Male Infertility Treatment Hospital in Delhi Ncr, India

Male Infertility Treatment Overview

Male Infertility refers to a health issue in men which lowers the chances of pregnancy in a fertile female. About 15 out of 100 couples face the problem of not getting pregnant with unprotected sex. This refers to the fact that they are not able to conceive a child after having frequent intercourse for more than a year.

Male Infertility Treatment Hospital in Delhi Ncr, India

Symptoms of Male Infertility

Major sign of male infertility is an inability to conceive post-sexual activity. Other symptoms may include

  • Difficult ejaculation
  • Low sexual desire
  • Having issues in maintaining an erection
  • Lower sperm count ( eg., total sperm count less than 39 million per ejaculate )
  • Pain followed by swelling in the testicle area
  • History of prostate problem or any testicle related problem

Causes of Male Infertility

There are various causes associated with male infertility :


  • Be odd-shaped
  • Not moving the right way
  • Azoospermia ( not at all moving )
  • Not fully growing

Varicoceles are basically swollen veins in the scrotum. It is present in 15% of men (normal) and about 40% of infertile men. It's the most common cause of male infertility. It could be because of abnormal testicular temperature. Varicocele causes low and reduced quality of sperm in men. It harms sperm growth by blocking blood flow. Varicocele makes blood back to the scrotum from the belly and thus making testicles too warm for making sperm, thereby causing low sperm.

At times, sperms are blocked because of past infections, surgeries like - vasectomy. Having such blockage prevents sperm from testicles to leave the body during ejaculation.

With retrograde ejaculation, the semen goes backwards in the bladder instead of coming out of the penis. Semen might have normal sperms but unable to reach the vagina. Many health issues can cause retrograde ejaculation, including spine injury, diabetes, bladder surgery, urethra or prostate surgery. Etc. Men with spinal cord injuries can't ejaculate sperm, even if they produce sperm.

Dry ejaculation and less fluid in ejaculation and cloudy urine are signs of retrograde ejaculation.

The pituitary gland makes hormones that then tell testicles to make sperms. Men with low hormone levels have poor sperm growth. Male hypogonadism (low testosterone) and hormonal problems are major causes of male infertility.

Men on anabolic steroids cause testicles to shrink and thereby decrease sperm production. Usage of weeds and other forms of drugs, reduce the quality and number of sperm count. Excessive consumption of alcohol leads to lower testosterone levels and decreased production of sperm and erectile dysfunction.

Stress is an important factor and affects sperm production. Prolonged and severe stress with problems of fertility may affect sperm count as well. Research shows, male partners with severe depression have low chances of pregnancy. Depression causes reduced libido, erectile dysfunction and delayed ejaculation.

Disorders such as Klinefelters Syndrome, where a male is born with 2X chromosomes and 1 Y chromosome, causes abnormal development of male reproductive organs. Changes in the number of the structure of chromosomes affect fertility.

It is observed that due to certain medications, sperm production, function and delivery is changed. Medications that are given to patients to treat health problems like:

  • Depression
  • Infection
  • Arthritis
  • High Blood Pressure
  • Cancer

Men with prior surgeries prevent from having sperm in the ejaculate. Viz, vasectomy, testicular surgeries, hernia, rectal cancers etc.

Exposure to lead, heavy metals, exposure to radiation, pesticides, organic solvents, painting materials and elevated temperature of testicles impair sperm production and function. Sitting for long hours and wearing tight clothing may slightly reduce sperm production.

Diagnosis

Causes of male infertility are tough to diagnose, however mostly associated with sperm production or delivery.

Examination and tests to be carried out to see the causes of infertility.

  • Semen Analysis: Semen analysis is the 1st choice of male infertility. Semen is collected by having the person masturbated in a sterile container and sent for studying. The reports show sperm volume, count, movement, concentration and structure. If results show no sperms or low no. of sperms, it doesn't mean the patient is permanently infertile. It reveals problems with the growth or delivery of sperms. More tests may be needed.
  • Testicular Biopsy: This involves taking samples from testicles with a needle. If the biopsy shows normal sperm production, the problem is likely caused by a blockage. Testicular Biopsy helps find the cause of infertility and at the same time sperm is collected for use in assisted production.
  • Hormonal Profile: Hormonal profile is assessed to learn how well testicles are making sperm. Abnormality in hormonal or organ systems also contributes to male infertility. Blood tests are needed to measure testosterone levels and other hormones. FSH is the hormone that tells testicles to make sperm.
  • Scrotal USG: A scrotal USG helps the doctor to assess if the patient is having a varicocele or other problems in testicles and supporting structures.
  • Genetic Tests: There should be a genetic cause if the sperm concentration is very low. The test reveals if there are changes in the Y chromosome - it's a sign of genetic abnormality.

Line of Treatment

1. Non Surgical Treatment

Anejaculation: This means there's no semen. Though, it's not common but caused by various factors :

  • Diabetes
  • Prior surgery
  • Spine Injury
  • Stress or emotional problem
  • The first line of treatment is to try drugs, if failed - Electro ejaculation and penile vibratory stimulation is used to retrieve semen.
  • IVF and ICSI are great choices for men with anejaculation.

2. Surgical Treatment To Treat Male Infertility

Microsurgical Varicocelectomy : It helps to fix the swollen veins leading to sperm movement, numbers and structure. The surgery is performed under an operating microscope to get the highest success rates with minimal side effects. Hospitalization is usually for 24 hours and patient recovery to full activity in one to two weeks.

Treatment for Azoospermia : If there is a lack of sperm in semen because of certain blockage, we have many surgical choices :


Microsurgical Vasovasectomy

This surgery is used to undo or reverse vasectomy, also known as vasectomy reversal. It's a microsurgery wherein 2 cut parts of vas deferns are joined in each testicle. Hospitalization is for 24 hours and the patient can resume normal activity in a week.

Vasoepididymostomy

In this procedure, the upper end of vas-deferens is joined to the epididymis. This method is used to treat epididymal blocks.

TURED ( Transurethral Resection of Ejaculatory Duct)

This procedure is performed to treat ejaculatory duct blockage surgically. Post-procedure, 65 out of 100 men get sperm into semen. There are possibilities that 1 out of 4 couples get pregnant naturally post this treatment.

TESA

The most common line of treatment to diagnose the cause of azoospermia. Sperm extraction is done from testicles and used fresh or frozen (cryopreserved) for ICSI.

PESA (Percutaneous Epididymal Sperm Aspiration)

This procedure involves the same needle and syringe technique, but the needle is placed directly into the epididymis.

MESA (Microsurgical Epididymal Sperm Aspiration)

An open surgical sperm retrieval procedure that uses an operative microscope to locate the tubules of epididymis precisely so that a large number of sperms can be extracted.

Micro-Tese

In this procedure, the dissecting microscope is used to pinpoint the tissue to be removed. This aims to cause less damage to the structure inside the testicles. It also appears to unease the number of sperms that can be retrieved.