Male factor Infertility
Male factor Infertility

 

How common is male factor infertility?

Of all infertility cases, approximately 40–50% is due to “male factor” infertility and as many as 2% of all men will exhibit suboptimal sperm parameters.

The rates of infertility in less industrialised nations are markedly higher and infectious diseases are responsible for a greater proportion of infertility.

The fertility rate in men younger than age 30 years has also decreased worldwide by 15%.

Male infertility
Male infertility

Is it necessary for all infertile men to undergo a thorough evaluation?

 If you are facing difficulty in conceiving then semen analysis should be done at the earliest.

Male infertility is commonly due to deficiencies in the semen, and semen quality is used as a surrogate measure of male fecundity.

Males with sperm parameters below the WHO normal values are considered to have male factor infertility.

The most significant of these are low sperm concentration (oligospermia), poor sperm motility (asthenospermia), and abnormal sperm morphology (teratospermia).

Semen analysis remains the single most useful and fundamental investigation with a sensitivity of 89.6%, that it is able to detect 9 out of 10 men with a genuine problem of male infertility.

What is the clinical value of traditional semen parameters?

Males with sperm parameters below the WHO normal values are considered to have male factor infertility.

The most significant of these are low sperm concentration (oligospermia), poor sperm motility (asthenospermia), and abnormal sperm morphology (teratospermia).

male infertility
male infertility

 

What key male lifestyle factors impact on fertility (focusing on obesity, heat and tobacco smoking)?

Cigarette smoke is a common somatic cell carcinogen and mutagen, and may adversely affect male reproduction factors.

Obesity is also linked to subfertility due to alteration in the hormone environment. Constant exposure to lead for instance, without safety measures, predisposes such individuals to low fertility.

Men who are exposed to high temperature at their workplace – welders, dyers, blast furnace workers and those employed in cement and steel factories – are more prone to infertility. A 1° elevation in testicular temperature leads to 14% depression of spermatogenesis.

Diet enhances sperm health
Diet enhances sperm health

Do supplementary oral antioxidants or herbal therapies significantly influence male factor infertility?

 Oxidative stress in the seminal fluid causes damage of the sperm plasma membrane and loss of its DNA integrity. Normally, a balance exists between concentrations of reactive oxygen species and antioxidant scavenging systems. If oxidative damage exceeds natural scavenging capacity then it affects sperm parameters. High dosage of vitamin C & E may rescue from such damage and increase fertility in male factor infertility.

 

What are the evidence-based criteria for genetic screening of male factor infertility?

Genetic testing is required in all severely oligospermia and non-obstructive azoospermic men. Such men demonstrate small testes and increased FSH. Chromosome structural and numeric abnormalities, YCMD, and other genetic mutations have been implicated in male sub fertility. These men may benefit from genetic testing.

How does a history of neoplasia and related treatments in the male impact on reproductive health and fertility options?

Cancer, or post cancer treatments, can interfere with male factor fertility and reduce the ability to have children. Different types of treatments can have different effects.

Higher doses of cancer drugs are more likely to cause permanent fertility changes. The combinations of drugs can have greater effects. The risks of permanent infertility are even higher when males are treated with both chemo and radiation therapy.

What is the impact of varicocele on male fertility and does correction of varicocele improve semen parameters and/or fertility?

Varicocele is among the most common causes of male infertility. Varicocele affects fertility and sperm quality in some, but not in all men. The adverse effect of varicocele on sperm parameters may be due to increased testicular temperature, increased pressure, or reduced blood flow.

Causes of Male Infertility
Causes of Male Infertility

Effectiveness of varicocelectomy is however not proved and hence not practiced in many infertility setup.

How to Improve sperm count and motility

Sperm quality can be harmed by several environmental and lifestyle factors, of which obesity and related diseases, such as type 2 diabetes, are well-known risk factors for poor sperm quality. High consumption of sugar affects the RNA fragments in human sperm and reduces quality. The genetic integrity of each sperm cell is essential for successful fertilisation. Damage to DNA strands in the sperm cell makes it unable or less likely to fertilise an egg and produce healthy embryo.

Can tomatoes improve sperm health?

Sperm quality can be improved with a simple diet supplement containing a compound found in cooked tomatoes. Lycopene can be found in some fruits and vegetables, but the main source in the diet is from tomatoes. Lycopene is a pigment that gives tomatoes their red colour, but dietary Lycopene is poorly absorbed by the human body. People taking more tomatoes are having more lycopene in blood. Thus consumption of tomatoes protects sperm from DNA damage.

The improvement in morphology ( the size and shape of the sperm), is dramatic. Lycopene’s beneficial action is due to its antioxidant action. Consequently it  potentially inhibits the damage caused by oxidation of sperm which is a known cause of male fertility problems.

Nuts are good for enhancing sperm quality

The inclusion of nuts in a regular diet significantly improves the quality and function of human sperm.

Significant improvements in their sperm count, vitality, motility and morphology is seen in people consuming nuts in long term basis.

Decline in quantity and quality of human sperm in the recent years is attributed in industrialised countries to “pollution, smoking, and trends toward a western-style diet.

Nuts are dense foods containing many nutrients and other phytochemicals. Diets rich in omega-3 fatty acids, antioxidants like vitamin C and E, selenium and zinc and folate have resulted in improvement in sperm quality. Diet supplemented with 60 grams/day of mixed almonds, hazelnuts and walnuts is associated with improvement in sperm health.

Zinc and folic acid, a pair of dietary supplements long touted as an effective treatment for male infertility, failed to improve pregnancy rates, sperm counts, and sperm potency.

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