Male infertility, Quality of Sperms and Treatment.Dr Chinmayie R

If you and your partner are struggling to have a baby, you’re not alone. A big per cent of couples in India are facing the spectre of infertility and in over 50% of cases, male infertility problems like low sperm count, poor sperm movement, abnormal sperm shape, and poor sperm quality is the main culprit.

A semen analysis is a test performed to screen for male fertility problems. The evaluation of sperm cell motility and morphology is an essential parameter in the examination of sperm quality and Computer-assisted sperm analysis (CASA) allows an objective assessment of sperm quality. At GarbhaGudi, we use a sophisticated electronic imaging system to visualize the sperm and an advanced software program to evaluate dozens of individual sperm parameters. This examination provides very accurate results and treatment can be specifically tailored for male infertility.

A man’s sperm count is considered lower than normal if he has fewer than 15 million sperm per millilitre of semen which can decrease the chances of conceiving a child simply because it means fewer opportunities for fertilization. Low sperm count is caused by a variety of physiological, environmental and lifestyle factors, from infections, hormonal imbalances, and autoimmune problems, to emotional stress, depression and obesity.

Sperm motility is the ability of sperm to move efficiently. It is important in fertility because sperm need to move rapidly and directly through the woman’s reproductive tract to reach and fertilize her egg before the sperm cells die. Damage to the testicles, which make and store sperm, could be a reason to low sperm motility. Semen analysis is the most basic and useful test to diagnose poor sperm motility, as well as other fertility problems.

Sperm size and shape are other factors affecting fertility. Normal sperm have an oval head with a long tail. Abnormal sperm have faulty heads or tail anomalies which might affect the ability of the sperm to reach and penetrate an egg. Men with abnormally shaped sperm contribute to trouble in the conception process and the shape of sperm is typically a factor in whether a couple is advised to pursue IVF.

Degradation of sperm DNA affects the health of an embryo’s genetic make-up and can contribute to miscarriage. After men turn 40, the quality of their sperm’s genetic material lessens and the new sperm isn’t as good as the sperm they produced when younger. It’s a natural and irreversible effect of ageing, much like how women’s eggs deteriorate after age 35. Declining sperm quality may not impact a man’s ability to ejaculate or successfully fertilize an egg, but it is more likely to make an embryo non-viable.

Miscarriage is the body’s way of dealing with a pregnancy that can’t proceed further due to genetic abnormalities. When miscarriage occurs, it is often assumed that there is something wrong with the mother. Yet, it’s just as likely the male contribution is responsible; when one half of the genetic material is degraded from the start as in the case of men over 40. The result is often an embryo that’s not chromosomally good enough to develop into a fetus. Thus, miscarriage happens.

According to experts, couples are often advised to make better choices about the right lifestyle and the best fertility treatment for them. Below are some Infertility treatments for men.

Medications.

Discontinuing select medications, reducing or eliminating harmful substances, improving frequency and timing of intercourse, regular exercise may help. We may prescribe medications to improve sperm count along with an increase in testicular functions like sperm production and quality.

Surgery.

Certain conditions may require surgery to reverse a sperm blockage. In other cases, surgically repairing a varicocele may improve chances for pregnancy.

Sperm retrieval.

There are some techniques to obtain sperm when ejaculation is a problem or when no sperm are present in the ejaculated fluid. Some techniques are Testicular Sperm Extraction, Testicular Sperm Aspiration, Microsurgical Epididymal Sperm Aspiration, Percutaneous Epididymal Sperm Aspiration, Microsurgical Testicular Sperm Extraction. Recovery after sperm retrieval depends on the method used and recovery time can range from a few days to a week.