Male infertility: Causes, sperm problems, diagnosis, treatment and coping tips

Male infertility: Fertility experts on the causes, sperm problems, diagnosis, treatment, coping tips for infertility in men and why they should talk about it

Infertility is a difficult phase to accept for any individual, including men as while being diagnosed, a person goes through physical, emotional and mental turmoil however, being diagnosed with infertility does not indicate that one cannot dream of having a child. Infertility is a common condition where couples including men fail to conceive a child despite several attempts due to certain issues which range from factors like age, sperm quality or lifestyle.

Male infertility: Causes, sperm problems, diagnosis, treatment and coping tips (Photo by Ethan Sykes on Unsplash)

When a person is diagnosed with infertility, they undergo physical, mental as well as emotional turmoil but before understanding the treatment procedures, understanding the causes of infertility is important. In an interview with HT Lifestyle, Dr Amitha N, Consultant - Fertility Specialist, Motherhood Hospitals and IVF Electronic City in Bangalore, insisted that men should consult a doctor after failed attempts for one year of trying to conceive which may happen due to reasons like -

• erectile dysfunction
• problems with ejaculation ranging from delayed ejaculation or retrograde ejaculation
• decrease in sex drive
• experiencing pain or swelling in the genital area
• cases of previous surgery in the genital area

Causes of male infertility

Dr Amitha N informed that when it comes to men, infertility may be caused due to issues ranging from:

• production of sperm
• sperm count
• shape and movement of the sperm

Besides these issues, other risk factors include-

• older age
• consumption of alcohol and smoking cigarettes
• being overweight or obese

In terms of medical conditions, a few of them include-

• experiencing a condition where the semen enters the bladder instead of emerging through the penis commonly termed as retrograde ejaculation.
• swelling around the testicles
• testicles that are unable to descend into the scrotum
• consumption of antibodies that attacks the sperm and destroy them
• a hormonal imbalance that causes low testosterone production

According to Dr Preeti Mahawar, Fertility Consultant at Nova IVF Fertility in Kolkata East's Uttam Kumar Sarani, the major causes of male infertility can be categorized under -

1. Obstructions causing infertility in men: When sperms are produced, they pass through small tubes called epididymis where they mature and exit to a larger tube called the vas deferens which empties the sperms in the ejaculatory duct where it is mixed with seminal fluid. During ejaculation, the muscular contractions force the semen into the urethra and out of the penis. When either of the tubes is blocked or absent due to vasectomy or injury, it may result in infertility.
2. Problems with sperm numbers or quality may affect the fertility rate of a man. A few sperm problems include:

• Absent sperm (azoospermia) – the semen does not contain any sperm due to a blockage of the tubes, infection or injury in the testicles which prevents sperm production.
• Low sperm count (oligospermia) – during ejaculation, low of sperm count causes hindrance while achieving conception.
• Abnormal shape – usually a healthy sperm is shaped like a streamlined tadpole however abnormally shaped sperm poses problems while penetrating through a woman’s egg.
• Poor motility – Sperm with poor mobility is unable to swim through the woman’s reproductive system.

3. Functional problems which contribute to infertility include:

• Impotence – a condition where a man is unable to get or maintain an erection for sexual intercourse.
• Ejaculation problems – a condition where the semen enters the bladder instead of emerging out through the penis.
• Problems with the testicles caused by factors such as injury, infection or chemotherapy.
• Certain disorders ranging from sclerosis or diabetes may cause erection and ejaculation difficulties.
• Consumption of alcohol which may hinder the sperm’s activity.

Diagnosis of male infertility

Dr Amitha N said, “While consulting a doctor, the diagnosis can be segregated into two stages. First, a general physical examination is undertaken where the genitals are examined. The doctor also looks into the individual’s medical history where questions are asked about any injuries, surgeries or chronic health issues which can affect fertility. After the medical history is examined, the semen samples of the individual are obtained for analysis of the mobility, production, shape, and sperm count.”

Treatment procedures for male infertility

“The ideal treatment to improve fertility depends on certain factors such as age, the cause of infertility as well as personal preferences however, with medical advancements, men can explore other alternative treatment measures and opinions which may take some time but will achieve good results,” Dr Preeti Mahawar said. She recommended:

• Surgery - Obstruction in the tubes such as the vas deferens or the varicocele can be surgically corrected and repaired.
• Treating infections in the reproductive tract by antibiotic treatment may not restore fertility but may improve the condition of the reproductive organs which foster fertility.
• In cases of sexual intercourse problems, medication or counselling can help improve issues like erectile dysfunction or premature ejaculation which causes fertility issues.
• When fertility issues are caused by high or low levels of male hormones, there are hormone treatments and medications.
• Sperms are injected to egg directly through a process called in Assisted reproductive technology (ART) involves obtaining sperm which are then inserted in the female genital tract through processes like in vitro fertilization or intracytoplasmic sperm injection.

Dr Amitha N suggested, “The treatment procedure for male infertility depends upon certain conditions such as age and the cause behind the infertility. After the doctor makes an observation, various alternative treatment options are suggested like surgery where the obstructions or corrections in the tube can be done along with medications to help treat hormonal imbalances and infections which may affect sperm count, and assisted reproductive technology (ART) where the eggs and sperms are handled in a laboratory.”

Dealing with infertility issues

“For an individual, coping with infertility can be uneasy and difficult due to the uncertainty it brings. Not being able to figure out why and being unable to estimate how long it would take to recover or the fear of what the outcome could be brings an emotional and mental burden. In these situations, it is important for men to seek help and establish plans to cope during these difficult times. It is important to set a benchmark where you can decide what procedure is emotionally and financially available,” Dr Amitha N advised.

She added, “Secondly, it is important to communicate and express one’s feelings, especially in these dire times instead of holding in the negative feelings. Reach out to family members, friends or even support groups and counselling services to help ease the grief during the treatment. In these times, it is important to manage emotional stress during treatment by practicing stress-reduction techniques like yoga and meditation. Infertility is a common condition experienced by many individuals and in these situations, maintaining an optimistic outlook is important. As technology has advanced to considerable lengths, numerous treatment options are available and with the doctor’s suggestion following these procedures can help treat infertility with time.”