Male infertility is a common but often overlooked issue that can significantly affect a couple’s journey toward parenthood. Understanding the causes and potential solutions for male infertility is essential in navigating this difficult situation.

In this article, we will talk about male infertility, understanding its symptoms, diagnostic methods, and how it can be treated to help a couple achieve their dream of starting a family.

Symptoms

In many cases, detecting infertility symptoms in men can be challenging. The primary sign of male infertility is the inability to achieve pregnancy. However, in some cases, specific underlying issues can lead to noticeable signs and symptoms. These underlying issues include inherited disorders, hormonal imbalances, enlarged veins near the testicles, or conditions obstructing the flow of sperm.

These male infertility symptoms and signs may vary depending on the underlying issue and may include the following:

• Sexual dysfunction, such as ejaculation difficulties or small amounts of ejaculated fluid, decreased sexual desire, or inability to achieve or maintain an erection (erectile dysfunction).
• Pain, swelling, or lumps in the testicles (this indicates underlying conditions like infections or varicoceles)
• Frequent respiratory infections
• Loss of smell (anosmia)
• Abnormal breast enlargement (gynecomastia)
• Reduced face or body hair, or other symptoms of chromosomal or hormonal abnormalities
• Low sperm count (less than 15 million sperm per milliliter of sperm)

If you experience any of the above symptoms, it is advisable to consult a doctor for further evaluation and diagnosis.

Diagnosis

Male infertility is diagnosed through a series of tests that evaluate several factors affecting sperm production and function. Typically, male fertility tests include:

Physical Examination and Medical History:

Your doctor may start your diagnosis by conducting a thorough physical examination and gathering your medical history. This may include examining your genitals and inquiring about hereditary conditions, including chronic health problems, past illnesses, injuries, or surgeries that could impact fertility. Additionally, your doctor may ask about your sexual behaviors, pubertal sexual development, and lifestyle choices.

Semen Analysis:

Semen analysis is a crucial male infertility test. It involves examining semen samples to evaluate various parameters related to sperm health and determine the potential cause of infertility. During this test, the semen sample is collected and evaluated in a laboratory. Semen analysis measures the following factors:

• Sperm count (the number of sperm present)
• Sperm motility (the ability to swim and move)
• Sperm morphology (shape and structure)
• Semen volume (amount of fluid ejaculated)
• pH level
• Presence of infections

Your doctor may also offer additional male fertility tests to determine the cause, including:

• Scrotal Ultrasound: A scrotal ultrasound is a diagnostic test that employs high-frequency sound waves to provide images of the inside tissues of your scrotum. It can help your doctor identify potential problems in the testicles and supporting structures, such as varicocele or other abnormalities.
• Transrectal Ultrasound: This diagnostic procedure involves inserting a small, lubricated wand into your rectum to inspect your prostrate and any obstructions in the tubes that deliver sperm.
• Hormone Testing: The pituitary gland, hypothalamus, and testicles produce hormones that influence sexual development and sperm production. Imbalances in these hormones or abnormalities in other organ systems can contribute to infertility. A blood test is performed to measure the amount of testosterone and other hormones.
• Genetic Tests: A low sperm concentration may indicate a genetic factor contributing to infertility. A blood test can be performed to detect changes in the Y chromosome, which may suggest genetic abnormalities. Genetic testing is commonly used to diagnose congenital or inherited syndromes that could affect fertility.
• Post-ejaculation Urinanalysis: The presence of sperm in your urine can indicate retrograde ejaculation, where sperm travel backward into the bladder instead of being expelled through the penis during ejaculation. This condition can occur due to a failure in the muscles and valves that typically direct sperm flow.

These male fertility tests allow your doctor to diagnose the specific cause of your infertility and recommend effective treatment options.

Treatment

In many cases, the root cause of male infertility remains unknown. However, even without the root cause, your doctor may suggest treatment options to help achieve pregnancy. Some of them include:

• Medications: Your doctor may prescribe medicines depending on the cause of infertility. For example, your doctor might recommend hormone replacement therapy to treat hormonal imbalances, while antibiotics may be given to cure the reproductive tract infection. Medications can also be prescribed to improve sperm production, erectile dysfunction, or premature ejaculation and treat sperm quality issues.
• Surgeries: Your doctor may recommend surgical procedures to correct abnormalities causing infertility. Common surgeries include:
• Varicocele repair to correct swollen veins in the scrotum
• Vasectomy reversal to restore sperm flow after a vasectomy
• Testicular sperm extraction (TESE) to extract sperm directly from the testicles or epididymis using sperm retrieval techniques
• Assisted reproductive technology (ART): If other treatments are unsuccessful, your doctor may recommend ART. This approach involves collecting sperm through normal ejaculation, surgical extraction, or from donors, depending on your circumstances. The sperms are then used to fertilize eggs outside the body. Examples of ART include intrauterine insemination (IUI), in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and sperm or egg donation.

Remember, the appropriate treatment for male infertility depends on the specific cause and individual circumstances. Therefore, it is crucial to consult with your doctor to determine the best course of action.