MALE INFERTILITY
PROCEDURES AND EFFECTIVENESS
Causes of Male infertility?
- Alcohol
- Drugs
- Physical injury to the testicles
- Vericocele
- Certain chronic medical conditions
- Blockage of the ducts that carry sperm
- Sexually transmitted diseases
- Hormone deficiency
- Adverse effects of medical or surgical treatments
- Specific abnormalities in the Y chromosome
- Genetic or inherited diseases
(Assessment, Diagnosis & Treatment)
The best time to evaluate a man, the most effective way to conduct a thorough physical examination, and the justification for suitable medical and surgical treatments for these conditions are all significant topics in the assessment of the male factor. Assessing infertility as a couple and treating them as such are crucial aspects of the process, as is continuing parallel investigations until an issue is found. Research indicates that the longer a couple is infertile, the less likely it is to find a successful treatment. After only a few months of infertility, many couples endure severe worry and nervousness.
Before a man’s examination is conducted, excessively protracted and unprotected sexual activity should not be encouraged. If infertility is the patient’s primary complaint, a screening of the guy should be done initially. This preliminary assessment ought to be quick, non-invasive, and reasonably priced. It’s interesting to note that, even in cases where the guy was found to have relatively severe abnormalities in semen quality, pregnancy rates as high as 50% have been reported when only the woman has been examined and treated.
Fifteen percent of couples who try for the first time end up not getting pregnant. After a year of unprotected sexual activity, the majority of authorities classify these patients as predominantly infertile if they have not succeeded in becoming pregnant. In 80-85% of cases, conception occurs within a year of no contraceptive usage. Those who present after this period should be considered potentially infertile and should undergo evaluation. According to data gathered over the last 20 years, pathology is discovered in around 30% of cases in the man alone, and in another 20% of cases, both the guy and the woman exhibit abnormalities. Therefore, in roughly 50% of infertile couples, the male component is at least somewhat to blame.
Fertility Drugs for Men
Men require specific hormones to create healthy sperm, just as women require the proper hormone balance to ovulate on a regular basis. Remarkably, luteinizing hormone and follicle-stimulating hormone regulate these reproductive processes in both men and women. For this reason, physicians can induce ovulation and sperm production using the same reproductive medications.
Unfortunately, men’s success rates with fertility medications are only approximately one-third those of women’s, and although a specialist can prescribe them, the FDA hasn’t yet approved these treatments for use in males. One thing is clear from the scant research on fertility medications’ impact on men: these medications are only beneficial for men who have particular hormonal abnormalities that are pituitary gland-related.
The Drugs and how they Work
Clomiphene citrate and human menopausal gonadotropin, or hMG, combined with human chorionic gonadotropin, or hCG, are the two most commonly prescribed fertility medications for women. Men with primary hypogonadotropic hypogonadism, a hormone shortage in the pituitary gland that stops a man’s testicles from producing sperm, are also treated with them.
Both clomiphene (taken daily as a pill ) and hMG injected two to three times a week, prompt the pituitary gland or hypothalamus (the part of the brain that regulates basic functions such as temperature) to make more luteinizing hormone and follicle-stimulating hormone. These hormones tell the testicles to produce testosterone and, possibly, more sperm.
Good Candidates
Hormonal imbalances in males that are associated with low sperm counts and, occasionally, with poor sperm motility and quality can be treated with fertility medicines. The pituitary gland must be the source of the issue for medication to be effective at all.
Length of Treatment
Drug therapy typically lasts about three or four months. Taking the medication longer doesn’t improve the success rates , so if you try it for three or more months and your partner doesn’t get pregnant, your doctor may increase the dosage, switch you to another medication, or, most likely, suggest another kind of treatment. However, as long as a man’s hormone levels remain normal, he can take clomiphene in low doses for six months to a year.
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Success Rate
Although success is far from guaranteed, fertility drugs can sometimes help men jump-start their sperm production, upping their counts to 20 million or more (anything under 20 million is considered low). If the medications work, a man won’t have to think about undergoing a testicle biopsy to see what else might be wrong with his sperm.
Some studies cite an estimated 20 to 25 percent pregnancy rate for couples when the man has used fertility drugs — low compared to the rates for women on fertility drugs (20 to 60 percent). But even that number loses some of its punch when you consider that it’s about the same rate infertile couples battling a low sperm count or poor sperm quality can expect for a spontaneous pregnancy with no treatment at all.
Side Effects
In men, both clomiphene and hMG can cause temporary blurred vision, weight gain, and temporary breast enlargement and tenderness. In rare cases, clomiphene can cause liver damage.
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Dr. Mahesh Nawal is a one of the best sexologist Indore & laser proctologist consultant in Indore with an experience of more than 35 years, Dr. Nawal performed or all type of major surgery including laparoscopic general surgery reconstructive surgery.
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