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Although male and female fertility issues play an equal role in the number of infertility cases, male fertility problems remain neglected in our society. Male infertility refers to any reproductive health issue in men that reduces or completely eliminates the odds of their female partner conceiving. This is primarily due to the low sperm production or healthy sperm. Let's understand the various causes, treatments, and stigma associated with male infertility!
Several factors can lead to problems that affect male fertility, sperm may be abnormal shaped, unable to swim or may not have enough sperm. The leading causes include:
Infections: This occurs when there is infection like MUMPS during puberty or infection of prostate through sexually transmitted infections like HIV, infection of testis (orchitis). These infections results in sperm damage.
Hormone or pituitary problems: Low levels of hormone release cause poor sperm growth or low count.
Immunologic Infertility: In this you make antibodies of your own sperm. Your body mistakenly identify sperm as harmful invaders and attempt to eliminate them.
Environmental causes: Overexposure to certain environmental elements such as heat (saunas, hot tubs, tight underwearusage, laptops), toxins and chemicals (pesticides, painting materials),heavy metals, radiation and X-rays, etc. can reduce sperm production or sperm function.
Genetic causes: These include chromosomal defects, cyctic fibrosis, etc that cause abnormal development of the male reproductive organs
Structural problems: Anything that blocks the genital tract can stop the flow of semen. This could be a genetic or birth defect. Infection or inflammation from a sexually transmitted disease can also block semen. Other causes include scar tissue from surgery or twisted, swollen veins (VARICOCELE ) in the scrotum.
Varicoceles: This refers to swollen veins in the scrotum responsible for harming sperm growth. They also increase the temperature in the testicles, further causing low sperm count and low sperm quality
Retrograde Ejaculation: It refers to the medical condition in which the ejaculated semen goes back or enters in to the bladder this may be due to diabetes, spinal injuries, medications, or surgeries to bladder, etc.
Medications usage to other illnesses like depression, cancers, prior surgeries, injury, sedentary lifestyle and unhealthy diet habits, obesity, tobacco alcohol or drug abuse etc. can also lead to male infertility.
Similar to female infertility, the treatment of male infertility depends on the cause of the reproductive health problem. While most fertility problems can be fixed with non-surgical therapy, some may require surgery. The treatment through medication and surgery allows conception. However, the only way to treat unknown causes of male infertility includes assisted reproductive techniques, intrauterine insemination, in vitro fertilisation (IVF), sperm retrieval for ART, and intracytoplasmic sperm injection.
When we talk about infertility, it is mostly thought of as a female issue. Men usually take a backseat and are unwilling to get themselves tested as there is a lot of stigma around infertility in general and male infertility in particular. Unfortunately, the standards of being masculine are defined by how sexually active and virile a man is. Moreover, some men confuse fertility issues with sexual problems. This prevents young men from seeking medical care for their reproductive issues as they fear getting their masculinity and sexuality questioned. This delays the process of men getting diagnosed and receiving adequate treatment for their infertility. A preliminary evaluation of reproductive history and semen analysis is necessary to diagnose male infertility. However, most men fear the shame and stigma, resulting in lack of testing.
There is a serious need of starting a conversation around male infertility. A holistic effort involving public and private healthcare authorities, government and the general public needs to be made. Information sharing can go a long way. We see many female public figures especially celebrities coming out and speaking openly about their fertility problems. But male infertility is still spoken of in hushed tones, this needs to change. It can only happen when make fertility becomes a part of mainstream media conversation.
When men gather the courage to seek medical guidance for their fertility problems, it is the responsibility of the healthcare professional to provide easy and accessible care. They should create a welcoming environment for the patients and be more understanding and transparent. As there is a lack of awareness about the causes and consequences of male infertility, doctors should also explain the problem, potential treatment options, provide mental health support, and share ways to improve their chances of conceiving by making lifestyle changes or through diet and exercise. This will also encourage other men to finally ask for help and not shy away.
The article is contributed by Dr Y.Swapna, Fertility Consultant at Nova IVF Fertility, Vijayawada.