Male infertility: Diagnosis and treatments for men to cure low sperm count

Men are equally responsible for infertility as females since male partners can have Oligozoospermia (low sperm count), Asthenozoospermia (which is poor motility), teratozoospermia or Oligoasthenoteratozoospermia (OAT).

OAT is the most common kind of male infertility but sometimes patients may have Azoospermia, when no sperms can be found in a man’s semen and up to 10% to 15% of infertile men are diagnosed with it.

In an interview with HT Lifestyle, Dr Ankush Raut, Senior Fertility Consultant at Apollo Fertility, revealed, “There can be many factors which can cause above conditions like Genetics factors, Abnormal hormone levels, anti-sperm antibodies, infections of the reproductive system, lifestyle habits and choices like alcohol consumption, smoking and illegal drugs, trauma, infection, surgery in the pelvic area, inflammation, vasectomy, a cyst, cystic fibrosis gene mutation that can cause the abnormal development of the vas deferens.”

Insisting that it is very important to diagnose the underlying condition so that appropriate treatment can be given, he said, “Today because of advancement in the field of ART, assisted reproductive technology treatment is possible in almost all cases of male infertility if we do proper evaluation and diagnosis. For diagnosis, general physical examination and medical history is very important. Apart from that, the most important investigation is Semen analysis. In semen analysis we check for concentration of sperm present, its morphology as well as its motility. Apart from that in cases where required DNA fragmentation index can also be done.”

He highlighted that a scrotal ultrasound can help us to see if there is a varicocele or other problems in the testicles and supporting structures and advised:

· A blood test for the level of testosterone and other hormones is also important.

· Post-ejaculation urinalysis, Genetic tests, Testicular biopsy are important in cases of Azoospermia.

· Treatments for male infertility starts with lifestyle modification. Having sexual intercourse every day or every other day in a fertile window will increase chances of conception.

· Avoid the use of lubricants. Products such as Astroglide or K-Y jelly, lotions, and saliva might impair sperm movement and function.

· Follow a healthy lifestyle. Eat healthy foods, maintain a healthy weight, get enough sleep, and exercise regularly.

Stop or reduce your use of alcohol, quit smoking, and don’t use illicit drugs.

· Supplements like Coenzyme Q10, Folic acid and zinc combination, L-carnitine, Selenium, Vitamin C, Vitamin E can help.

· Apart from healthy lifestyle, treatment of infection with antibiotics, considering surgery if significant varicocele is present, medication or counseling to improve fertility in conditions such as erectile dysfunction or premature ejaculation, Hormone treatments and medications can help you to conceive.

· Assisted reproductive techniques such as ICSI (Intracytoplasmic sperm injection), P-ICSI, TESA, Micro TESA, Noasera, etc. can help to have pregnancy even in cases like OATS, Obstructive and non-obstructive Azoospermia.

In the end treatment is possible in almost all the cases of male factor infertility. Most important is proper evaluation, diagnosis and treatment according to that. According to Dr Anu Sadashiv, Reproductive Medicine Specialist at Milann Fertility and Birthing Hospital in Bangalore’s KumaraPark, “More than five million couples struggle with infertility, making it a widespread issue. One in every six couples who are attempting to get pregnant suffer with infertility. Male factors are a main or contributing cause in at least half of all cases. Fortunately, having infertility problems does not prohibit someone from having a kid of your own with your partner. There are procedures and therapies that can help diagnose and treat male infertility.”

She shared that finding the reason for infertility may need a variety of diagnoses like:

• Examining your genitalia and questioning about any hereditary disorders- ongoing health issues, ailments, injuries, or operations that may have an impact on your fertility are part of this process.
  By Semen Analysis which has to be taken out into a designated container at the doctor’s office or by using a special condom during intercourse.
• Hormone Testing as hormonal or organ system abnormalities could potentially be a factor in infertility. The quantity of testosterone and other hormones can be determined by a blood test.
• She pointed out that to assist and determine the reason for your infertility, your doctor might suggest additional tests. These may include:

· Scrotal ultrasound, Transrectal ultrasound, post-ejaculation urinalysis, Testicular biopsy, Genetic tests.

· A fertility specialist determines the best course of treatment for your specific situation.

As per her, the following treatments may be used, depending on the cause of infertility:

1. Surgery- For instance, a varicocele can frequently be surgically fixed, and a blocked vas deferens can usually be fixed. An earlier vasectomy can be reversed. Sperm can frequently be extracted straight from the testicles or epididymis using sperm retrieval procedures in situations where there are no sperm in the ejaculate.

2. Treating infection- An infection of the reproductive tract may be treated with antibiotics.

3. Treatments for issues with sexual intercourse – In cases of erectile dysfunction or early ejaculation, medication or counseling can assist enhance fertility.

4. Medications and hormonal therapies– In circumstances when infertility is caused by high or low levels of particular hormones or issues with how the body uses hormones, your doctor may advise hormone replacement or medicines.

5. Assisted reproduction techniques (ART)– Depending on the specific situation and preferences, ART treatments may involve obtaining sperm by normal ejaculation, surgical extraction, or from donors. The sperm are subsequently used for intracytoplasmic sperm injection, in vitro fertilization, or insertion into the female vaginal canal.