Male Factor Infertility: When It's All About the Sperm

What Is Male Factor Infertility?

According to the World Health Organisation, infertility affects one in every six people of reproductive age around the world. WHO also confirms that infertility can occur due to both male and female factors, making it a shared concern [source].

Male fertility depends on multiple factors. A male’s body must produce healthy and structurally sound sperm. The sperm needs to be successfully mixed into the seminal fluid and delivered through the reproductive tract without facing issues. Any obstacle in the pathway can result in reduced fertility or infertility.

What Does Healthy Sperm Mean?

Sperm health is calculated through the following parameters:

• Quantity: In healthy men, sperm count should be at least 15 million sperm per millilitre, as a low sperm count can reduce the chances of successful fertilisation.
• Sperm Motility: For sperm to reach the egg, they must be motile enough to move through the cervix, uterus, and fallopian tubes. Low sperm motility decreases the chances of conception.
• Morphology: A sperm cell has an oval head and a long tail, making it easier for movement. While the sperm’s shape is not as important as its quantity and movement, an ideal shape assists fertilisation.

Common Causes of Male Fertility Issues

There are a number of causes that may result in male infertility, ranging from blockages in the reproductive tract to the presence of unhealthy sperm.

• Obstruction in the male reproductive tract can interfere with normal ejaculation. Blockages can occur anywhere (epididymis, vas deferens, or ejaculatory ducts) and can be caused by infection, inflammation, congenital problems, or surgical operations.
• Another common problem that could influence infertility is disorders of the hormonal system, since hormones are responsible for producing enough testosterone needed for sperm production.
• Some conditions, such as a varicocele (swollen veins in the scrotum), can increase testicular temperature, which can negatively affect sperm quality.
• Genetic conditions like Klinefelter syndrome and Cystic fibrosis, as well as treatment methods such as chemotherapy and radiation, can also cause subfertility or infertility in men.
• Issues with the sperm, such as low motility, low sperm count, malformation, or the complete absence of sperm in the ejaculation, can also affect fertility.
• Lastly, lifestyle and environmental factors such as regular exposure to high temperatures, smoking, alcoholism, substance abuse, poor metabolic health, unhealthy weight, and wearing tight underwear may affect fertility in males.

Treatment Options for Male Infertility

Before we get into assisted reproductive techniques (ART), there are other treatment methods that can help males restore their fertility:

• Medications: Patients might be recommended to use hormone therapy to regulate their hormone levels. Some medicines can also negatively affect fertility (tricyclic antidepressants, calcium channel blockers, and anti-androgens), which is why they may need to be replaced or removed.
• Surgery: Surgeries like vasoepididymostomy to remove blockages or obstructions in the male reproductive tract can help restore fertility. Another surgery, known as a varicocelectomy, helps treat a varicocele by removing the varicose veins.

If neither of the above-mentioned methods works, fertility specialists may recommend one of the most common assisted reproductive techniques, including:

• Intracytoplasmic sperm injection: ICSI is a fertility treatment which allows experts to insert sperm directly into an egg’s cytoplasm in the laboratory. This helps in the formation of the embryo outside the human body. The embryo is then transferred into the uterus by inserting a catheter into the female partner’s vagina.
• In vitro fertilisation: IVF is one of the most common and successful forms of ART. During the process, mature eggs are retrieved from the ovaries and fertilised by sperm in a lab. A complete IVF cycle can take anywhere between 2 and 3 weeks, sometimes longer.
• Intrauterine insemination: IUI is carried out by directly inserting the sperm into the womb, without it needing to pass through the cervix. This method is useful when the sperm count is low or the motility is reduced. This method is useful when the sperm count is low or the motility is reduced.

Comparing Solutions for Male Infertility

Conclusion

Conception is an intricate biological process that can be disrupted for a number of reasons. Infertility is not limited to females but rather is a condition that affects both genders, making it important that both partners are in optimal reproductive health. Male factor infertility can be overwhelming at first. Fortunately, there are a number of ways through which the condition can be treated, either through medications, surgery, or assisted reproductive technology.

If a couple is having trouble conceiving, they must both be thoroughly evaluated by a fertility expert to determine the most effective clinical solution for them.