Male Infertility Guide

Male Infertility Guide

What is Male Infertility

Male infertility is a male’s inability to cause a pregnancy after having regular intercourse with a fertile female without using any birth control methods for one year. According to estimates, male infertility accounts for over 40 percent of the causes of infertility. In general the main reasons for male infertility are low sperm count and poor semen quality due to immobile sperms or malformed sperms.

Once diagnosed with male infertility, a patient may undergo mental stress and embarrassment, which further intensifies the problem. Therefore prevention when possible and timely treatment is advised.

Causes of Male Infertility

Broadly, the major causes of male infertility could be genetic or acquired. Predominantly, any one or more of these conditions can lead to male infertility: illness, mental stress, ageing, hormone imbalance, infection, injury, lifestyle factor and environmental factor.

For instance, many xenobiotics are released in the environment, with the rising of use of chemicals across most products we use in our day to day lives. They could enter the human body through food, water, air etc. and harm the male reproductive system.

Further, men who smoke can have a lower sperm count as compared to those who don’t smoke.

In addition, depression in a male can lead to sexual dysfunction due to reduced libido, erectile dysfunction, or a delayed ejaculation.

Also, prolonged usage of some of the medications may lead to this condition. These could be antibiotics, anti hypertensives, chemotherapeutic agents, hormones and psychotherapeutic agents.

Obesity may lower male fertility by directly affecting sperm and indirectly by leading to hormonal changes that could reduce the fertility.

Taking alcohol regularly could reduce testosterone levels. It may also give rise to erectile dysfunction and lessen sperm production. Resultant liver illnesses can also lower male fertility.



In today’s modern times, a modification program of lifestyle through a well-designed programme of educational, environmental, physical exercise and psychological support factors can surely aid in preventing the further rise in male infertility cases. It will help couples have better chances of spontaneous conception and have a better quality of life.

Therefore, Male Infertility is preventable, like many other conditions. The main causes should be closely understood and the causing factors should be avoided, whatever may be closely affecting our lives such as excessive use of mobile phones, physical activity, caffeine level, obesity, smoking, alcohol, drugs, chemicals use etc., as applicable in a particular case.

For instance, overheating the testicles is a known cause for male infertility and it can be prevented. Very frequent use of saunas or hot tubs may be avoided, sitting for long hours, wearing tight clothing or working on a laptop computer for long stretches could be lessened. The reason is that these things can be probable causes of increase the temperature in scrotum and lowering of sperm production.

Persistent mental stress should be avoided and the factors that are leading to it should be gradually eliminated. The reason is that stress may release steroid hormones that reduces the testosterone levels and sperm production. It may also lower semen quality and fertility.


The diagnosis of male infertility in undertaken through physical examination followed by a semen analysis. The main semen measurables are its concentration, appearance and sperm motility. There is sometimes also a need of hormonal assessment of the HPG axis.

The scrotum, testes, and prostate are checked during the physical examination for any infection, obstruction or varicocele.

Semen analysis is a totally pain free process. Semen sample can be provided either through masturbation or during intercourse by using a special condom. The sample should be delivered to the laboratory within two hours for accurate results.

Some of the tests prescribed are transrectal or scrotal ultrasonography, post-ejaculatory urinalysis, and genetic testing, as may be required.

The patient history components can be one or more of these factors: reproductive (like previous infertility treatments and sexually transmitted infections), medical (like diabetes), surgical (like bladder surgery or vasectomy), social (like tobacco), occupational (like radiation or heavy metals) and medications (like antibiotics).

A close diagnosis of history can identify risk factors that could affect fertility potential.


The current rising demand for infertility services has come about die to an increased awareness about the treatment options, an acceptance of infertility, and a trend of delayed marriage and childbirth causing more fertility issues.

Treatments will be suggested based on the exact underlying disease. Also apart from the male’s infertility condition, female’s fertility also is a consideration for recommending a suitable solution.

For instance, after the diagnosis, a proper treatment may be suggested for the men who might benefit from Assisted Reproductive Technology (ART) such as intrauterine insemination (IUI) or in vitro fertilization (IVF) with or without intracytoplasmic sperm injection (ICSI).

ART procedures are being used successfully for the past 3 decades or so to raise the fertility rate. IVF-ICSI is one of the ART procedures that overcomes oligospermia or azoospermia by injecting a single sperm into the cytoplasm of a mature egg.

Probable treatments for some common male infertility conditions are as elaborated below:

Low sperm count – If a male is diagnosed with low sperm count, its underlying cause has to be found out. For example, in case the reason is veins’ swelling that are draining the testicles, or blockage of the sperm ducts, surgical treatment could be the solution. On the other hand, if the reason is infection or hormonal imbalance, medication might be the cure. For some other cases, Assisted Reproductive Technology might be the answer.

Infertility due to vasectomy – In case a male has undergone the vasectomy procedure and now the couple wishes to have a baby, an operation called intracytoplasmic sperm injection (ICSI) could be the answer. ICSI may be a preferred choice as compared to vasectomy reversal in a scenario when time is a concern, and the couple wants only one child. ICSI is less complicated as compared to vasectomy reversal and needs a small surgical procedure.

Hormonal therapy– In case the cause of male infertility is hormonal imbalance, giving luteinizing hormone (LH) and follicle-stimulating hormone (FSH) might be curative.

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