What is Male Infertility?

What is Male Infertility?

Male infertility is the inability of men to conceive naturally due to a disorder in the reproductive system. This condition can occur due to a problem in men’s sperm production, transportation, or ejaculation processes. With early diagnosis and appropriate treatment, male infertility can be managed effectively, increasing the chance of conceiving.

When to Suspect Male Infertility?

Investigating infertility should be done early in cases where the testicles are not present at birth, in cases of undescended testicles, in men with missing body hair, in men with breast enlargement, in cases of testicular torsion where the testicle twists on its own axis causing disrupted blood flow, in men with a history of testicular trauma, in men with abnormal testicle volume and consistency, in men who have had testicular inflammation, and in men who have undergone hernia surgery.

Causes of Male Infertility

There can be various reasons for male infertility. These include hormonal reasons, genetic factors, sexual dysfunction, infections, varicocele, undescended testicles, testicular trauma, testicular torsion, chemotherapy, radiotherapy, and chronic illnesses.

Today, there are many treatment options available in this regard, and many couples can have the chance to conceive through assisted reproductive techniques.

Hormonal Causes

Hormonal imbalances are a common cause of male infertility. Failure to produce or properly utilize male hormones like testosterone can have adverse effects on the reproductive system. Hormonal imbalances can affect sperm production and lead to a decrease in sperm count and motility.

There can be many reasons for hormonal imbalances. Hypogonadism, the condition where the testes do not produce enough testosterone, can be congenital or occur during the aging process. Problems in the hypothalamus or pituitary gland can also lead to hormonal imbalances. For example, tumors in the hypothalamus or pituitary gland or brain traumas can affect testosterone production.

Genetic Causes

Genetic factors are a significant cause of male infertility. Genetic disorders such as Klinefelter syndrome and Y chromosome microdeletions can prevent natural conception. In such cases, it is important for couples to consider alternative reproductive methods with medical assistance.

Klinefelter syndrome (47 XXY) is among the most common genetic causes. In these patients, there is a 30-50% chance of finding sperm with the micro-TESE method. To ensure that the child born is not affected by Klinefelter syndrome, preimplantation genetic diagnosis can be added to IVF treatment, allowing for the transfer of healthy embryos to the uterus.

Klinefelter syndrome is a genetic disorder that occurs when males have an extra X chromosome. This condition can lead to infertility in males. It prevents the normal development of the testicles and negatively affects sperm production. Men with Klinefelter syndrome typically have low sperm count and poor sperm motility, making natural conception difficult. Sexual dysfunction is also commonly observed in men with Klinefelter syndrome, including issues such as erectile dysfunction, low libido, and orgasm problems. Early diagnosis and appropriate treatment can manage symptoms and improve reproductive health.

Y chromosome microdeletion is another genetic disorder that can have serious effects on the male reproductive system. In this condition, specific regions of the Y chromosome may be missing or deleted. The Y chromosome is the sex-determining chromosome in males and plays a crucial role in reproductive functions. Y chromosome microdeletion can affect sperm production and lead to male infertility. Men with Y chromosome microdeletion may have decreased sperm count and motility, making natural conception challenging. Diagnosis of Y chromosome microdeletion is typically made through genetic testing, which involves analyzing the missing regions of the Y chromosome. This allows for the identification of genetic abnormalities causing infertility and the planning of appropriate treatment methods.

Some infections, especially sexually transmitted infections, can affect sperm production and lead to male infertility. Infections can cause inflammation in the organs of the reproductive system, which can negatively impact sperm production and motility. Particularly common sexually transmitted infections like chlamydia and gonorrhea are among the most common causes of male infertility. These infections can lead to damage in the reproductive system and affect sperm production.

Other infections that can cause infertility in men include prostate infections, urethritis, and epididymitis. These infections can lead to inflammation and damage in the reproductive organs, affecting sperm production.

Although rare, mumps-related orchitis can cause infertility in men who had mumps during childhood.

Sexual dysfunction is also a significant cause of male infertility. These disorders may manifest as erectile dysfunction or premature ejaculation, making natural conception difficult.

What is Azoospermia?

Semen analysis is performed to determine semen volume and sperm production in men. Azoospermia refers to the absence of sperm in the semen sample when sperm analysis is conducted.

Azoospermia presents in two forms in the clinic: obstructive azoospermia and non-obstructive azoospermia. Obstructive azoospermia is defined as the absence of sperm in the semen due to obstruction of sperm transport in the male ducts. In these men, there may be bilateral congenital absence of the vas deferens. This condition is associated with cystic fibrosis, and CTFR mutation screening should be performed due to genetic transmission.

The most common cause of non-obstructive azoospermia in men is testicular failure. Diagnosis is made by examining serum total testosterone and FSH levels.

Men with azoospermia have the chance to become parents through the IVF method. In these men, sperm is surgically obtained from the testes and frozen for later use depending on the individual’s medical condition.

Diagnosis of male infertility

The diagnosis is made through physical examination, semen analysis, hormone tests, and if necessary, genetic tests. If the sperm analysis shows a low sperm count, reduced sperm motility, abnormal sperm morphology, or absence of sperm, male infertility may be indicated.

A low sperm count is one of the most common symptoms of male infertility. Normally, there should be at least 15 million sperm per milliliter of semen sample. However, in cases of infertility, the sperm count may be below this level. A low sperm count significantly reduces the chance of natural pregnancy. Decreased sperm motility is also a symptom of male infertility. Healthy sperm cells should move quickly and effectively to fertilize the egg. However, in cases of infertility, sperm motility may decrease, reducing the chance of natural pregnancy.

Treatment of male infertility

Male infertility can be managed with various treatments, including medication, surgical intervention, and assisted reproductive techniques. Medication can be used to correct hormonal imbalances or increase sperm production. Your doctor may prescribe appropriate medications to correct hormonal imbalances or increase sperm production. This treatment often requires a long-term treatment plan. Testosterone hormone medication can be used to increase testosterone levels and stimulate sperm production in men, and antioxidant medications can be used to reduce sperm DNA damage. This increases sperm count and motility, increasing the chances of couples becoming parents. Medication is often used in combination with other treatment methods. Your doctor will determine the most suitable medication for you. It is important to take medications regularly, follow your doctor’s recommendations, and undergo regular check-ups.

Infections can be a treatable cause of male infertility. In most cases, treating infections can restore sperm production and motility to normal levels, allowing couples to conceive naturally. Therefore, it is important for men to protect themselves from sexually transmitted infections and regularly attend health check-ups.

Surgical intervention can correct or open blockages that may affect sperm production in some cases. For example, a condition called varicocele can cause the veins in the testicles to dilate and affect sperm production. In cases of severe varicocele, this issue can be corrected with surgical intervention, and sperm production can be increased. Surgical intervention can be an effective option in the treatment of male infertility. However, surgical intervention may not be necessary in every case. Therefore, it is important to consider your doctor’s recommendations and discuss treatment options in detail. After surgical intervention, the healing process is important. Your doctor will provide you with information on what to be mindful of after surgery. It is important to rest and take the medications prescribed by your doctor regularly during the healing process.

The diagnosis of Klinefelter syndrome is usually made during adolescence or adulthood. It is often sought medical attention and genetic tests are performed when symptoms are noticed. Treatment is usually aimed at managing symptoms and improving reproductive health. The chance of men with Y chromosome microdeletions to have children can generally be increased with assisted reproductive techniques. Assisted reproductive techniques such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) can offer couples the opportunity to have children despite sperm shortages or mobility issues.

Regulating lifestyle habits will also help eliminate male infertility. Lifestyle habits such as smoking, excessive alcohol consumption, drug use, or being overweight can lead to male infertility. These habits can negatively affect sperm quality and production.

In conclusion, each treatment method should be evaluated individually and implemented according to your doctor’s recommendations. Treatment for male infertility can increase the chances of couples having children naturally and offer promising results.