About one third of all infertile cases are entirely due to male factor only. And, in another one third, semen factor contributes to infertility in addition to female factor. From the days of "Ramayan" and "Mahabharata", male dominated Indian society has blamed only the woman (baanzh)to be responsible for failure to reproduce. It is a highly biased approch to a genuine medical problem which can affect both male and female. After a reasonable period of marital life, when a couple fails to conceive, by default, they visit a gynaecologist. And, at good number of times, the gynaecologist concentrates on the female partner and fails to attend the male. As an easy recourse to the problem, donor semen is offered and the child-hungry poor lady easily accept this offer to save herself from the social harassment for not becoming pregnant. In a civilized society and that to so much scientific advancement in reproductive medicine, offer of donor semen is not only unscientific and unreasonable but immoral as well.
A man could be completely healthy, but produce poor quality sperms. Some men may have more serious medical problems, such as low male sex hormones, or testosterone levels. Urogyn being equipped with full time urological facilities, as compare to most other centres where urologist is not available, boasts of being the best place for infertile couples having male factor infertility. Here, male partner is investigated and worked up to the last to find out viable sperms in the testis. Only when all the possiblities of having husband's sperms are ruled out, donor semen is used.
Semen analysis is a simple test to undertake and it measures number of sperms, their motility (ability to move), their morphology (size and shape), and the volume and consistency of the ejaculated sample with reasonable degree of accuracy.
How does semen analysis work?
Male partner will need to produce a semen sample by masturbation, following 3 days abstinence from ejaculation. He will be asked to collect the entire amount of ejaculate in a sterile specimen container in private room our centre. Semen sample will be analysed within one hour, in order to avoid compromising the quality of ejaculate.
Our andrologist will then assest semen appearance, colour, pH and presence of leucocytes. Sperms number (concentration) will be counted and the sperm motility (how fast sperm are moving) will be measured. A normal result would show a sperm count of at least 20 million sperm per mL, with at least half showing forward progressive movement.
The morphology (shape) of sperm is also assessed. If indicated, the sperm vitality can also be counted (the percentage of immotile sperms that are alive or dead) based on the effect of a dye on the sperm.
If we find abnormalities, we often require repeat tests to assess the type and degree of the problem, and wheather it is a persistent feature. Sperms have a life cycle of 72 days, so if you are ill or stressed during those 72 days, it can temporarily affect your sperm quality.
How do you treat male infertility?
If you have a low sperm count, poor sperm movement, or high numbers of abnormally shaped sperm, then Intracytoplasmic Sperm Injection (ICSI) can be used as a part of your IVF treatment cycle.
If sperm stick to each other head-to-head, tail-to-tail or in a mixed way, this is known as agglutination, and the presence of sperm antibodies may be the cause. Put simply, that means you’ve developed antibodies against your own sperm, and it can significantly affect sperm penetration into the cervical mucus, and the success of any IVF treatment. ICSI is used to overcome this issue as well.
Sperm DNA testing:-
For some patients, we may recommend testing for DNA fragmentation within the sperm.
If you have experienced recurrent miscarriage, or several unsuccessful treatment cycles, this can help us diagnose and treat high levels of DNA fragmentation. It is also useful for men who have elevated leukocyte levels in the semen, have been exposed to toxic substances, are over 40 years of age, or have diabetes.
The SCSA (sperm chromatin structure assay) test measures the stability of the chromatin and provides an estimate of the level of DNA damage in the sperm.
Anti-oxidant therapy can be used to improve sperm health, or we may select the best sperm for ICSI treatment using Digital High Magnification of Sperm.
Blocked Vas Deferens:-
If your vas deferens was cut during a vasectomy or if it is blocked, you may need surgery. A simpler procedure to collect sperm surgically may also be possible.