Male Infertility

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Male Infertility

Male infertility is a medical condition in males that reduces the likelihood of their respective spouses/ partners from conceiving and becoming pregnant.

It is estimated that around 13 out of 100 couples are unable to get pregnant even with unprotected intercourse and that for more than half of the total of infertility cases, the issue is with a male. It is most likely attributed to abnormalities with sperm development or with sperm distribution.

It is estimated that infertility affects nearly 15% of all the couples who are not able to get pregnant even after a year of unprotected intercourse. Male factor infertility impacts nearly 20-50% of infertile couples and in more than 15-20% of these cases, azoospermia is usually the leading cause of infertility. In azoospermic cases, previous treatments involving donor insemination and depressing had limited success however with the advent of new medical breakthroughs such as microsurgery and intracytoplasmic injections (ICSI), the rate of conception and pregnancy have significantly improved.

Semen Analysis

Semen screening is advised when couples have trouble with conceiving.
The examination allows clinicians to decide if a male is infertile and also further evaluate if poor sperm count or sperm deficiency is the cause for infertility.
Idiopathic, Isolated abnormalities of semen and sperm parameters, Varicocele, Immunological infertility, Genital Tract infection, Primary testicular failure, Kallmann Syndrome, Klinefelter Syndrome, Cryptorchidism, Obstruction, Ejaculatory dysfunction, Erectile dysfunction, Genetic causes: Y chromosome microdeletion

The exact etiopathological mechanism through which varicocele and antisperm antibodies contribute to male infertility remains to be elucidated.

WHO 5th Manual Standards 5th percentile 75th percentile
Volume 1.5 ml
Total Ejaculate 39 mil/ mL 120 mil/ mL
Sperm Concentration 15 mil/ mL 40 mil/ mL
Motility
Progressive 30% 40%
Morphology 4% 9%

Spermia

Abnormal sperm production or poor sperm quality can be attributed by various factors such as genetic defects, medical conditions and varicocele in the testicles. Along with these comorbidities, several other causes may impact sperm quality and therefore the chances of conception.

Oligozoospermia

Often classified as Oligozoospermia or Oligospermia, it is a male fertility disorder that implies that the semen produces fewer sperm than usual sperm counts.

Asthenozoospermia

Asthenozoospermia is characterised by poor sperm motility, i.e. sperm that can not move on its own. When only motility is compromised but sperm production is good, couples with asthenozoospermia may still get pregnant by Vitro Fertilization (IVF).

Teratozoospermia

Irregular sperm quality is called teratozoospermia (terato = monster). One of the causes of male infertility, the prognosis, conception and pregnancy for couples with teratozoospermia has significantly improved.

Azoospermia

Azoospermia is the lack of sufficient male sperm and in this condition, the issue of obstructive azoospermia may be addressed by either rejoining or restoring tubes or ducts that may not be allowing the sperm to discharge correctly. Though it can require surgery or some medical interventions, hormonal medications and drugs may also benefit if the root cause is insufficient hormone output.

In any case, even for male patients with azoospermia, medical innovations have made the prognosis extremely good with a high rate of success in conception and pregnancy.

Aspermia

When the male patient is unable to produce sufficient sperm or no semen at all during ejaculation owing to hereditary defects in the reproductive system or during sexual climax, the condition is called Aspermia.

Terminology

Aspermia No ejaculate (0 mL)
Asthenospermia <40% total motility
Azoospermia 0 sperm on two centrifuged specimens
Normospermia >39 million sperm/ ejaculate
Oligospermia <39 million sperm/ ejaculate
Teratospermia <4% normal morphology

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