Male infertility is a sensitive and complex issue that significantly affects the lives of couples dreaming of creating a happy and stable family. When a man faces difficulties in conceiving, he experiences anxiety, frustration, and feelings of inadequacy, leading him to seek solutions for this problem that threatens his hopes and dreams.
In this article, we will discuss in detail the treatment of male infertility, its causes, treatment methods, and prevention. We will highlight the latest technologies and treatments available in this field that can restore hope and happiness to couples wishing to fulfill their dream of parenthood.
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What is male infertility?
Infertility is defined as the inability of a couple to achieve pregnancy after one year or more of regular unprotected intercourse.
If you are experiencing difficulty conceiving, you are not alone, 15% of husbands face fertility issues, and in half of these cases, the cause is male-related. Therefore, it is important to understand and diagnose the causes of male infertility and address the issue with the best medical solutions.
The cause of delayed conception could be related to a health condition in either partner. Studies indicate that 10% of women of childbearing age (15-45 years) face difficulties in achieving and maintaining pregnancy. A combination of factors prevents conception, and it is essential to identify and diagnose these factors to choose safe and appropriate methods to improve your chances of conceiving and having children.
Half of infertility cases are attributed to the male partner, with causes ranging from reduced sperm production and weakness to blockages in the sperm-carrying ducts. Accurate diagnosis of the cause of infertility is the essential first step in treatment.
Causes of male infertility
To achieve fertility and fertilize an egg, a man needs sperm with specific characteristics.
The process of sperm creation requires at least one functioning testicle and sufficient male hormones, with testosterone being the most important. The ducts carrying sperm from the testicles to the prostate and seminal glands must be open without any blockages or diseases.
Semen must contain more than twenty million sperm per milliliter, which should be fast and have a strong head capable of penetrating and fertilizing an egg.
The treatment of male infertility primarily depends on diagnosing the cause, which can be classified as follows:
Varicocele
The valves in the veins around the testicle close, leading to blood retention. These blood vessels play a significant role in regulating temperature and maintaining a suitable environment for sperm. Varicocele is the most common reversible cause of male infertility.
Infectious diseases
Viral or bacterial infections, especially sexually transmitted ones, can affect sperm production and shape, or cause fibrosis and inflammation in the ducts. Treating urinary tract infections and prostate infections is crucial in addressing male infertility.
Erectile Dysfunction and Premature Ejaculation
Men with chronic diseases like diabetes, spinal injuries, or neurological disorders face difficulties in ejaculating semen. Psychological issues such as painful intercourse and premature ejaculation also contribute to conception difficulties.
Undescended Testicles
Some men have undescended testicles (cryptorchidism) that remain in the abdomen during fetal development. If not detected and treated early, the testicle becomes non-functional and must be removed to prevent cancer.
Genetic and Hormonal Causes
Testosterone is essential for producing sufficient and healthy sperm. Hormonal imbalances in the pituitary gland, hypothalamus, and testes affect sperm production. Genetic conditions like cystic fibrosis and Klinefelter syndrome (an extra X chromosome) also impact male fertility.
Environmental and Lifestyle Factors
Men in certain professions are more exposed to harmful substances that weaken or kill sperm. These include pesticides, heavy metals, and radiation. Additionally, surgeries on the testicles, ducts, or prostate can lead to infertility. Lifestyle factors such as smoking, alcohol, drug use, and obesity also affect fertility.
Tumors
Tumors or cancers affecting hormone-producing glands, like testicular tumors or pituitary tumors secreting prolactin, are linked to male sexual dysfunction.
Symptoms of Varicocele
Varicocele is a condition characterized by the enlargement and dilation of veins in the testicular area, and it is considered one of the causes of male infertility. Several symptoms may be associated with this condition, including:
Swelling of the Testicle
You may feel swelling and enlargement in the testicle affected by varicocele. The swelling can be noticeable and may increase after standing for long periods or at the end of the day.
Testicular Pain
Varicocele can be accompanied by varying degrees of pain in the affected testicle. The individual may experience constant or throbbing pain in the testicle, which may worsen after standing for long periods or following strenuous physical activity.
Reduced Sperm Count
Varicocele can affect sperm production, leading to a decrease in sperm count and quality. This can make it difficult to achieve pregnancy.
Hormonal Imbalance
Varicocele may impact the production of hormones responsible for reproductive functions. You may notice a decrease in hormone levels, such as testosterone, which can affect sexual ability and libido.
Appearance of Twisted Veins
Read more about: Causes and Treatment of Hydrocele around the Testicle.
Symptoms of Male Infertility:
The most evident sign of male infertility is the inability to achieve pregnancy or maintain it naturally without miscarriage. There are other symptoms that may explain the failure to conceive. Some men suffer from varicocele, which is characterized by swelling in the blood vessels causing blood retention in the man’s testicle and its enlargement, or they may have hormonal changes and genetic factors.
The symptoms of infertility in men who suffer from a health condition leading to delayed childbearing may include:
- Enlargement of the testicles or dilation of the blood vessels leads to increased temperature and death of sperm cells
- Ejaculation problems such as premature ejaculation, low volume of ejaculation, or difficulty in ejaculation.
- Issues related to sexual intercourse such as reduced sexual ability and desire, as well as insufficient erection.
- Abnormal enlargement of the breasts
- Abnormal distribution of hair and hair loss from the chest, making it appear similar to the hair distribution in women, due to genetic or hormonal imbalances.
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The Hardest Types of Male Infertility
It is difficult to definitively identify the “hardest” type of male infertility, as each case is unique and depends on a range of factors.
However, some types of infertility may pose greater challenges in treatment and achieving pregnancy. These include:
- Azoospermia: The absence of any sperm in the semen, making natural fertilization nearly impossible.
- Oligozoospermia: A significant decrease in the number of sperm can hinder their ability to fertilize the egg.
- Teratozoospermia: A high percentage of abnormally shaped sperm, reducing their ability to swim and interact with the egg.
- Asthenozoospermia: Reduced sperm motility, impeding their ability to reach the egg.
- Obstruction of the sperm ducts: Preventing sperm from reaching the semen, thus hindering fertilization.
Treatment of Male Infertility in Turkey
To ensure effective treatment, the affected individual must first acknowledge their need for treatment and confirm that the wife does not have any health issues causing infertility.
The best way to treat infertility is to identify and address the underlying cause. Some methods of treating male infertility include:
Varicocele Surgery in Turkey
Surgical treatment can resolve many cases of infertility, such as those resulting from varicocele or blockage in the sperm ducts. In cases where the ejaculate lacks sperm, a procedure to retrieve sperm from the epididymis or testicles can be performed.
Hormonal Treatment
If blood tests reveal hormonal imbalances, these can be corrected through hormone replacement therapy or hormone inhibition therapy.
Infection Treatment
Bacterial or viral infections affecting sperm formation can be addressed by treating the infection, although curing the infection does not necessarily guarantee the reversal of infertility.
Treatment of Sexual Problems
In cases preventing proper intercourse, such as erectile dysfunction or premature ejaculation.
Assisted Reproductive Techniques (ART)
These techniques facilitate sperm-egg fertilization. The basic principle of ART is to collect a sample of the husband’s sperm either naturally or surgically and then fertilize the wife’s egg either by injecting them into the woman’s reproductive tract or by in vitro fertilization (IVF), where the fertilized egg is transferred to the wife’s uterus.
Diagnosing Male Infertility in Turkey
Diagnosing and identifying the causes of male infertility involves several tests and examinations, which can be expensive but help in identifying the cause of infertility and formulating an appropriate treatment plan. Diagnosis typically involves:
General Physical Examination and Medical History
A thorough examination, including an inspection of the reproductive organs for abnormalities, and a detailed medical history, including chronic diseases, past surgeries, and family history of genetic disorders related to infertility.
Semen Analysis
An essential test for determining the cause of infertility, where a semen sample is examined under a microscope to study the sperm’s shape, movement, and number, and to check for infections.
Hormonal Tests
Assessing hormones from the hypothalamus, pituitary gland, and testes to detect hormonal imbalances.
Genetic Tests
If semen production is low or a genetic syndrome is suspected, blood tests and genetic screenings can identify conditions like Klinefelter syndrome.
Cases Cured of Male Infertility
Many cases of male infertility have been successfully treated, thanks to medical and technological advancements in reproductive medicine. It is now possible to diagnose the causes of infertility and provide effective treatments for men with this issue.
Untreatable Cases of Male Infertility
Some infertility cases may be particularly challenging to treat, including:
- Obstruction of Sperm Ducts: In cases of complete obstruction where sperm cannot be retrieved, treatment may not be possible. However, advanced techniques can sometimes be used.
- Absence of Sperm: In rare cases where there are no sperm in the semen (azoospermia), treatment can be difficult. However, techniques like intracytoplasmic sperm injection (ICSI) can be used to inject a single sperm directly into the partner’s egg to achieve pregnancy.
- Testicular Damage: Permanent damage to the testicles due to injury or previous surgery can severely affect sperm production. If both testicles are permanently damaged and no viable sperm are available, treatment may be difficult.
Duration of Male Infertility Treatment
The duration of male infertility treatment varies depending on the underlying cause and the type of treatment required. Some cases may require only simple lifestyle changes and minor adjustments, while others may need complex and prolonged medical treatments, taking several months.
Cases Requiring Immediate Medical Consultation
Newlywed couples do not need to consult a fertility doctor or seek infertility treatment until they have been trying to conceive regularly and without contraception for at least a year. However, some patients should seek immediate medical advice, such as:
- Men with a history of medical conditions or surgeries affecting fertility
- Men with a known genetic disorder affecting fertility
- Couples where the female partner has known reproductive health issues
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