Are you having trouble conceiving a baby? Let's talk about Male Infertility!

If you and your partner are expecting a baby, but that dream has not yet come true, it is normal to feel a lot of sadness and burden. At times like this, many people think that the problem lies in the hands of the woman. But in reality, the fertility of the male partner is just as important when it comes to conceiving a child. Today we are going to talk about this condition called ``Male Infertility``.

Do you know what male infertility is?

Simply put, Male Infertility is the reduced or loss of a man's ability to get pregnant due to a problem with his reproductive system. If you have been having regular sex for more than a year without using any form of family planning, and your partner is still not getting pregnant, you may need to consider this condition.

This is something that can affect not only a girl, but a man as well. Many times, some people are reluctant to talk about it. But this is a medical condition, not something to be ashamed of.

How common is this situation? Why is raising a child sometimes difficult?

About 186 million people worldwide suffer from infertility. And it has been found that about half of these cases are caused by male factors . Some studies show that male infertility affects between 10% and 15% of men trying to conceive.

It's not easy to conceive a child. Humans are a relatively infertile species. Even a healthy, young couple with unimpeded sexual intercourse has a 20-25% chance of getting pregnant each month.

Just think, how many things need to be right for a child to grow up:

• The male body needs to produce healthy sperm , and the female body needs to produce a healthy egg .
• A woman's fallopian tubes must be open and unblocked so that sperm can reach the egg.
• Once the sperm meets the egg, it must be able to ``fertilize'' it .
• The fertilized egg, or embryo, that forms in this way needs to implant properly in the uterus.

For a pregnancy to go to full term (39-40 weeks and 6 days), the fetus must be healthy. Also, the hormonal environment in the woman's body must be adequate for the fetus to develop. If any of these factors are affected, infertility can occur.

How do you know if there is a problem with sperm? What is the psychological impact?

The main symptom of male infertility is the biological inability to father a child . However, this can have many psychological and emotional effects. For example:

• Depression.
• The feeling of losing something `(Loss)`.
• Grief.
• A feeling of inadequacy.
• The feeling of failure.

If you or your partner are experiencing these feelings, it would be a good idea to talk to a professional counselor or psychiatrist.

Sometimes, male infertility can be related to a decrease in the production of the hormone testosterone by the testicles. In this case, symptoms such as fatigue, sexual dysfunction, depression, weight gain, and loss of interest in anything can occur. If this is the case, it is important to see a urologist or reproductive endocrinologist who specializes in male infertility.

What are the causes of male infertility?

A number of biological and environmental factors can cause male infertility. Some of them are:

• Sperm problems: Distorted shape of sperm, reduced sperm count (Oligospermia), absence of sperm in the semen (Azoospermia).
• Genetic disorders: For example, Klinefelter syndrome and myotonic dystrophy.
• Some medical conditions: Diabetes Mellitus, some autoimmune diseases that attack sperm, cystic fibrosis.
• Infections: Epididymitis (infection of the tube that connects the testicles), orchitis (infection of the testicles), and sexually transmitted infections (STIs) such as gonorrhea or HIV.
• Swelling of the veins in the testicles (Varicoceles) .
• Cancer treatments: Chemotherapy, radiation therapy, or surgical removal of the testicles (Orchiectomy).
• Testicular trauma .
• Hormonal disorders affecting the hypothalamus or pituitary glands .

Who is most at risk?

Any man can develop infertility, but you may be at increased risk for the following reasons:

• If your body mass index (BMI) is more than 25 (overweight/obese).
• If you are 40 years old or older.
• If you have been exposed to radiation.
• If you have been exposed to environmental toxins such as lead, calcium, pesticides, or mercury.
• If you use tobacco, marijuana, or alcohol.
• If you are taking certain medications such as flutamide, spironolactone, and bicalutamide.
• Frequent exposure to things that increase the temperature of the testicles, such as saunas or hot tubs. Using a wheelchair can also increase the temperature of the testicles.
• If there is a history of undescended testicles at birth.
• If the above-mentioned `varicoceles` condition has been present before.
• If you are taking testosterone as a treatment for low testosterone levels.
• If you take anabolic-androgenic steroids (AAS) or hormone supplements to build muscle.

What is healthy semen like?

Semen is a white to grayish liquid that is released from the penis during ejaculation. Semen contains sperm, fluids that help the sperm travel back into the vagina, and proteins, vitamins, and minerals that nourish the sperm.

Normally, semen is thick and sticky . If there is runny or watery semen, it may indicate a low sperm count. This can also be a cause of male infertility.

How do you diagnose male infertility? What tests are done?

Your family doctor (Primary Care Physician - PCP) can diagnose male infertility. Or he or she may refer you to a urologist or reproductive endocrinologist who specializes in male infertility.

The doctor will do a complete physical exam to check for any physical problems that may be affecting your overall health and fertility. They will also ask you and your partner questions about your sexual habits and health history. For example:

• How long have you been trying to get your partner pregnant?
• Have you ever gotten a partner pregnant before?
• Have you ever had a sexually transmitted infection (STI)? If so, what was it and when?
• Have you received treatment for it?
• Have you used any family planning methods (contraceptives)? If so, what and when?
• Does any of your blood relatives suffer from male infertility?
• Do you smoke, use alcohol, or other drugs?
• What kind of medications are used?

If a physical examination and health history do not reveal a clear cause, the doctor may order further tests.

What are the main tests performed?

A semen analysis is one of the main tests used to diagnose male infertility. In this, a sample of your semen is examined in a laboratory to check the quantity and quality of sperm.

Remember, this is a very important test. It is what can detect many problems with sperm.

There are other tests as well. Among them:

• Imaging tests:This may include non-invasive tests such as ultrasound or magnetic resonance imaging (MRI), or invasive tests such as a venogram.
• Blood tests: These can measure your hormone levels and look for abnormalities in your genes or chromosomes.
• Urinalysis: This helps detect things like sexually transmitted infections (STIs) and diabetes.
• Testicular biopsy: In this test , the doctor takes a small amount of tissue from the testicles to see how well the testicles are producing sperm.

Is there a treatment for this condition? What is it?

Yes, the good news is that there are various treatments available to reverse or manage male infertility . The cause will determine the treatment that is right for you.

Lifestyle changes

Making some lifestyle changes can help increase healthy sperm production:

• You maintain a healthy weight .
• Eat more fruits and vegetables.
• Engage in regular exercise such as walking, jogging, cycling, dancing, or weight lifting.
• Managing stress.
• Stop smoking, alcohol and other drug use .
• Avoid using sexual lubricants during sexual intercourse.

Medicines

If your hormone levels are high or low, you may need to take hormone therapy to correct them. You may also need to stop taking certain medications or switch to other medications. For example:

• Tricyclic antidepressants.
• Calcium channel blockers.
• Anti-androgens.

Surgery

In some cases, surgery may be necessary:

• Vasectomy reversal: If you have previously had a vasectomy to prevent having children, you can have it reversed and regain the ability to become pregnant.
• Vasoepididymostomy: This surgery removes a blockage in the epididymis, a tube where sperm mature.
• Sperm retrieval: A doctor takes a biopsy and obtains sperm from the testicles or epididymis.
• Varicocelectomy: A varicocele is a blood clot in the veins of the testicles. This can negatively affect sperm quality. This surgery removes the veins. In some cases, it can increase the chances of getting pregnant.

Assisted Reproductive Technology (ART)

In these methods, an egg is taken from your partner's ovaries and combined with your sperm in the laboratory.

• Intracytoplasmic sperm injection (ICSI): In this, a doctor injects a single sperm directly into an egg.
• In vitro fertilization (IVF): In this procedure, your doctor injects your partner with fertility drugs. This causes several eggs to mature in her ovaries. When the eggs are ready, a doctor collects the eggs and exposes them to sperm in a laboratory. After a sperm fertilizes the egg, the fertilized egg (embryo) is implanted into the uterus.

Will male infertility improve on its own ? Can it be prevented?

In most cases, male infertility requires treatment . It is not wise to wait for it to get better on its own .

Also, doing certain things can reduce the risk of male infertility:

• Avoid or stop smoking, alcohol, and over-the-counter drugs.
• Limiting exposure to hazardous chemicals.
• Getting vaccinated against viruses that can affect your fertility.
• Avoid exposing the testicles to excessive heat for long periods of time.
• Avoid high-fat foods and maintain a healthy weight that suits you.

If you are suffering from cancer, talk to your doctor about sperm banking before starting treatment.

How do you live with infertility? How do you stay mentally strong?

Male infertility is not easy. Many people are uncomfortable talking about it with their partner or a doctor. Be kind to yourself and your partner . It can be helpful to see a therapist or join a support group to work through your feelings. Remember, you are not alone.

What are the effects of food and drink? What is good?

According to some studies, these foods and drinks can affect sperm quality:

• Processed meats.
• Sweets.
• Soy `(Soy)`.
• Dairy products (according to some studies).
• Canned fish.
• Soda pop and other beverages that contain a lot of sugar.
• Alcohol.
• Caffeine.

A balanced diet like this can benefit you:

• Fresh fruits and vegetables.
• Dried fruits.
• Legumes.
• Lean fish.
• Low-fat milk.

When should I see a doctor? What questions should I ask?

If you and your partner have been trying for a year and haven't gotten pregnant, see a doctor.Also, if you are experiencing feelings of depression, sadness, or inadequacy, don't hesitate to see a therapist.

When you see the doctor, you can ask questions like these:

• What causes male infertility?
• Does my partner need to be tested too?
• What is the best treatment for me?
• What is the success rate of the treatment you recommend?
• Are there any side effects to that treatment?
• Are there any other symptoms or complications I should be aware of?
• What is the complete list of medications that can cause male infertility?
• Should I see a urologist or a reproductive endocrinologist?
• Can you recommend a therapist or support group?

How do I know if my sperm is in good condition?

The best way to know exactly the health of your sperm is to have a semen analysis done at a fertility clinic or laboratory .

There are also OTC at-home semen analysis tests available. However, these are not as accurate as a lab test, and may not be as effective. Remember, there are no obvious outward signs that your sperm is healthy without a test.

Finally, things to remember (Take-Home Message)

Male infertility is a challenge. However, this does not mean that you will never be able to have a biological child . Thanks to modern technology, many couples are able to conceive a biological child.

If your partner hasn't gotten pregnant after trying for a year, talk to a doctor. Lifestyle changes can help prevent infertility, and surgery and other procedures can treat the underlying cause. Never give up hope!

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