Male Fertility

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Male Fertility Factors

Male factor infertility represents 35% of all infertility cases. Conceiving a baby is influenced by a number of factors, including healthy sperm. After a woman’s age, male infertility is the second biggest cause of pregnancy delay and affects almost half of all couples having trouble conceiving.

Male infertility can be divided into two major categories that include: abnormalities of sperm production and obstruction or absence of the ductal system. The majority of male factor infertility is idiopathic (cause unknown).

At Footsteps To Fertility Centre in Nairobi, Kenya we offer patients personalized evaluation to assess the fertility potential of sperm. This helps to provide clinical diagnosis and the management of male infertility. Our aim is to correct the underlying cause of infertility in order to achieve pregnancy and have a healthy child.

Causes of Male Infertility

  • Age and Sperm. Male fertility does change with age. You might get the impression that age only matters in female fertility. Men younger than 40 have a better chance of fathering a child than those older than 40.
  • Abnormal sperm production. Sometimes, sperm cells are malformed or die before they can reach the egg. In rare cases, a genetic disease such as cystic fibrosis or a chromosomal abnormality can cause male infertility.
  • Retrograde Ejaculation. This occurs when semen, which would normally be ejaculated via the urethra, is redirected to the bladder at the time of ejaculation. This can occur due to the muscle that closes the bladder not functioning normally, nerve damage caused by illness, removal of the prostate gland, or side effects of medication.
  • Occlusion. Occlusion is the medical term for a ‘blockage’ or absence of tubes. In men, the duct system (the vas deferens or epididymis) may prevent sperm from reaching the ejaculate. This may be caused by injury, congenital conditions, STIs or a vasectomy.
  • Hyperprolactinaemia. This is the presence of abnormally high levels of prolactin(the hormone responsible for milk production) in the blood. In men, high levels of Prolactin may cause infertility and erectile dysfunction. Hyperprolactinemia can be caused by tumors on the pituitary gland, thyroid disorders, surgery from previous illnesses, some medications and recreational drugs.

Diagnosing male Infertility Conditions

Diagnosing male infertility problems usually involves:
  • General physical examination and medical history: This includes examining your genitals and asking questions about any inherited conditions, chronic health problems, illnesses, injuries or surgeries that could affect fertility.
  • Semen analysis: After collection, semen is sent to a laboratory to measure the number of sperm present and look for any abnormalities in the shape (morphology) and movement (motility) of the sperm. The lab will also check your semen for signs of problems such as infections.
  • Hormone testing: Hormones produced by the pituitary gland, hypothalamus and testicles play a key role in sexual development and sperm production. Abnormalities in other hormonal or organ systems also might contribute to infertility. A blood test measures the level of testosterone and other hormones.
  • Testicular failure may be diagnosed by elevated levels of FSH and/or LH along with low levels of testosterone. In case Medical or surgical treatment is not successful, donor sperm is oftentimes utilized.
  • Alternatively, sperm can be obtained from the testicles by a biopsy and used in conjunction with IVF and ICSI procedure, and if no sperm is found at the time of the biopsy donor sperm becomes the only option.

Treatment of Male Infertility

Microsurgical epididymal sperm aspiration (MESA) and testicular sperm extraction (TESE) are procedures involving the introduction of a thin needle directly into the testicle under anesthesia to obtain sperm for IVF/ICSI procedure.

It is most commonly utilized in cases of spermatic duct occlusion or absence, but can also be performed in cases of ejaculatory dysfunction, such as spinal cord injuries or in cases of intractable male impotency.

IVF offers the best treatment option for all male factor infertility cases regardless of the severity, but should not suggest that all male factor infertility cases be treated with IVF.

In mild forms, IUI treatment is acceptable, especially in early infertility cases with no other identifiable cause.IVF along with intracytoplasmic sperm injection (ICSI) allows couples to achieve pregnancy even with very low sperm count and can be applied to all male factor infertility cases.

Vasectomy reversal. Sometimes, a vasectomy reversal may be the preferred option for men who wish to conceive with a new partner.

This is performed as a day surgery procedure utilizing the operating microscope. As the surgery involves very tiny sutures, a week at least must be set aside to aid healing and prevent injury to the especially small area of the vasectomy reversal site.

Can Male Infertility be Prevented?

There is usually nothing that can be done to prevent male infertility caused by genetic problems or illness. However, there are actions that men can take to decrease the possibility of infertility.

These include:

  • Avoiding sexually transmitted diseases
  • Avoiding illicit drugs
  • Avoiding radiation when possible
  • Avoiding exposure to toxic substances
  • Avoiding heavy or frequent use of alcohol
  • Observing good personal hygiene and health practices
  • Avoiding long, hot baths, hot tubs or saunas
  • Wearing loose-fitting underwear

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