Medical treatment options for Male Infertility

In the fast ultra-technology world, health is one of the main concerns. Fertility-related health issues are fast affecting men and women. Medically male infertility is any health condition in which the male partner has a low chance of naturally impregnating the female partner. Over one-third of total infertility cases have male-related issues. Off late, it has been observed that couples are facing multiple issues of infertility, so it’s good for both of you to see a doctor. Despite thorough testing and diagnosis, the cause of infertility might not be known.

Medications used for certain conditions interfere with sperm production, function and delivery. These conditions are:

  • Arthritis
  • Depression
  • Digestive Problems
  • Anxiety Or Depression
  • Infections
  • High Blood Pressure
  • Cancer

Male Infertility Diagnosis

The main causes of male infertility are sperm production or sperm delivery. When you visit the ZIVA fertility clinic, our fertility experts will first evaluate your condition to determine the underlying cause of infertility. Determining the cause of male infertility is the first step in determining the next action. Below are the testing procedures:-

Physical examination and medical history analysis: the ZIVA fertility specialists will examine your genitals. They will also enquire about any inherited conditions, chronic health problems, illnesses, injuries or surgeries of the past. The doctors will also collect information regarding your sexual habits and sexual development during puberty.

Semen analysis: Semen samples are collected into a special container at the doctor’s office.

In the lab, semen analysis is done to measure the number of sperm present and look for any abnormalities in the shape (morphology) and movement (motility) of the sperm. Infections in the sperm are also checked. Several semen analysis tests are done over some time for accuracy.

Additional tests: After the above two testing methods, if the cause of infertility cannot be determined, then the doctors will suggest the below-advanced tests:

  • Scrotal ultrasound. 
  • Transrectal ultrasound
  • Post-ejaculation urinalysis. 
  • Testicular biopsy. 
  • Specialized sperm function tests. 
  • Genetic testing

Medical treatment options for Male Infertility

The treatment for male infertility includes both surgical and non-surgical options. Depending on the case, fertility specialists might suggest ART as well.

General Treatments for male infertility

Surgery: A varicocele is often surgically corrected. An obstructed vas deferens is also repaired via surgery. Any earlier vasectomies are reversed. Some infertility cases are due to no sperm being present in the ejaculate. Microsurgical techniques are used to retrieve sperm directly from the testicles or epididymis.

Treatment for infections: Using antibiotics might cure reproductive tract infections, but it does not always restore fertility. Antibiotics are used in cases of high infections but not for lesser inflammations. But antibiotics may harm sperm production or function; hence non-steroidal anti-inflammatories are often used instead.

Treatments for intercourse issues: In conditions such as erectile dysfunction or premature ejaculation, medication or counselling can help improve fertility.

Hormone treatments and medications: If infertility is caused by abnormal hormonal levels or problems with hormone consumption, your doctor might recommend hormone replacement or medications.

Non-treatable cases: Rarely when male fertility problems can’t be treated, the fertility specialist might suggest using donor sperm or adopting a child.

Medical Treatments for Specific Male Infertility Cases

Anejaculation (dry ejaculate): Anejaculation is when no semen fluid is released during a man’s sexual climax. Common reasons for Anejaculation are:

  • Spinal Cord Injury
  • Prior Surgery
  • Diabetes
  • Multiple Sclerosis
  • By birth Abnormalities
  • Psychological issues

Medication is the first method of treatment. If the condition is not fixed with drugs, Penile vibratory stimulation (PVS) or Rectal probe electroejaculation (RPE) is performed to induce ejaculation. Sperm is retrieved directly from the testicle with a needle (Testicular Sperm Aspiration)

Assisted reproductive techniques like in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are most suited for men with anejaculation. ART works because the sperm may be weak in men with anejaculation.

Hyperprolactinemia: In men suffering from this condition, the pituitary gland makes too much of the hormone prolactin causing infertility and erectile dysfunction. Drugs are given, or surgery is done to treat any tumours if present.

Hypogonadotropic Hypogonadism: In this condition, the testicles don’t make sperm due to poor stimulation by the pituitary hormones. An MRI is done to confirm the condition, followed by a blood test to check prolactin levels and evaluate for pituitary tumours. High prolactin levels with no tumour on the pituitary gland are treated by lowering the prolactin. If it does not work, the Gonadotropin replacement therapy is done, and the chances for pregnancy are very good. Post-treatment, the sperm is normal.

Genetic Conditions: Men with no sperm in the ejaculate (azoospermia), is a common genetic condition. Genetic conditions also cause abnormalities in the male tract that carries sperm. In such cases, fertility specialists suggest ART with donor sperm.

Retrograde Ejaculation: The semen flows back instead of leaving the penis. Treatment often involves over-the-counter medications. You need assisted reproductive techniques (ARTs) if the problem remains unresolved. The ZIVA Fertility specialist will collect sperm from your bladder after ejaculation.

Transurethral Resection of the Ejaculatory Duct (TURED): Any blockages to the ejaculatory duct can be treated surgically. A small incision is made using a cystoscope passed through the urethra. In 65 out of 100 men, the issue is resolved via surgery. 

Assisted Reproductive Techniques

If all the above treatments fail, there are ways to get pregnant via assisted reproductive techniques (ARTs). In ART treatments the sperm is obtained via normal ejaculation, surgical extraction or from donor individuals. Using donor individuals is an individual choice. The retrieved sperm is inserted into the female genital tract or used for IVF-In vitro fertilization or ICSI-Intracytoplasmic sperm injection. On case to case basis, your healthcare provider may suggest the following:

Intrauterine Insemination (IUI): The sperm is placed into the female partner’s uterus through a tube. Men suffering from low sperm count and movement problems, retrograde ejaculation, and unknown causes of infertility can benefit from IUI.

In Vitro Fertilization (IVF): IVF is a process of joining the egg of a female partner or donor with sperm in a lab Petri dish. The ovaries are stimulated to produce multiple eggs (ova) using drugs given as daily injections. After 3 to 5 days, the embryo is put back into the uterus. It is mostly done where the man has very severe and untreatable oligospermia (low sperm count).

Intracytoplasmic Sperm Injection (ICSI): ICSI is a variation of IVF which is a boon for severe male infertility. Only a single sperm is injected with a tiny needle into the egg. The fertilized egg is put in the female’s uterus. 

Sperm Retrieval for ART

Using microsurgical methods, sperm blockages are removed. Below are the methods:

Testicular Sperm Extraction (TESE): One or many small biopsies are done to get enough tissue for sperm extraction. The sperm can be used immediately or frozen (“cryopreserved”).

Testicular Fine Needle Aspiration (TFNA): With a needle and syringe, the scrotal skin is punctured to extract sperm from the testicle.

Percutaneous Epididymal Sperm Aspiration (PESA): Under local or general anaesthesia, the urologist sticks a needle attached to a syringe into the epididymis. The fluid is gently drawn. 

Microsurgical Epididymal Sperm Aspiration (MESA): Under a surgical microscope, the sperm is retrieved from the epididymal tubes. This method yields high amounts of motile sperm. 

At ZIVA Fertility Centre, we have the latest and most specialized treatment facilities. Our team is highly experienced in treating all forms of Male Infertility. If the cause of infertility is unknown, then our state of art ART techniques will help you realize your dream of having a baby. Please visit our website or contact us at +91-9100002737, +91-9392834024,