Treatment of male infertility is an important aspect of infertility treatment. Many factors can be prevented with lifestyle modifications and appropriate treatment.

1. Infertility in men
- Fertility issues in men are equally responsible as those in
women for failure in conceiving a baby.
- Male infertility is an important cause of infertility in couples
with a fertile female partner.
- Infertility in men is also a chief reason for stress, depression
and other psychological conditions in men due to
incompetence of child-bearing.
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2. H2- What is infertility?
• Medically, infertility is the inability to conceive within 12 months of
regular and unprotected sexual intercourse.
• According to the World Health Organization, currently 60 to 80 million
couples are childless due to infertility.
• The rates are rising due to different health issues arising with advancing
technology at work, stress and various other environmental factors.

3. H2 - Signs of infertility in men
Multiple factors are responsible for causing male infertility. Semen analysis
test is an efficient and reliable male fertility test that helps in detecting
abnormalities of sperm and semen that result in infertility.
1. Low sperm count : Oligospermia is a condition in which the sperm count is
less than 15 million sperm per milliliter of semen. Azoospermia is the complete
absence of sperm in the semen.
2. Low sperm motility : Motility or movement of sperms is vital for fertilizing an
egg. Sperms with low motility are unable to enter the egg and fertilize it.
3. Abnormal sperms : Abnormality in the shape and structure results in low
sperm motility.
4. Aspermia or total absence of semen during ejaculation: This is a condition
commonly arising from infections and/or abnormality in male genital tract,
medications, etc.
5. Problems in ejaculation such as premature ejaculation, delayed ejaculation
and retrograde ejaculation contribute to male infertility.

4. H2 - Causes of infertility in men
Different reasons have been attributed for male infertility.
1. Increase in the scrotal temperature is the most common cause of
decreased production of sperms in the testis. Men working in factories with
extensive use of heat such as cement factories, welding, blast furnaces, etc.
commonly suffer from infertility.
2. Varicocele is a condition in which the blood vessels in the testis are swollen
resulting in stagnation of blood and raising the temperature. This affects the
production and shape of sperms.
3. Injury or trauma may lead to a decrease in the sperm count and cause
male infertility.
4. Certain medications such as steroids, anti-acne medicines, antacids, anti-
cancer drugs, chemotherapy, surgery (vasectomy), and a few herbal
medicines too can affect the sperm count.

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6. 4. Infections of the testis, diabetes, mumps and other auto-immune disorders
can lead to male infertility by decreasing the sperm count.
5. Hormonal disorders affecting the production of hormones in the brain and
testis result in abnormalities in sperm production. E.g., pituitary gland tumor,
Cushing’s syndrome, etc.
6. Genetic problems with abnormal number of chromosomes affect the sperm
production. E.g., Klinefelter’s syndrome, Y-chromosome microdeletion, etc.
7. Failure of one or both testis to descend in the scrotum (undescended
testis), congenital deformity in testis, cancer of testis, etc. also result in
infertility in men.
8. Other causes of male infertility resulting in decreased sperm count include
increasing age, obesity, excessive alcohol and smoking, drugs like marijuana,
testosterone use for increasing muscle mass, toxin exposure such as
pesticides, lead, mercury, etc.

7. H2 - Treating male infertility
Three types of Infertility treatment is available for men - medical, surgical and
treatment with assisted reproductive technology.
1. Medical line of treatment includes use of hormones like gonadotropin-
releasing hormone therapy and gonadotropin replacement for hormonal
problems at the level of brain (hypothalamus and pituitary gland).
- Other hormonal drugs that help in increasing the testosterone (male
hormone) levels are human chorionic gonadotropin (hCG) in combination
follicle –stimulating hormone and luteinizing hormone, estrogen modulating
drugs, clomiphene citrate, tamoxifene and steroids for autoimmune
disorders.
- Medicines for retrograde ejaculation help in closing the bladder neck to
facilitate the flow of semen in urethra instead of urinary bladder during
ejaculation.

8. 2. Surgical treatment for male infertility consists of surgical correction of
conditions that result in a low sperm count due to obstructions, e.g., swollen
veins in testis or varicocele (varicocelectomy), blocked tubes that carry sperm
from testis due to congenital deformity or trauma to the testis, etc.
3. Treatment with assisted reproductive technology
- In-vitro fertilization or IVF treatment technique involves fertilization of the
egg with a sperm outside the body in a lab. The egg from the woman is
mixed with the semen containing sperms and the fertilized egg is then
transferred into the women’s uterus. This line of treatment is helpful in men
with a minor low sperm count with efforts taken for natural conception for 2
years.
- ICSI or intracytoplasmic sperm injection is similar to IVF, in which a sperm is
directly injected into an egg. This increases the chances of fertilization. The
fertilized egg is later transferred into the uterus. ICSI method of fertility
treatment for men is useful in cases of abnormality in the structure and
shape of the sperm which results in failure to conceive and in unexplained
infertility in men .

9. 4. Lifestyle modifications play a significant role in the treatment of male
infertility.
When planning for a baby:
- Avoid cigarette smoking, consumption of alcohol, drug abuse, and exposure
to toxic substances completely.
- Take care to prevent infections and carry out proper treatment of existing
disease conditions.
- Maintain appropriate body weight with regular exercise and intake of
healthy and nutritious diet.
- Meditation and yoga help in maintaining sound mental health.

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