Workup for Male Infertility

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Workup for Male Infertility

Male infertility is a disorder in which a guy cannot make his wife pregnant due to an underlying health problem. These underlying disorders are infertility issues that make it difficult to conceive normally. Low sperm count, no sperm count, poor sperm generation, environmental variables, and other factors can all contribute to male infertility. A male infertility workup is used to determine a guy’s specific infertility condition.

These examinations include a medical history questionnaire, a physical examination, and testing. These tests, therefore, rule out the possibility of a male infertility problem.

Everything You Need to Know About Workup for Male Infertility

Male Infertility | Causes | Workup For Male Infertility | Steps | Conclusion

Male Infertility

Male infertility is one of the most common causes of a couple’s inability to conceive a child. In 40% of couples, male factor infertility is the cause of infertility. Therefore, the assessment of the male spouse is part of the male infertility workup to determine the specific issue that is creating difficulties.

Male fertility is dependent on your body producing and distributing appropriate sperm. First, the sperm is injected into the female partner’s vaginal canal. Next, the sperm is placed in the vaginal canal of the sexual partner. On the journey to her ovaries, sperm pass via her cervix, womb, and reproductive organs. When semen and an egg come into contact, fertilization happens.

The system works when genes, hormone levels, and environmental circumstances are all in place.

Causes

Many factors go into producing mature, healthy sperm that can travel. A variety of issues can prevent cells from developing into sperm. The sperm may be unable to reach the egg due to various issues. For example, the temperature of the scrotum can impact fertility. The following are the most common reasons for male infertility:

Disorders of the Sperm

The most frequent issues are with sperm production and growth. Sperm may:

1. Be Not Completely Developed
2. Be Strangely Formed and Not Travel in The Proper Direction
3. Be Produced in Small Quantities (Oligospermia)
4. Not Be Made in Any Way (Azoospermia)

Low or no sperm might result from damage to the reproductive system. Approximately four out of every ten males with complete sperm deficiency (azoospermia) have a blockage in the tubes through which the sperm migrate. A blockage might be caused by a congenital abnormality or a condition such as an infection.

Varicoceles

They’re discovered in 16 of every 100 guys. Infertile males are more likely to have them (40 out of 100). By obstructing adequate blood drainage, they impair sperm development. Varicoceles may cause blood to flow back into your scrotum from your stomach. As a result, the testicles become too heated to produce sperm. Low sperm counts might result as a result of this.
Inherited characteristics can cause sperm issues. Sperm counts might be lowered as a result of lifestyle decisions. Sperm counts can be lowered by smoking, consuming alcohol, and taking certain medicines. Long-term illness (such as renal failure), childhood illnesses (such as mumps), and chromosomal or hormone abnormalities are also possible reasons for low sperm counts (such as low testosterone).

Retrograde Ejaculation

It is a kind of ejaculation that occurs when sperm travels backward in the body. It is known as retrograde ejaculation. Instead of exiting through the penis, they travel into your bladder. When the nerves and muscles in your bladder don’t shut during orgasm, this happens (climax). Normal sperm may be present in the sperm, but because the sperm is not discharged from the penis, it cannot reach the vagina.

Surgery, medicines, and nerve system issues can all induce retrograde ejaculation. Cloudy urine after ejaculation and a lack of fluid or “dry” ejaculation is signed.

Immunologic Infertility

It is a kind of infertility that occurs when a man’s body can produce antibodies that target his sperm. Antibodies are produced most commonly due to injury, surgery, or infection. They obstruct sperm movement and function. We don’t yet understand how antibodies affect fertility. For example, they can make it difficult for sperm to reach the fallopian tube and penetrate an egg, as we know. However, male infertility is seldom caused by this.

Obstruction

The tubes that sperm pass through might get clogged at times. Blockage can be caused by repeated infections, surgery (such as vasectomy), edema, or developmental abnormalities. It is possible to obstruct any portion of the male reproductive system.
During ejaculation, sperm from the testicles cannot escape the body due to a blockage.

During ejaculation, sperm from the testicles cannot escape the body due to a blockage.

Chromosomes

Half of the DNA is carried by sperm to the egg. Therefore, changes in chromosomal number and structure can impact fertility. Parts of the male Y chromosome, for example, may be absent.

Medication

The generation, function, and transport of sperm can all be affected by certain drugs. The most common conditions for which these medicines are prescribed are:

1. Arthritis/depression
2. Digestive Issues
3. Depression or Anxiety
4. Infections
5. Blood Pressure That Is Too High
6. Cancer

Male fertility issues might be difficult to identify. The most common issues are with sperm production or delivery. A full medical assessment of the patient is necessary to determine a diagnosis. Your doctor may also recommend blood testing and sperm tests.

12+ Years of Experience as
Sexologist and Infertility Specialist

12+ Years of Experience as
Sexologist and Infertility Specialist

Workup for male infertility

Infertility in men is a significant factor among couples having trouble conceiving a child. For 40% of couples, infertility is due to male factor infertility. Therefore, male infertility treatment involves a thorough examination of the male spouse to determine the root of the problem.

Men with infertility will go through a similar evaluation process as women, which will involve certain tests and investigations to rule out any underlying medical conditions. Semen analysis and a thorough review of one’s reproductive history are the extents of this assessment.

Steps of Infertility workup for a male

Oral medications can address minor problems in sperm analysis, such as sperm counts and motility. On the other hand, severe irregularities may necessitate a thorough hormonal examination and treatment. In cases when there are no visible sperm in the sperm (azoospermia), small surgical treatments such as PESA, TESE, and Micro-TESE may be required.

For a man, the steps of the infertility workup are as follows: The complete examination of male infertility is broken down into three key steps:

1. Medical Background

Information on reproductive history, medicines, surgery, and medical history will all be important aspects of the medical history. This includes your lifestyle, family history, and any previous diseases or infections. Your doctor will keep an eye out for things like:

  • Coitus or intercourse frequency and time
  • Any indications of sexual dysfunction, such as ejaculation or erectile dysfunction
  • Infertility lasts for a long time
  • Prior Conceiving
  • Any disease that a kid has had as a youngster, as well as its developmental history
  • Any medical condition that affects the entire body
  • Some prior surgical procedures (e.g., cryptorchidism with or without surgery)
  • Any medicine, including anabolic steroids and supplements (e.g., testosterone), as well as allergies
  • History of sexual activity, as well as sexually transmitted diseases
  • Toxins or injuries to the gonadal plexus

2. Sperm Analysis

The first test or analytic method used to treat male infertility is sperm analysis. During this preliminary examination, the doctor examines physical features such as the quantity of ejaculate, its pH, the time it takes to liquefy, and the levels of fructose.

Examining a man’s sperm is a crucial part of his infertility evaluation. First, it provides information about the severity of male infertility. Semen analysis is a high-magnification microscope-based quantitative examination of sperm parameters. Before undergoing sperm analysis, two to five days of abstinence are recommended. As a consequence, the best results are ensured.

Masturbation in the laboratory collecting room is ideal for obtaining the semen sample. On the other side, if we bring the sample to body temperature for examination within 30 minutes, we may collect sperm at home. Repeat testing and additional research should be done if there are anomalies in the semen analysis.
Semen analysis reveals a lot about the amount of sperm, their concentration, motility, and shape. Following the completion of the semen analysis, your doctor will be able to decide based on the results.

3. Male Infertility Is Analyzed Using a Specialized Test

Depending on the clinician’s judgment, some specialist tests may be provided in particular situations of recurrent miscarriages, repeated IVF failures, or severe oligospermia:

1. Index of DNA Fragmentation
2. Karyotyping
3. Microdeletion of the Y chromosome
4. Gene Testing for Cystic Fibrosis

Unexplained infertility is identified in as many as 20 to 30 percent of infertile couples. When the infertility criteria are satisfied, the basic infertility assessment is completed, and all test findings are normal, unexplained infertility develops. These individuals should have ovulation, tubal patency, and a normal semen analysis at the very least.

Conclusion

Male infertility is frequently treated as an outpatient surgery. These procedures are carried out either under general anesthesia or intravenous sedation. Our expertise believes in accurate and timely diagnosis, essential for successful therapy. Therefore, each of our experts draws on the expertise of others to listen intently to you, assess you holistically from all angles, and create a diagnosis and treatment plan tailored to your needs and goals specifically.

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Dr. Ramit Raosaheb Kamate

MBBS ,DNB, DGO, FRM (UK)

Dr. Ramit Kamate is a Reproductive Medicine Consultant and Sexologist with experience of 12+ years. He specialises in Sexual Medicine for male and female, Fertility Treatment, Pre and Post Delivery Care, Normal Vaginal Delivery (NVD), Tubectomy/Tubal Ligation, Natural Cycle IVF, MTP.

Dr. Ramit Kamate finished MBBS from B J Medical College, Pune. He pursued Masters’s In Reproductive Medicine from Hamilton University, UK & IBCME Dubai. Completed Fellowship in Cosmetic Gynaecology and Sexual Medicine from USA.

Workup for Male Infertility

by | Oct 12, 2021

Workup for Male Infertility

by | Oct 12, 2021

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