaly of the pituitary gland can cause hormonal imbalance e.g. lower testosterone, and higher prolactin level. Hormones like testosterone stimulate sperm production in the male reproductive system. Medicines and injections such as Clomid and Pergonal help with hormonal improvement.
  • Genetic Factors: Few genetic conditions namely azoospermia, klinefelter syndrome, Kallmann syndrome, etc., can be noxious to the development of the genital tract which carries sperm, and hence affect semen parameters. Roughly 15-60% of infertility cases are genetic factors. Some medicine might help with this.

Surgical Treatments

  • Varicocele:

varicocele is an abnormal growth of veins in the scrotum. This can badly affect semen parameters. However, it can be surgically fixed to improve the overall quality and quantity of sperm.

  • Epididymovasostomy:

This is a microsurgical treatment to fix epididymal blocks so that semen/sperm can pass through the epididymis.

  • Transurethral Resection of the Ejaculatory Duct (TURED):

Ejaculatory Duct blockage is treated by making an incision in the ejaculatory duct with the help of a cystoscopy via the urethra.

  • Vasectomy reversal.

Assisted Reproductive Technology Treatments

If the exact cause of male infertility is unknown – ‘Idiopathic’ male infertility – then your doctor may go for ’empiric therapy.

In case all the surgical and non-surgical methods fail to help you conceive assisted reproductive techniques (ARTs) are very competent. In ARTs, pregnancy can be achieved without sex as sperm or egg are assisted for artificial insemination and fertilization.

For all ART treatments, sperm retrieval is a must. Sperm samples are retrieved from semen or directly from the testis and further processed to isolate the quality sperms. If your semen has enough sperm count then sperm will be isolated from semen after ejaculation. Otherwise, some sperm retrieval methods for ARTs are given as:

  • Testicular Sperm Extraction (TESE):

In this process, sperms are extracted from testicles. This method is employed in case of no sperm count (azoospermia) or anejaculation. A micro biopsy is performed to assist the microscope inside the testicles to find the sperm tissues.

  • Testicular Fine Needle Aspiration (TFNA):

This is another diagnosis for azoospermia. Sperms are removed from the testis by penetrating with a needle and syringe.

  • Percutaneous and Microsurgical Epididymal Sperm Aspiration (PESA and MESA):

In both procedures, the sperms are retrieved from epididymal tubes. In PESA, a needle is used to extract fluid from the epididymis. If we failed to get sperm by PESA, then transurethral microsurgery (MESA) is performed under general anesthesia.

After successful sperm retrieval, they can be isolated as well as frozen for further ARTs processes. Determined by your root and type of infertility, your fertility expert may suggest one or a combination of these techniques:

Intrauterine Insemination (IUI)

In IUI, the sperms are placed inside the female uterus during ovulation with the help of a tube or catheter. The sperm then reach out to eggs via the fallopian tube for fertilization. Male with bad sperm parameters or other infertility causes can rely on IUI.

In Vitro Fertilization (IVF)

IVF is one of the most promising infertility treatments for male infertility. In this technique, both the egg and sperm are extracted from the female (uterus or follicles) and male (Semen or testicles), respectively. Later, the healthy egg and sperm are placed in a culture in a closed vicinity to carry out fertilization. Upon development of the embryo(s) (fertilized egg) up to the blastocyst stage ( three-five days) it is transferred back to the uterus for implantation. Successful implementation of an embryo(s) on the uterine lining results in pregnancy.

This method is applied in the case of female fallopian tube blockage, and oligospermia or idiopathic infertility for males.

Intracytoplasmic Sperm Injection (ICSI)

ICSI is a modified IVF technique. If the sperm quality is very low, the sperm is directly injected into the egg. The fertilized egg is monitored until the blastocyst stage (embryo). The rest of the process follows the IVF technique.

Most surgical and ART techniques are invasive, so your consent is obligatory.

Donor Sperm and Donor Egg:

If by all means, we fail to retrieve any healthy sperm and egg from you and your partner, respectively, then opting for donor sperm, donor egg or even donor embryo is a sustainable option.

Our Specialists team investigates your infertility and counsels you on the best treatment available specific to you and your needs. We also provide Surrogacy facilities for female patients with hysterectomy, endometriosis, etc.

Dr Rita Bakshi

Dr. Rita Bakshi is a well renowned gynaecologsts and obstetrician with a rich experience of more than 20 years in the field of Assisted Reproductive technology (ART). Dr. Rita has extensive experience in all fields of assisted conception, with a special interest in IVF and Egg Donor Surrogacy. She’s also the founder of ADIVA group of Hospitals. During the past two decades of service, Dr. Rita Bakshi has brought happiness to thousands of couples and performed over 6000 caesarean sections, 3000 Hysterectomies, 1000 cases of IVF annually with a success rate of over 45%. She takes your dreams seriously and focuses on the long term and best interests of the child, the surrogate and the intended parent(s).