For normal pregnancy to occur both male and female must be healthy. Male factor is solely responsible for about 20% of infertile couples. Unfortunately, everybody has a misconception that females are solely responsible for infertility. Traditionally, females are blamed for barrenness . So, females are subjected to unnecessary interventions. For the fertility process to proceed smoothly, both the man and woman should be healthy and normal. Identifying any underlying conditions that may affect a man's fertility prior to initiating any treatments can help spare couples the distress of attempting ineffective treatments.
The male factor evaluation is normally done by a male infertility specialist or a urologist. Adequate history taking and general physical examination is of paramount importance. The main goal of evaluation is to identify the correctable causes, irreparable causes and most appropriate method of correcting them.
History taking:
o Sexual history
o Social history
o Previous children
o Childhood diseases
o Injury, radiation, chemotherapy, toxins
o Drug history
o Medical or surgical problems
General and local examination :
1. Height, weight
2. Features of Hypoganadotrophic hypoganadism
3. Hormonal imbalance
4. Varicocoele
5. Hydrocoele
6. Undescended testes
7. Anatomical abnormalities
As the saying goes prevention is better than cure. Avoiding the risk factors like, smoking, recreational drugs, alcohol, excessive heat and protection to testicles while into sports may prevent or reduce the risk of infertility.
Some of the cause can be correctable by medications to improve the count, treating the infections. Surgical correction is needed in some cases of obstruction.
In cases where the above treatments are unsuccessful, or when the cause for male infertility is unknown or untreatable, IUI treatment or IVF treatment may be suggested.
Obstructive causes of post-testicular infertility can be overcome with advanced techniques like
Drugs of some help:
Clomiphene citrate
Vitamin E
Low dose estrogen testosterone combination
Gonadotrophins :
Though the therapeutic use of antioxidants appears attractive, antioxidant benefits by various commercial supplements for fertility purposes are still to be investigated .
Despite the availability of so many treatment modalities and advanced techniques some of the patients remain untreatable, and for some it may be expensive. Then there is no alternative but to recommend donor insemination (AID).
The first test in the evaluation of the infertile male is the semen analysis. This test is inexpensive, easy to perform and gives valuable information. A perfectly normal semen analysis report generally indicates a healthy man. Often, in the case of male infertility, the semen analysis is abnormal .
STANDARD SEMEN ANALYSIS TEST
Almost all laboratories will conduct tests and report on the following information, using values established by the World Health Organization :