Even in today’s world, it is a tradition that fertility issues are mainly concern with women and not men. But studies have proven that the male contribution to infertility is around 45-50% of the cases. This is often due to problem either in sperm production or in sperm delivery, resulting in lower chances of their female partner getting pregnant.
· Approximately 1 in 25 men has abnormal sperm parameters, which make them impossible to have a child on their own naturally.
· In 10% of them, either they do not produce sperm at all or produce sperm with very low motility or very poor morphology
Under normal conditions, the sperm are produced in the testis and stored in epididymis with the help of chemicals called male hormones (Testosterone). During ejaculation, the sperm travels from epididymis to another set of tubes called vas deferens. These vas deferens joins the ejaculatory ducts in the seminal vesicles. As they travel through these tubes they are mixed with secretions from the seminal vesicles, prostate and bulbouretheral glands. Sperm along with these secretions forms the semen. Semen travels through the urethra and out of the penis.
Once the semen is deposited into the vagina, the sperm tend to ascend through the cervix, uterus and fallopian tubes. If the sperm happens to meet the egg, then fertilisation takes place. The entire process happens in the coordinated manner only when certain conditions- hormones, environment and genes are right. If there is any problem with any of the sequence then the chances of conception declines.
Male Infertility can be due to any of the following reasons:
|Sperm Production Problem||Either very low or no sperm produced.||
· High temperature in the groin
· Undescended Testis
· Genetic problem
|Sperm Transport Problem||Blockage in the passage||
· Absence of Vas deferens
· Recent Infections
· Recent Trauma or injury
|Hormonal Problem||FSH, LH and testosterone plays an important role in the sperm production. Sub-optimal hormonal levels can affect sperm quality and quantity||
· Trauma or Injury
· Dysfunction or tumor in pituitary gland
· Metabolic disorders
· Genetic factor (Kallman Syndrome or Klinefilter syndrome)
|Sexual Problem||Not able to achieve erection or engage in sexual intercourse||
· Spinal cord injury
· Diabetis Mellitis
· Advanced Paternal age
· Consumption of alcohol
|Health and Environmental factor||Changes in health and life style||
· Increased Stress
· Alcohol Consumption
· Unhealthy lifestyle
· Chronic diseases
· Reason is unknown
A thorough medical history and physical examination including scrotal ultrasound and semen analysis are the standard assessment for all men.
Semen analysis is a simple, cost effective, laboratory tests which assess the sperm parameters. Semen testing assess for number of sperm present, whether they can move and how do they look. It also informs us about the volume, presence of infection or anti bodies.
all parameters above the reference range
|Oligozoospermia||total sperm number below the reference value|
|Asthenozoospermia||total or progressive motility below reference values|
|Morphology below reference range|
no sperm observed
Combinations of the above can also occur
Definitions associated with semen quality :
- Semen culture – Assessment of semen sample for bacterial infections
- Hormonal evaluation – Assessment of FSH, LH, Testosterone levels
- Sperm antibodies testing
- Sperm Chromatin Test – Assess the sperm DNA fragmentation
- Genetic Testing
- Testicular Biopsy