Article on Male Infertility

Basics

Conception depends upon fertility parameters of both partners being normal. It is absurd and a misconception to blame only the female partner.

The first and foremost is normal sperm count. The sperms after getting deposited in the vagina travel through the cervix, uterus, fallopian tubes. The egg, after getting released from the ovary gets trapped by the tentacles and conception takes place in the tube and the conceptus slowly gets back into the uterine cavity and nidates itself.

In short, we need to have:-

Normal sperm count
No cervical hostility
Normal uterine cavity
Patent fallopian tubes
In time ovulation
Proper entrapment of the egg (No abnormal peritonial factor)

Male Infertility

Male is responsible in one-third of all the cases. Abnormal semen count can be either because of inadequate production or obstruction.

Spermatogenesis (formation of sperm) is affected by the raised local (scrotal) temperature, presence of varicocele, use of tight under-garments, as an occupational hazard where men are subjected to excessive heat, incomplete development of testis, late descent or non-descent of the testis. Obstructions can be due to infections, injury, absence of the tract (vas) from birth. Failure to deposit sperm into the vagina can be due to impotence, premature or retrograde ejaculation.

Normal Semen Analysis would show the following parameters:-

Volume 3-5 ml
Count > 20 million / ml
Motility Grade 2-3 @70%
Morphology 80% or more

Investigations indicated to diagnose a case of Infertility:-

 

Testicular biopsy
Radio-immuno-assays like FSH, LH, Prolactin
Agglutination tests
Scrotal Sonography or Colour-doppler

Management

Hormone replacement therapy or other medication, depending upon the cause.Surgery may be indicated in case of varicoceles or other obstructions.