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MALE INFERTILITY:
Male infertility refers to the inability of a male to achieve a
pregnancy in a fertile female. In humans it accounts for 40-50%
of infertility. Male infertility is commonly due to deficiencies
in the semen, and semen quality is used as a surrogate measure
of male fecundity.
Pre-testicular causes:
Pre-testicular factors refer to conditions that impede adequate
support of the testes and include situations of poor hormonal
support and poor general health including:
- Hypogonadism due to various causes
- Drugs, alcohol, smoking
- Strenuous riding (bicycle riding,[6] horseback riding)
- Medications, including those that affect spermatogenesis such
as chemotherapy, anabolic steroids, cimetidine, spironolactone;
those that decrease FSH levels such as phenytoin; those that
decrease sperm motility such as sulfasalazine and nitrofurantoin
- Genetic abnormalities such as a Robertsonian translocation
Testicular factors
Testicular factors refer to conditions where the testes produce
semen of low quantity and/or poor quality despite adequate
hormonal support and include:
- Age
- Genetic defects
- Abnormal set of chromosomes
- Klinefelter syndrome
- Neoplasm, e.g. seminoma
- Idiopathic failure
- Cryptorchidism
- Testicular cancer
- Retrograde ejaculation
- Ejaculatory duct obstruction
- Hypospadias
- Impotence
- Defects in USP26 in some cases
- Acrosomal defects affecting egg penetration
- Idiopathic oligospermia - unexplained sperm deficiencies
account for 30 % of male infertility.
Sperm sample:
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Main article: Semen analysis
Further information: Semen quality
The volume of the semen sample, approximate number of total
sperm cells, sperm motility/forward progression, and % of sperm
with normal morphology are measured. This is the most common
type of fertility testing.[13] Semen deficiencies are often
labeled as follows:
- Oligospermia or **Oligozoospermia - decreased number of
spermatozoa in semen
- Aspermia - complete lack of semen
- Hypospermia - reduced seminal volume
- Azoospermia - absence of sperm cells in semen
- Teratospermia - increase in sperm with abnormal morphology
- Asthenozoospermia - reduced sperm motility
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There may be combinations of above as well.
What Are the Options for Male Infertility Treatment?
Some causes of male infertility are treatable or correctable
through surgery. Options for treatment may include:
- Treatment with antibiotics, in cases of infection
- Surgical correction, in order to remove a varicocele, reverse
a vasectomy, or repair a duct obstruction
- Medications or fertility drugs to improve sperm production
In cases where the above treatments are unsuccessful, or when
the cause for male infertility is unknown or untreatable, IUI
treatment or IVF treatment may be suggested.
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