MALE INFERTILITY

Let’s continue from our last post, we successfully defined infertility and its causes. In this post, however, we will address male infertility.

Oftentimes, women are blamed for infertility issues especially in Africa, God forbid you insinuate that the ‘‘head of the house’’ is infertile but men can be too… We have clarified that infertility is the ability to achieve pregnancy after one year of unprotected intercourse; let’s now see how the male factor plays its part.

HOW OFTEN ARE MALE FACTORS INVOLVED?

Infertility is equally likely to be caused by male and female factors. The remaining one third of cases are caused by a mixture of male and female issues or by unknown reasons.

HOW IS MALE INFERTILTY EVALUATED?

The initial male infertility evaluation starts with a medical and reproductive history and semen analysis (sperm count). If any abnormalities are found in the initial evaluation, then the man should see a male reproductive specialist. The specialist will take a complete history and perform a physical examination and, based on those results may recommend further testing.

WHAT MALE FACTORS CAN CAUSE INFERTILITY?

Some of the common problems that cause infertility include a varicocele, obstruction and medications.

Varicocele

Varicocele is an abnormal dilation of veins within the scrotum and is detected on physical examination. It is more common on the left but it can occur on both sides. In addition to infertility, a varicocele can cause discomfort.

Generally, it is recommended that a varicocele be corrected if a man is infertile, has an abnormal semen analysis and there is little or no infertility issue in the female partner. Most men with a varicocele, however, are not infertile and have no problems related to the varicocele.

Obstruction

Another common cause of male infertility is obstruction, or a blockage in the reproductive tract. The most common reason is vasectomy, but other conditions such as trauma or infection can also lead to blockage.

Medications

Medications can also cause infertility. In some cases, simply stopping the medication can allow a man and his partner to have a pregnancy. Common medications that cause infertility include testosterone and chemotherapy (for cancer). Both types of medications cause infertility by suppressing sperm production. In most men, stopping testosterone will allow sperm production to return to the same level as before starting the medicine. Depending on the amount and type of chemotherapy, some men will recover sperm production over time.

IS IT POSSIBLE TO HAVE A CHILD IF THE MALE PARTNER HAS ONE OF THESE OTHER PROBLEMS THAT CANNOT BE CORRECTED?

Yes.

As long as sperm can be obtained, then pregnancy is possible with specialized – fertility treatments. Some men can have sperm retrieved from the reproductive tract for use with In Vitro Fertilization (IVF).

HOW OFTEN SHOULD A COUPLE HAVE INTERCOURSE?

Surprisingly, long periods of abstinence can decrease the quality of sperm. Couples should have intercourse at least two to three times a week during the fertile period. A couple has more chances of pregnancy if they have intercourse every one or two days during the fertile window, and a pregnancy is most likely if a couple has intercourse within the six-day time frame that ends on the day than an egg is released.

DOES DIET AFFECT FERTILITY?

Obesity has been clearly linked to an impaired sperm production. Overweight men interested in optimizing fertility should attempt to attain an ideal body weight. Antioxidants such as vitamins E and C are found in most multi-vitamins, have been found to result in a slight increase in both sperm count and movement. Fruits and vegetables also provide a natural source of antioxidants and should be part of a balanced and healthy diet.

WHAT ARE THE EFFECTS OF SMOKING AND RECREATIONAL DRUG USE?

Smoking is associated with reduced sperm quality. Men who are trying to conceive should consider quitting smoking immediately. Also, recreational drugs, including anabolic steroids and marijuana, are associated with impaired sperm function; they should not be used.

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