Infertility is a condition that can be seen in both men and women and affects many people around the world. Approximately 50 percent of fertility problems between couples are known to be male-related problems. However, when it is thought that there is a problem with fertility, it is best to evaluate the couples together. While not being able to have children can be stressful and frustrating, there are a number of treatments for infertility.
Infertility is a problem in the reproductive system that prevents pregnancy. If couples have unprotected sexual intercourse for more than a year and no pregnancy occurs, they should consult a specialist for this condition and the underlying cause of the problem should be investigated.
What is Infertility in Men?
Infertility is defined as the absence of pregnancy after at least one year of regular and unprotected sexual intercourse. Approximately 50% of infertility in couples is caused by male infertility. Infertility in men can be in the form of decreased sperm count and motility, impaired structure or low concentration levels. While environmental and psychological factors are known to have an impact on sperm quality, advancing age in men can cause a decrease in sperm quality and affect fertility.
What Causes Infertility in Men?
Infertility in men is a disease of the reproductive system. While there may be many biological and environmental factors among the causes of infertility in men , it may arise from genetic mutations or birth-related problems. In addition, there may be a number of reasons such as medications and lifestyle differences.
A man's reproductive health is linked to the interconnectedness of the hormone, immune and nervous systems. Therefore, in general, poor health affects the reproductive system and infertility can occur. Infertility in men can therefore be seen as a consequence of cardiovascular disease, immune system and various chronic diseases.
Although there are many known causes of infertility in men, in about 30 percent of cases no cause can be identified. This condition is called idiopathic male infertility.
Infertility in men can be caused by genetic factors, but it is also related to lifestyle and environmental factors. Overweight and obesity, the presence of high blood fats (cholesterol) can cause many health problems, and increased adipose tissue can affect hormones and negatively affect sperm quality.
Men who do not have weight problems and have normal values have a higher sperm count than obese individuals. In addition to these, people who smoke and drink alcohol also have decreases in sperm count and mobility.
Some diseases may also be among the causes of infertility. Among the diseases related to sperm motility, number and concentration; high blood pressure, diabetes, cardiovascular diseases, kidney diseases, varicocele, sexual disorders. Factors that negatively affect sperm health may include neurological diseases such as Multiple Sclerosis, testicular infection, injuries and traumas, and exposure to high temperatures.
Among the environmental factors of infertility; chemicals such as plastic industry chemicals, flame retardants, pesticides can cause damage to sperm cells and hormone disorders. In addition, another cause of infertility in men is drugs that disrupt hormone levels. Chemotherapy drugs, male hormone treatments, antidepressants and cortisone group drugs can affect sperm production.
What are the Symptoms of Infertility in Men?
Amongthe symptoms of infertility in men , the absence of pregnancy is known as the first and main symptom. While symptoms may occur in some cases, it can also be detected without any symptoms. The symptoms that appear are mostly caused by a different problem. The underlying problems should be identified and treatment planning should be made depending on the causative factor. Symptoms can be listed as follows:
- Changes in sexual desire
- Problems with erection and ejaculation
- Pain, lump or swelling in the testicles
- Small or hard testicles
- Problems maintaining an erection
- Abnormal growth of breast tissue
- Hormone dysfunction
Diagnosis and Testing for Infertility in Men
Both men and women should have a screening test if pregnancy has not occurred after at least one year of regular and unprotected sexual intercourse. The diagnosis of male infertility includes a physical examination, medical history, hormone control and semen analysis.
Semen analysis is a test method that measures the number, structure and motility of sperm. In cases where a physical examination and semen test are not sufficient, the specialist may recommend additional tests to determine the cause of this condition. These tests can be listed as follows:
Post-ejaculatory urinalysis: It shows if the sperm goes back into the bladder instead of coming out during ejaculation.
Genetic testing: When the sperm concentration is extremely low, there may be a genetic cause. A blood test can reveal whether there are subtle changes in the Y chromosome that are signs of a genetic abnormality. Genetic tests may be ordered to diagnose various congenital or inherited syndromes.
Scrotal Ultrasonography: helps to see if there are varicoceles or other problems with the testicles and supporting structures.
Transrectal Ultrasonography: This is an examination through the rectum to determine if there is a blockage in the ejaculatory duct.
Testicular Biopsy: It is done by taking a sample from the testicle with a needle. Treatment is planned depending on the biopsy result.
Hormone Test: A blood test that measures the level of male hormone and other hormones.
Infertility Treatment in Men
Infertility treatment in men varies depending on the underlying cause of the problem. After examinations and evaluations, the specialist doctor initiates the treatment process. Medication and hormone therapy can be used to increase sperm count. Although male hormone is needed to ensure sperm production, external supplements suppress sperm production by inhibiting the production of this hormone and are therefore not recommended. Low male hormone levels should be evaluated depending on the underlying cause.
If the sperm goes back into the bladder instead of coming out, the specialist may prescribe medication. In cases where treatment applications such as medication or hormones are insufficient, surgery is preferred. If the person has varicocele, abnormal sperm values and infertility, a procedure called varicocelectomy is performed. This procedure is the surgical correction of enlarged and swollen veins in the testicles.
Antibiotic treatment is applied in cases of infection. In this case, the infection of the reproductive system can be eliminated, but fertility is not always restored as a result of this treatment. Medication or therapies to improve problems with sexual intercourse, such as erectile dysfunction or premature ejaculation, can help to improve fertility.
Many different techniques can be used to obtain sperm from patients who do not want surgery. In these applications, sperm is collected with the help of a needle and used in assisted reproductive techniques. One of these techniques is the treatment method called in vitro fertilization.