Male Infertility

Some men might not exhibit any kind of symptoms while others can be confronted with difficulties in their sex life or hormonal changes that can affect them. There are a number of functional changes that stand behind male infertility. Some of them are of a physical nature and they prevent normal ejaculation of spermatozoids with the semen, while others affect the quantity and/ or quality of semen. Most common causes of male infertility :

• Sexual transmitted diseases: infections in the male genital area may result in infertility that can usually be reversed after appropriate treatment.
• Blockage or trauma in the testicles, prostate or urethra: males can either be born with or acquire such over time, in these cases a surgical approach is often advised.
• Retrograde ejaculation: spermatozoids are not ejaculated outside the penis but they end up in the bladder. This condition might occur in diabetics, while administering certain medication or post-surgery.
• Genetic diseases: rarely encountered, genetic conditions like chromosomal anomalies or cystic fibrosis may cause infertility.
• Hormonal dysfunctions at the level of the pituitary or thyroid gland.
• Sexual dysfunctions like impotence or erectile dysfunction due to the anxiety and stress - Varicocele: varicose dilation of the veins inside the scrotum which blocks normal blood flow.

• Excessive physical effort or exercise.
• Stress.
• Obesity;
• Drug and alcohol abuse.
• Extended exposure to toxins: pesticides, lead, radiations, radioactive substances, mercury etc.
• Heat on the scrotum might also reduce the spermatozoids production. This can be caused by wearing underwear that is too tight, riding a bike or excessive use of saunas.

The doctor will ask about the medical history of the patient and assess what tests are required to establish diagnosis. A sperm analysis might be required and after the test results arrive, the doctor will advise whether the condition can be reversible with medication, therapy or surgery and if there are options for sampling sperm for in vitro fertilization. Depending on the cause of infertility the doctor can advise on adopting lifestyle habits that can increase fertility. There are also procedures that allow for harvesting of sperm directly from the testicles :

• TSA stands for testicular sperm aspiration.
• MESA is testicular biopsy (microsurgical epididymal sperm aspiration.) Both can be performed by a small scrotal incision