Male Infertility Specialist

What is a Male infertility specialist?

A male infertility specialist is a medical specialty that focuses on male reproductive health and disorders, especially male infertility and sexual dysfunction. Male infertility is a common reproductive problem in men. When a couple is unable to conceive after at least one year of unprotected sex, it is important that both partners be examined by their doctor. Out of three infertility cases, one of them is related to men.

What are the causes of male infertility?

Male infertility is a common reproductive problem in men. When a couple is unable to conceive after at least one year of unprotected sex, it is important that both partners be examined by their doctor. Out of three infertility cases, one of them is related to men.

Some of the major causes of male infertility may include:

• Size, shape, number and motility of sperm
• Enlarged veins in the testicles (varicocele)
• Reverse ejaculation of sperm (retrograde ejaculation)
• Abnormal testicles
• Obstruction of sperm transport ducts
• Hormonal imbalance
• Sperm attack by the body’s defense system
• Chromosomal abnormalities
• Certain diseases and infections such as kidney disease, testicular cancer, and sexually transmitted diseases (STDs)
• Certain medications and previous surgeries
• Sexual problems
• Excessive exposure to radiation, industrial chemicals and heavy metals
• Excessive use of illegal drugs, alcohol and tobacco
• Stress and obesity

Signs and symptoms of male infertility?

You may not show signs of infertility until you try to have a baby. If symptoms occur, they may include:

• Changes in hair growth
• Changes in sexual drive
• Small and firm testicles that may be painful or swollen.
• Difficulty in erection and ejaculation

Who is at risk of male infertility?

You may be at risk of male infertility if you have the following factors:

• Smoking, excessive alcohol consumption and drug abuse
• Overweight
• Exposure to toxins
• Excessive heat or damage to the testicles
• Previous major abdominal or pelvic surgery, or vasectomy (permanent birth control)
• Past or present infections
• History of unwanted testicles
• Family history of fertility disorder
• Certain medical conditions, including tumor and sickle cell disease
• Special drugs
• Undergoing medical treatment for cancer

How is male infertility diagnosed?

To diagnose male infertility, the doctor first performs a general physical examination and medical history to understand sexual habits, sexual development during puberty, chronic health problems, medications and surgeries that can lead to infertility. Additional male fertility tests that may be ordered include:

• Semen Analysis: This is a laboratory test that is performed to evaluate the sperm count and sperm quality from the ejaculated semen sample in a sterile bottle.
• Correct ultrasound of the prostate: This research is done to evaluate the prostate gland and detect any blockage in the ducts transporting sperm.
• Scrotal ultrasound: This is an imaging test to detect abnormalities of the scrotum or testicles.
• Testicular biopsy: A small piece of testicular tissue is removed using a sterile needle and evaluated under a microscope.
• Anti-sperm antibody test: This test is done to detect antibodies that attack sperm.

What are the stages of male infertility?

There are two types of male infertility:

• Primary infertility: You are unable to conceive after at least 1 year of unprotected sex.
• Secondary infertility: You have been able to conceive a child at least once, but now you cannot.

What are the treatment options for male infertility?

Male infertility treatment depends on the cause of infertility. Sometimes, a combination of treatment options is suggested to address the underlying problem. These include:

• Surgery: In cases of obstruction of the sperm duct, it is performed to improve sperm movement and reverse ejaculation.
• Medications: Medications such as antibiotics prescribed to treat genital tract infections.
• Male hormone replacement therapy: May be used to treat hormonal imbalances.

What are the alternative treatments for male infertility?

Some alternative treatments for male infertility may include:

• Counseling on sexual problems and relationships: This can help increase fertility levels.
• Lifestyle modification may be suggested: this includes changing habits such as illicit drugs, smoking and alcohol use, and using stress reduction techniques.

How is male infertility surgery performed?

Some of the common surgeries that are performed to treat male factor infertility are:

Varicocelectomy

Varicocelectomy is surgery to treat varicocele, which is the most common cause of infertility in men. Enlarged vessels in the testicle are constricted and destroy nearby arteries and lymphatic vessels.

Reverse vasectomy (vasovasostomy)

Reverse vasectomy reverses the effect of vasectomy. This is done by resetting the vas deferens in your penis so that you can ejaculate sperm again.

Unblocking the ejaculatory ducts

This method involves opening the ejaculatory ducts and allowing the natural flow of ejaculate.

Electric ejaculation

An electrogeniculator or electrical probe is inserted into the intestine and placed in front of the prostate gland. High frequency energy is used to stimulate ejaculation. The ejaculate is collected and used for IVF procedures.

Sperm recovery techniques

Sperm can be retrieved by inserting a needle through the skin or by making a small incision and aspiration from the testis or epididymis.

assisted reproductive technology (ART)

ART is another option for treating male infertility. It includes treatments that help couples with infertility problems try to conceive. Some of them are:

• Intrauterine insemination (IUI), where sperm is placed in the partner’s reproductive tract.
• Intracytoplasmic sperm injection (ICSI), in which a healthy sperm is injected directly into the egg.
• In vitro fertilization (IVF), in which fertilization takes place outside the body in a laboratory.
• IUI – Intrauterine Insemination: Intrauterine insemination (IUI) is a procedure in which washed ejaculated sperm are placed in the uterus at the time of ovulation.

Intrauterine insemination is indicated in the following cases:

• The sperm count is low
• Low sperm motility
• The presence of anti-sperm antibodies
• Erectile dysfunction or inability to ejaculate

Microinjection or intraocular sperm injection (ICSI)

Intra-ovulatory sperm injection is a procedure in which mature sperm are injected directly into the separated egg from your partner.

ICSI is indicated for the following:

• When the number of male sperm is very low.
• There are other problems caused by sperm such as abnormal shape or low motility.
• Previous attempts at ectopic fertilization have resulted in failure or low fertility rates.
• Men with a history of vasectomy that requires the collection of sperm from the testicles or epididymis (place of sperm maturation).
• In a situation where the number of sperms in the semen is zero, but there are sperms in the testicle tissue (non-obstructive azoospermia).
• Difficulty in ejaculating, such as people with spinal cord injury, diabetes and other disorders.

How is ICSI performed?

The steps of this method are completely similar to the steps of IVF; But instead of egg fertilization in a laboratory container, the embryologist extracts normal-shaped motile sperms from the semen sample and directly injects one sperm into each egg. That is, the stages of ovarian stimulation, egg collection and sperm preparation take place, and only in the fourth stage, unlike IVF, where the husband’s sperm is poured next to the woman’s egg in a container so that the sperm itself enters the egg and fertilizes it; In the microinjection method, the sperm is injected into the egg and then fertilization takes place.

How to prevent male infertility?

Male infertility cannot be prevented, but there are certain strategies that can help maintain the quality and quantity of sperm:

• Avoid smoking, drugs and drinking too much alcohol.
• Avoid excessive heat such as hot tubs and steam baths.
• Avoid exposure to environmental and industrial toxins.
• Talk to your doctor about using certain medications that may affect your fertility.
• Exercise regularly.
• Consider ways to protect your fertility from cancer treatment.

Am I a candidate for male infertility surgery?

You may be a good candidate for male infertility surgery if you have:

• Obstructive or non-obstructive azoospermia: Absence of motile sperm in semen
• Oligospermia: low sperm count
• Varicocele: enlarged veins of the scalp
• Ejaculatory duct obstruction (EDO)
• Ejaculation problem
• Want to reverse a previous vasectomy?