How do you deal with male infertility?

28.01.2009 | By: Sašo Stojanov

The article describes how medicine helps men with low fertility and what chances of success are.

Professional help is definitely recommended for treatment for male infertility. (jlp)

Treatment fro male infertility depends on its cause. Sometimes success is achieved quickly and sometimes it’s achieved after long-lasting treatment and patience. Often treatment also doesn’t help, or medicine is powerless.

Let’s first mention an example which doesn’t involve male infertility, but the problem is caused by the hymen. If a woman hasn’t lost her virginity, semen couldn’t penetrate her vagina. In that case, a small surgical procedure is sufficient – therefore, a cut of the hymen.

1. When reasons for infertility are of a transitional, inorganic nature (e.g. impotence), which means that they are of a psychological nature, this is treated by a psychiatrist. If you too often or too rarely have sex, you can adjust that by seeking advice on the interval between sexual intercourse which is the most suitable for you and your partner in terms of the value of semen and the women’s fertile days.

2. Men who are overweight are prescribed an appropriate diet (weight reduction diet). Men who smoke and drink alcohol are advised to be moderate. Men who are overburdened with work (particularly with physical labour) are advised to have more spare time.

3. Men who are underweight or have an incorrect diet are prescribed an appropriate as well as vitamins and minerals in the form of drugs.

4. Diabetics have to go to a diabetes clinic where they are examined and treated accordingly. New and chronic infections are usually treated with appropriate antibiotics.

Vasectomy also causes male infertility, but men feel intense desire afterwards. (jlp)

5. Treatment with male hormones (testosterone) is only rarely successful. At the beginning of the treatment and a few moths afterwards, when men cured in this way stop taking drugs, their semen is of poor quality, and sometimes the sperm cells in the semen disappear entirely. In some cases, the value of semen improves after 3 to 6 months, either in terms of the number of sperms or their mobility. If the value of semen is increased, the treatment can enable conception.

6. Treatment with the drug similar to the female hormone, oestrogen, in terms of composition is somewhat more successful. This drug (Clomid, Dyneric) cannot be obtained in a pharmacy because it’s rarely used. It’s only taken in specifically selected cases and under strict medical supervision because it causes unpleasant consequences.

7. In some, not rare, cases the testicles remain in the inguinal canal, i.e. in the case of a hydrocele, varicocele and blocked vas deferens. The testicles slip through the inguinal canal into the scrotum just before birth. If that doesn’t occur, they remain in the abdominal cavity (one or both), or they descend only half way and stop in the extended part of the inguinal canal (undescended testicles or retentio testis in Latin). When they are partially descended, it can often happen that the testicles withdraw to the inguinal canal, especially if a man is lying down. The difference in the temperature (2 to 3°C) between the scrotum (colder) and the abdominal cavity (warmer) suffices to harm spermiogenesis. Such a child has to be operated at least before the age of five. If the abnormality is discovered in pre-puberty, there is still a possibility to receive hormone treatment, otherwise an operation is needed. An urologist transfers the testicle on the right place, that is, from the abdominal cavity or inguinal canal to the scrotum. An operation can be very successful, but the value of semen isn’t sufficiently improved afterwards. Sometimes an operation is only partly successful (the testicles remain very close to the opening of the inguinal canal), but a spermiogram shows a good value.

Don’t give in. You can succeed if you try hard. (jlp)

8. A collection of enlarged veins, particularly in the left testicle (varicocele) is corrected with an operation by an urologist. In some cases, a vein is tied off and sometimes an artery and vein are tied off (inner artery and spermatic vein) and thus the enlarged veins are corrected. The operation isn’t dangerous and men can leave the hospital after a few days. Semen is checked after 1, 3, 6 and 12 months. This is the last time when success can still be achieved. The value of semen improves in terms of sperm count and mobility in approximately 60% of cases. It should be pointed out that the fertility of a woman also plays an important role. There’s a slimmer chance of a successful operation if men don’t seek medical help. The extensiveness of a varicocele and the success of an operation aren’t necessarily connected, which means that the surgical removal of a large varicocele can be unsuccessful, or the fertility of a man can be significantly improved after removal of a minor varicocele.

9. Azoospermia: if there are no sperm cells in semen, but the biopsy of the testicle confirms that sperm cells are produced, this means that the vasa deferentia tubes are blocked somewhere. In that case as well, an urologist makes one or both tubes passable (orchovasostomia – tying of the testicle and the vas deferens or epydidimovasostomia – tying of epydidimis and the vas deferens) with plastic surgery that depends on the location of the closure. Success of such operations isn’t encouraging, although there are recorded cases of conception.

Let’s sum up with a conclusion that treatment for male infertility is a very long-lasting process and its success isn’t guaranteed. It requires a lot of patience from all those involved in the process: a man, woman and doctor.