Written by Ben Bunting: BA(Hons), PGCert.
After numerous failed pregnancy attempts a couple may start to look at the available options to increase their chances to succesfully conceive.
In this article we shall look at male infertility and how IVF may be able to help as well as other available options.
- Treatment options
Infertility is the inability to reproduce. It means that you cannot have children with your partner.
Any of the two partners may be affected, male or female. Infertility can be caused due to numerous causes that negatively affect your reproductive ability. These may be physical or functional issues.
If a male is unable to have children with his female partner, chances are he may be infertile.
To have a healthy reproductive system and to be able to reproduce normally, you must have healthy semen and normal physiologic sexual processes which include successful erections and ejaculation.
Only when all these are normal, the sperm can fertilize the egg. Infertility can be caused by the following factors:
The most common cause of male infertility is sperm disorders. It can be caused due to low sperm count, decreased motility of the sperm, or abnormal sperms. These issues may be caused by
- Infection or an inflammatory condition such as mumps
- Genetic diseases e.g Cystic Fibrosis
- Unhealthy habits such as smoking, drug abuse, or excessive alcohol intake.
Any condition that may lead to obstruction of the ducts can cause infertility. Any scar tissue due to the following reasons can cause difficulty in reproductive ability.
- Previous surgery
- Varicose veins
- Testicular torsion
- Birth Defect
- Undescended testes
How will you know if you have infertility?
A couple that is unable to conceive after one year of unprotected and regular intercourse is said to have infertility.
Either of the partners or both may have fertility issues and should get checked.
Any sort of birth control technique should not have been used during this period.
How to diagnose male infertility
If your doctor suspects infertility in the male partner, he may order a series of tests to confirm it.
- Semen analysis
You may be asked to deposit semen samples twice on different days. It is taken to check several factors including the amount, pH, and lactate level of semen. Sperms are also checked for their number, shape, and motility.
- Blood analysis
- Imaging tests
An ultrasound may be taken to look for any physical deformity of the male reproductive system, such as undescended testes, blockage of the tube, etc.
If semen analysis shows a reduced number of sperm or abnormal sperm production, a biopsy sample is taken from both testes to see the architecture of the tissue to look for any abnormality.
Several options are available to treat infertility nowadays due to advancing technology.
Depending upon the type of infertility issue, you may be given one of the following options.
If you are having low hormones in your blood tests, these can be treated using simple medications.
Low hormone levels can be treated by giving hormone supplements such as gonadotropins or other natural formulations designed to fill any nutrient deficiencies.
Any physical deformity such as obstruction, varicocele, or scar tissue that is causing infertility can be treated via surgery. A simple surgery may improve fertility.
Obesity is considered a global epidemic. Obesity is also linked to male infertility alongside a number of chronic diseases.
Therefore, doing more exercise to help lose fat mass is an effective free tool to help improve fertility.
Furthermore, a study published in 2017 demostarted that exercise of varying degrees of intensity improved male fertility outcomes.
A poor diet high in saturated fats, energy and processed foods can cause inflammation and oxidative stress.
Inflammation and free radicals can exceed the bodies antioxidant capabilities which can result in reduced sperm health.
Assisted Reproductive Technique (ART)
These include In-vitro Fertilization (IVF), Intracytoplasmic Sperm Injection (ICSI), Gamete intra-fallopian transfer (GIFT), or artificial insemination.
All of these techniques are performed to improve the chances of fertilization.
What's In Vitro Fertilization?
IVF or In-Vitro Fertilization is an assisted reproductive technique. It is the process in which eggs from a female and sperms from a male are taken and fertilized outside of the body in a laboratory.
The fertilized embryo is then inserted into the womb for normal growth. There are plenty of indications for this reproductive technique. Male or female infertility due to different causes is the major reason for it.
Female causes may include fallopian tube damage, ovulation disorder, endometriosis, fibroids, tube removal, or any unexplained cause. Whereas male infertility may be due to low sperm, decreased motility, or abnormal sperm.
Another reason for IVF can be to screen for genetic disorders. If one of the partners has a genetic disorder that may be passed down to the offspring, then you may take out the egg or sperm which is tested for the disease and then inserted into the womb.
IVF and male infertility
IVF can provide you with a lot of options. In respect of the male, sperm can be donated by the same person or a donor's sperm can also be used.
One of these options is available considering female fertility is normal. However, before making a final decision, many tests must be done to screen fertility levels.
If semen analysis shows low sperm count or motility issues in the sperm, then IVF can still be used. This is because the sperms are still able to fertilize the egg, however, there are guidelines in place.
The International Journal of Andrology specifies that 30% of sperm is motile and 15% has progressive motility, in addition 20% of the sperm should also be of a normal morphology.
However, if the sperm is abnormal and cannot fertilize the eggs, then using the same person's sperm for IVF is not reasonable and a donor's sperm can be used.
Why use IVF?
IVF is an expensive procedurethat is time consuming. Hence, before suggesting IVF to a couple, other options should be considered.
- IVF is suggested when a couple has failed to conceive a child even after trying for two years.
- All other treatment modalities have failed, including medications and surgical procedures.
- The lesser the sperm count, the less is the chance of having a pregnancy. To be precise, a male having less than 10 million sperms is suggested to have IVF.
Steps of IVF
The IVF process requires the collection of eggs from the female partner and sperm from the male partner. Hence, both partners need to go through a series of steps to achieve it.
- The female partner is given medications so the maximum number of eggs can be retrieved safely. These medications are for ovarian stimulation, oocyte maturation, prevention of premature ovulation, or preparing the lining of the uterus for the implant of the embryo. One or more of these medications may be given to the female.
- Several tests may be done to ensure that everything is fine. These are ultrasound or blood tests. An IVF may be canceled if premature ovulation has occurred or excessive or a smaller number of follicles have developed.
- Only after careful screening, the female partner then goes to a clinic for retrieval of her mature eggs. It is a short procedure that can be easily done in an outpatient setting.
- The patient is seated with analgesics given. A transvaginal ultrasound is performed and a needle is inserted into the follicle to retrieve eggs. If the ovaries are inaccessible, then an abdominal ultrasound may be used for guidance of the needle. Multiple eggs are collected and then frozen in liquid nitrogen. After this process, you may feel abdominal cramps.
- The male partner has either frozen his eggs before or given a semen sample on the same day.
- The eggs and the sperms are then taken to the laboratory where specific measures are taken for successful fertilization of the egg and an embryo is produced.
- Multiple eggs and sperms are fertilized using ICSI or conventional insemination. Approximately 5 or 6 days are taken for fertilization and formation of an embryo.
- The fertilized embryo is then inserted into the womb of the same female partner or another selected carrier. Multiple embryos are inserted into the uterus using a tube-like catheter and a syringe. If successful, it takes around 10 days for implantation.
This whole procedure takes around 3 weeks for successful completion.
If you are having fertility issues, either due to a male or female partner, IVF can be the solution, however, it is advised that all other options are considered, especially exercise and nutrition which aren't invasive.
Your doctor may perform a series of tests to see the cause and possible treatments. Due to certain causes of infertility, IVF may be one of the limited options to have a child.