FERTILITY IN MEN
Updated: Jun 17, 2022
What Is Subfertility / Infertility?
When parents have children, it is unquestionably a joy. In today's world, however, many couples wait until they are ready to have kids before starting a family. When they do decide to start trying for a baby, they may experience anxiety and frustration.
At any given month, the success rate for young healthy couples conceiving is between 15% and 25%. As a result, the process of trying to conceive may take several months before the couple is able to conceive.
A diagnosis of infertility/subfertility may be given if you haven’t been able to get pregnant after a year of trying to conceive. Female infertility accounts for around one-third of infertility cases, according to the Office on Women's Health USA, while male infertility accounts for the remaining third. The other one-third of cases could be due to a mix of male and female infertility, or they could be due to an unknown cause.
What Are The Causes Of Male Infertility?
In general, concerns with the following are linked to infertility in men:
effective sperm production
morphology of the sperm
sperm’s movement – wiggling motion of the sperms themselves and their transportation through the male reproductive system
Fertility can also be affected by a number of risk factors, medical diseases, and drugs. Risk factors linked with infertility in men include:
heavy alcohol consumption
overweight or obesity
wearing overly tight undergarments or pants
Certain medical conditions are said to be associated with male infertility as well, such as:
chronic illnesses like diabetes and high blood pressure
hormonal problems like low testosterone levels
unusually large blood vessels around the testes, also known as varicoceles
undescended testes whereby the testicles have not descended into the scrotum
Male fertility can also be affected by a variety of medications and substances, including:
chemotherapy or radiotherapy in cancer patients
sulfasalazine which is usually prescribed for rheumatoid arthritis and ulcerative colitis
high blood pressure medications like calcium channel blockers
anabolic steroids which are commonly use to improve performance in athletes or in situations of delayed puberty
illicit drugs such as cocaine and marijuana
The issues listed above can result in sperms which swim poorly, are malformed, or contain damaged DNA, as well as a reduced number or even complete absence of sperm.
All of this reduces the chances of a successful pregnancy. Even if conception is successful, there is a higher chance that the pregnancy will not be carried to term.
How To Detect Male Infertility?
The actual sex cell involved in fertilisation is sperm. The encircling liquid released during ejaculation is known as semen. Sperm, as well as other nutrients like glucose and protein, are found in semen.
Male infertility testing begins with a quick and painless semen analysis. The volume of semen produced, the quantity of sperm produced, how well the sperms travel, how normal the sperms appear, and whether there is any indication of infection are all measured.
You must refrain from intercourse or masturbation for at least 3-5 days before taking this test. Self-stimulation or masturbation is commonly used to collect sperm into a sterile container. Since lubricants and even saliva might harm your sperm, you should take your sample without them. You have the option of producing the sample at the collection facility or in the comfort of your own home. The sample, on the other hand, should be examined within two hours.
An ultrasound of the scrotum is the next recommended test. This is done to evaluate the testicles and their surroundings. It is a simple, painless, and non-invasive procedure.
We can look at the anatomy of the testicles and make sure there aren't any underlying abnormalities that are causing infertility. Hydrocele (fluid around the testicles) and varicocele (prominent veins around the testicles) are two potential issues. A colder body temperature (about 2 degrees Celsius below normal body temperature) is required for good sperm quality. Insulation from prominent veins or fluid around the testicles raises the overall temperature, resulting in inferior sperm quality.
What Are The Parameters Tested For Semen Analysis?
There are several important parameters that are look at during semen analysis.
We check at the pH of the sperm to see how acidic or alkaline it is. Since the vaginal environment is acidic (to keep dangerous bacteria out of the vaginal area), it is vital for semen to be somewhat alkaline. Semen's slight alkalinity permits it to survive in the vaginal canal for longer.
Semen that is too acidic may cause the sperm to die thus preventing fertilization. Blockage of tubes carrying components of the sperm could cause pH problems.
The fluid from the testes, seminal vesicles, prostate, and bulbourethral glands makes up the semen. The larger the volume of the fluid, the more likely semen will spread throughout the female reproductive system.
An absence of or obstruction of the seminal vesicle, a blockage of the vas deferens, retrograde ejaculation, hormonal imbalance, or stress can all contribute to low semen volume.
As fertilisation is still primarily a numbers game, the higher the concentration of sperm inside a given volume of semen, the more probable fertilisation will occur.
White blood cell (WBC) count
The number of white blood cells in people with reproductive problems is higher than in males who are fertile. WBC in the sperm is also linked to a reduction in sperm count and sperm motility. WBC is thought to impair sperm function. A significant increase in WBC could indicate a male reproductive system infection.
The percentage of living sperm in a sperm sample is referred to as sperm viability. This is necessary to determine whether sperm motility is low in order to distinguish between live non-motile sperm and dead sperm. Reduced viability can be caused by the same factors that generate a low sperm count.
The sperm must be able to "swim" to the egg in order to fertilise it. Forward motion in a straight line or in a large circle is the type of motility desired which is also known as progressive motility.
Sperms may also move but doesn’t make forward progression or swim in extremely small circles. This is what we call as non-progressive motility. Non-moving sperms are called immotile sperms.
Shape of sperms
The shape of the sperm cells is referred to as sperm morphology. This test calculates the percentage of sperm with a normal shape. The head, midsection, and tail, as well as the measurements and proportions between them, are all inspected.
How Is Male Infertility Treated?
Male infertility is treated differently depending on the cause. Stopping smoking, doing regular aerobic activity, and avoiding wearing tight pants have all been proved to benefit.
It has also been proven that a diet high in micronutrients and antioxidants is advantageous. Nutritional supplements are a practical way to make sure you're getting the proper amount of micronutrients and antioxidants every day to help you boost your fertility.
Some of the treatment modalities use to treat infertility are as follows:
Human Chorionic Gonadotropin (hCG) injections
Doctors administer hCG to men to deal with hypogonadism symptoms like low testosterone and infertility. hCG can aid in the production of testosterone and sperm in the body, which can aid in the reduction of infertility.
In men, hCG functions similarly to luteinizing hormone (LH). LH activates Leydig cells in the testicles, resulting in testosterone production. LH also increases the production of sperm in structures called seminiferous tubules in the testicles. The testicles increase in size over time as hCG stimulates them to generate testosterone and sperm.
Clomiphene citrate (clomid)
Clomid is a popular brand name for the generic drug clomiphene citrate. Clomid prevents the pituitary gland from interacting with the hormone oestrogen. Less luteinizing hormone (LH) and follicle-stimulating hormone (FSH) are created when oestrogen interacts with the pituitary gland. This causes a drop in testosterone and, as a result, a drop in sperm production. Clomid suppresses oestrogen’s interaction with the pituitary gland, resulting in an increase in LH, FSH, and thus testosterone.
Clomid is most commonly used to treat female infertility. Although the FDA has not approved it for use in males, it is frequently administered off-label for the treatment of male infertility.
Clomid may cause an increase in testosterone and sperm count. Men have had conflicting outcomes in studies on its efficacy.
Supplements such as Coenzyme Q10 or Profertil
This is a common antioxidant which may help men with infertility. A recent study shows that daily supplementation with coenzyme Q10 can aid in improving sperm motility in infertile men.
Coenzyme Q10 is an antioxidant that is known to be active in the testes and plays a significant role in the formation of membranes and other structures within cells by combating the effects of oxidative stress, according to the researchers.
Researchers discovered that the men had lower-than-normal amounts of coenzyme Q10 in their seminal fluid at the start of the study. The men saw a considerable increase in these levels after six months of administration with the antioxidant.
Profertil is a specially formulated health supplement that aids in the fertility and reproduction of men who want to start a family, as well as contributing to regular spermatogenesis. It composed of amino acids, antioxidants (coenzyme Q10), vitamins and minerals to support normal fertility and reproductive functions of men resulting in normal spermatogenesis.
Take two capsules twice a day with or after a meal and a glass of water. To allow sufficient nutritional support for each individual phase of spermatogenesis, the capsules should be taken for at least three months. Profertil, on the other hand, can and should be used as long as the desire to have children is there.