Andrology

Almost one-seventh of all couples are infertile, meaning they haven’t conceived a child despite having regular, unprotected sexual contact for at least a year. Male infertility may be a contributing factor in as many as half of these relationships.

Some of the most common reasons for male infertility are poor sperm quality, abnormal sperm function, and physical barriers that prevent sperm from reaching an egg. Male infertility may be caused by a number of factors, including but not limited to illness, injury, chronic health issues, lifestyle choices, and more.

Numerous options exist for treating male infertility, which can alleviate some of the emotional and psychological strain associated with the inability to conceive a child.

Although the causes of male infertility are not always obvious, there are a few common ones. Many couples don’t learn that the man in their lives is infertile until after many failed attempts to conceive.

Causes of Male Infertility –

1. Obesity: A body mass index (BMI) above 30 can affect sperm quality because excess fat deposits can overload and influence the metabolism of androgens (hormones involved in male traits and reproductive activity), particularly testosterone. This results in substantial changes to the nucleus of sperm DNA and to the development of sperm.
2. Smoking and addictive substances: There are nicotine and cannabinoid receptors in testicular tissue, and these substances have a profoundly negative effect on sperm. Oxidative stress, an imbalance in the body caused by nicotine, affects the quality of sperm and their ability to fertilize an egg. Additionally, cocaine alters the maturation and motility of sperm. Smoking and drug use cause irreversible damage to sperm, but after a certain amount of time has passed after cessation, most of the damage is reversed.
3. Radiation: Although the impact of mobile phone irradiation on male infertility is hotly contested in the scientific literature (only one meta-analysis presented significant data on the effect), it is recommended that men avoid holding their phones near their scrotum and testicles. Cancer therapies like chemotherapy are a less avoidable source of radiation exposure. Sperm freezing and other cutting-edge techniques, like testicular biopsy and spermatogonial stem cell extraction and freezing, are part of the fertility preservation protocol here.
4. Nutrition: Consuming anti-oxidant-rich foods may help men maintain their fertility. Cheese (rich in vitamin A), oranges (rich in vitamin C), sunflower seeds (rich in vitamin E), fish (rich in omega 3), broccoli (rich in folic acid), beans, and artichokes are all examples of foods with antioxidant properties.
5. Supplements and steroids: The effects of dietary supplements on health and fertility should not be used without first consulting a physician or other qualified professional. Injectable testosterone and other steroid remedies are extremely harmful to sperm health. Excessive coffee consumption may also play a role, particularly in the presence of a preexisting fertility issue.
6. High testicular temperature: The male reproductive organs, which are cooler than the rest of the body, hang in a scrotal sac. The quality and viability of sperm can be severely diminished by as little as a 2 or 3 degree Celsius increase in testicular temperature. Working in hot environments, sitting for long periods of time, wearing restrictive underwear, and using laptops with their keyboards resting on the lap are all potential risk factors.
7. Infections: Infertility in men is a well-documented side effect of a number of sexually transmitted diseases (STIs), including gonorrhoea, chlamydia, and ureoplasma. Alterations in sperm quality can result from genital inflammation brought on by these microorganisms, while severe and chronic cases of these infections can lead to obstruction. Antibiotics should be used immediately at the first sign of infection.
8. Genital injuries: An injured testicle needs immediate medical attention. When participating in sports like MMA, cycling, or horseback riding where testes are not covered, men should exercise extreme caution.
9. Varicocoele: This condition is characterized by the enlargement of veins in the scrotal sac, which increases testicular temperature and has an effect on sperm production and quality. As part of the standard procedure for diagnosing and treating male infertility, testing and treatment for this condition are routinely performed. .

Age: Reproduction in older males is a complete myth. Fragmentation of DNA in the nucleus sharply reduces a man’s reproductive potential after the age of 35. After age 40, a man’s chances of having a child free of genetic defects decrease by 11% annually. Down syndrome, neurofibromatosis, autism, and Klein-Feil syndrome are all significantly more common in children whose fathers are older than 50.

Prevention –

Sadly, there are some cases of male infertility that cannot be avoided. Nonetheless, there are some factors that men can control to increase their chances of infertility. Take, as an illustration:

• Avoid smoking.
• Limit or avoid drinking alcohol.
• Avoid using illegal drugs.
• keep a healthy weight.
• Avoid having a vasectomy.
• Avoid activities that cause the testicles to become overly hot.
• Be less stressed.
• Avoid being exposed to toxins such as pesticides and heavy metals.

Reasons to Visit the Doctor

If you have any of the following and have been trying to conceive for at least a year with regular, unprotected intercourse, you should see a doctor.

• Problems with erection or ejaculation, low sex drive, or other sexual dysfunctions
• Symptoms such as testicular pain, discomfort, a lump, or swelling
• The presence of a family history of infertility S
• crotal, genital, or groyne procedures include surgery 
• A spouse who is over the age of 35

Commo Treatment Options Available for Male Infertility –

Testicular Sperm Aspiration (TESA):

A TESA, or testicular sperm aspiration, is a quick and painless procedure that only needs to be done once and does not require any recovery time. TESA can be considered for men with obstructed azoospermia if it is anticipated that viable sperm will be easy to locate. Sperm for an IVF-ICSI cycle is harvested directly from the testes during the procedure.

Testicular Mapping

In order to obtain small samples of testicular fluid, a fine needle is inserted into various areas of the testes during a testicular mapping procedure. As a final step, the aspirate is examined for sperm by being mounted on a glass slide. If sperm is located during the initial mapping process, a sperm retrieval will be scheduled during a subsequent IVF-ICSI cycle and performed at the same locations where sperm was located.

Advanced Testicular Mapping

During advanced testicular mapping, a thin needle is inserted into various spots on the testicles to draw out tiny amounts of fluid for subsequent testing for healthy sperm. 

After an IVF-ICSI cycle, any remaining viable sperm is frozen for use at a later date.

Micro-Dissection TESE (MicroTESE)

Men with severe testicular failure or non-obstructive azoospermia undergo micro-dissection TESE (MicroTESE), an invasive procedure used to locate sperm. Because blind biopsies and needle aspirations can miss very localized areas of sperm production, microTESE is especially helpful in these men. To perform a micro-TSE, a surgeon makes a small incision in the scrotum, removes a small piece of tissue, and examines it under a microscope. This allows the surgeon to look for areas of the testicle that are healthy and therefore more likely to contain sperm.

Simultaneous Staged Sperm Retrieval 

First, Advanced Testicular Mapping is performed, a method in which a fine needle is inserted into various areas of the testes to aspirate small samples of testicular tissue, which are then checked for viable sperm during the course of the Simultaneous Staged Sperm Retrieval Procedure. If a sufficient number of healthy sperm are recovered, the TESE open surgical micro-dissection won’t be necessary (MicroTESE). If the aspirated samples do not contain sperm, the surgeon will immediately perform a microTESE. The best chance of success with the least amount of discomfort for the patient is achieved through simultaneous staged sperm retrieval.

Varicocelectomy

In varicocelectomy, the normal blood vessels are not damaged as the enlarged veins are tied off using very small instruments. Most cases of male infertility are treated surgically, and the procedure most commonly used is a varicoceleectomy because it offers the best chance of repair for a varicocele.

Vasectomy reversal

Reversing a vasectomy is a microsurgical procedure in which the vas deferens tubes, which were severed during the initial procedure, are reconnected. In most cases, the longer it has been since the vasectomy, the better the chances of a successful reversal.