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Male Infertility: Everything you need to know

November is dedicated to men’s health. More specifically, the 19th of November is International Men’s Day, a day where we all raise awareness for men and their health issues. A typical example of awareness is Movember, an annual event involving the growing of mustaches during the month of November to raise awareness of men’s health issues, such as prostate cancer, testicular cancer, and men’s suicide. Apart from those health issues, another issue that worries men is their fertility levels. Infertility in men is something common and surely not something to feel guilty of.

Male infertility is any male health issue that lowers the chances of reproduction.

What are some of these health issues? Sperm disorders, retrograde ejaculation, obstruction, hormones, immunologic infertility, and medication. 

The most common issue is the sperm disorders where sperm may not grow fully, be oddly shaped, not move the right way, not made in large numbers, or not made at all. Men usually have sperm problems from when they are born, but lifestyle choices can affect fertility too. Irregular diet, alcohol drinking, smoking, and lack of exercise are factors that can cause lower sperm levels. Other causes of low sperm numbers include long-term illnesses (such as kidney failure), childhood infections, and chromosome or hormone problems (such as low testosterone).

Varicocele: are swollen veins in the scrotum. They’re found in 16 out of 100 of all men and they are more common in infertile men. They harm sperm growth by blocking proper blood drainage.

Retrograde ejaculation: is when semen goes backward in the body. It can be caused by surgery, medications, or health problems of the nervous system. Signs are cloudy urine after ejaculation and less fluid or “dry” ejaculation.

Immunologic infertility: is when sometimes a man’s body makes antibodies that attack his own sperm. Antibodies are most often produced because of injury, surgery, or infection and they keep sperm from working properly.

ObstructionSometimes the tubes through which sperm travels can be blocked. Repeated infections, surgery (such as vasectomy), swelling, or developmental defects can cause blockage and sperm can’t leave a man’s body during ejaculation.

Medications for arthritis, depression, infections, cancer, and digestive problems are the most common ones that can hurt sperm.

How can you detect if your sperm doesn’t work properly? Of course, it is not something you can fully diagnose by yourself. Your doctor will help you along the way, with all the proper tests such as blood and semen tests and by filling your whole medical history. Semen analysis, testicular biopsy, ultrasounds, and hormone therapy are some of the ways a doctor can help treat your fertility issues. Some symptoms that consequently lead to infertility are problems with sexual function, pain or swelling on the testicle area, respiratory infections, inability to smell, abnormal breast growth, and decreased facial or body hair. If any of those symptoms appear, a visit to the doctor is necessary. 

Let’s talk about IVF for men.

IVF (in vitro fertilization) is not a female’s treatment only. It is actually a technique that collects a woman’s eggs and a man’s sperm to combine them in a fertility clinic laboratory for fertilization. Once the fertilized egg -called an embryo- is created, it is transferred to the woman’s uterus where it can implant and create a pregnancy. During egg retrieval, medications are often used to stimulate increased mature egg production to increase the chances of creating healthy embryos. Sperm retrieval can be achieved naturally or through surgical procedures in certain cases of male infertility. Intracytoplasmic sperm injection (ICSI) is often used in conjunction with IVF for fertilization in cases of male infertility. 

What is ICSI exactly?

When sperm cannot penetrate the outer layer of a woman’s egg to fertilize it, an IVF lab technician may directly inject the sperm into the egg (intracytoplasmic sperm injection). This can happen for a number of reasons. Most are due to the quality of the sperm, including its motility (movement). But it is also possible that the egg’s outer layer is too thick and hard for sperm to penetrate it naturally. With traditional IVF, the IVF lab will mix much mobile sperm with the woman’s egg in a lab container to increase the chances that one will penetrate the outer layer of the egg and fertilize it. If traditional IVF doesn’t work, or if testing of the man’s sperm indicates the sperm may have trouble penetrating the egg, ICSI may be used to aid fertilization. With the help of high-powered magnification, the lab technician uses a small needle to inject one sperm into the egg so fertilization can occur. The IVF procedure then continues as usual. If the injected sperm successfully fertilizes the egg and forms an embryo, that embryo is then implanted in a woman’s uterus to begin a pregnancy. ICSI is successful in fertilizing 50-80 percent of inseminated eggs. 

Other assisted reproductive techniques are intrauterine insemination (IUI) where the lab technician places the sperm into the female partner’s uterus through a tube and sperm retrieval for ART where with microsurgical methods professionals remove sperm blocked by obstructive azoospermia. The goal is to get the best quality and number of cells and this is done while trying not to harm the reproductive tract.

The more educated you are about your body and its health, the more prepared you will be for any difficulties that may occur. Although male infertility is most of the time something you have by birth and is not preventable, there are some lifestyle choices you can make in order to be healthier and perhaps prevent a further sperm problem. Try to maintain a healthy weight and diet, don’t overdrink and smoke, steer clear of medications that harm sperm if possible, and avoid things that lead to prolonged heat for the testicles. Heat is found to act inhibitory to sperm levels. Stress also is an inhibitor for fertility.

Infertility is not something to be ashamed of and that is why you have to speak up and seek help especially if you see its disrupting signs. Help yourself and your life partner to achieve your goal with the help of professionals. We here in MEDIPASS are offering you a more personalized fertility journey, always according to your wants and needs.

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