Dr. Mahendra P Kamat

Hello and Good Afternoon,

My name is Dr. Pranay Ghosh and I am the director and infertility consultant and chief neurologist at Elixir Fertility Centre.

Today I will be talking about male factor infertility which is a relatively common but frequently neglected diagnosis. Usually when the couple comes in for the infertility assessment it is assumed that the problem lies with the female partner, but about 30% of cases the problem is solely due to the male factor and in about 50 to 20% cases the male partner is contributory. The problem of male infertility may be certain by a basic test as semen analysis and problem may be as severe as absence of sperm in the ejaculates, something that is known as azoospermia. And this is a potentially devastating diagnosis. However, in the majority of such cases it is now possible to have one’s own biological children with the availability of the new or assisted reproduction techniques. Foremost along with the detailed semen analysis, it is important to get a complete history and do a physical examination. A detail semen analysis implies that even in the presence of very few sperms in the ejaculate the diagnosis of a azoospermia should not be made because this is something that happens when the semen analysis is carried out by routine laboratories. A semen analysis is done to look into three variables. The count for the concentration, mobility of the sperm that is appearance of the sperm. This last perimeter that is the morphology of an overload and over reported. If the semen analysis comes out to be abnormal, the first thing that has to be done is repeat the semen analysis with a proper gap or absence of 2 to 7 days because there is a lot of fluctuation and variation in the semen parameters. If the repeat semen analysis comes out to be abnormal again, then advance sperm function test like sperm DNA fragmentation need to be carried out. In severe, in very severe cases of male infertility, just the semen analysis and sperm DNA fragmentation will not sufficient and by chromosome micro delusions studies need to be carried out to conform genetic normalcy. Once we have diagnosed that the male factor does exist and the male partner does suffer from deficient parameter, the good news is that now there are athlete treatment options available to rectify this and ones we are, we are usually able to pin point the cause of the male infertility which may be as uncommon fugnative abnormalities of hormonal imbalances, previous chemo radiations, previous surgery in pelvic area, substance abuse, certain medications or environmental toxins or maybe cannot be pinpointed due to idiopathic reasons. My male factor in infertility may be benefited by anti-oxidant supplementation and Intrauterine insemination/ IUI. However sever cases require intracytoplasmic sperm injection where cycle of IDF is carried out and after a pickup the fertilization is carried out by directly injecting one sperm inside the egg in a labotory. In cases of azoospermia, that is the absence of sperm in the ejaculate, the optional surgically obtaining the sperm from either the tester or the epidictic exists and this is usually done under anesthesia and the sperm that is obtained by surgical sperm retrieval is used to carried out exceed. For supportive treatment and tales, lifestyle modifications, quitting alcohol, giving up smoking, avoiding tight fitting under garments, hot baths and saunas. A very few, small fraction of the patients that knows the male factor infertility may be diagnosed with a condition called vericoseed, essentially dilation or distinction of the veins that trigger the testes, and this is a condition which may be benefitted by surgically correction. The options are many for the patients diagnosed with the male factor infertility and in the right hands; with the right expertise the results are excellent and gratifying.

Thank you.