Male Infertility: Causes, Treatments, and Options

Q: Male Infertility: Causes, Treatments, and Options

Yiyun： Hello, generally speaking, there is a saying： "When one is well-fed and warm, thoughts of lust arise." In professional terms, this means that the reproductive system only begins to function when the body is at ease and life is not threatened. <br>Conversely, any abnormalit

Infertility

Hello, doctor.
I have a five-year-old son, and for the past two years, I have been trying to conceive again without any success.
I recently went to a gynecology clinic in Beitun for an examination and found out that my sperm count is low, at only 5 million.
I am wondering if my recent lack of sleep and high stress levels could affect the accuracy of the test results.
If it is indeed a case of low sperm count, is in vitro fertilization the only option to have another child, or are there other treatments or solutions available?

Yi Yun, 30~39 year old female. Ask Date: 2004/12/23

Dr. Xu Weikai reply Urology

Yiyun: Hello, generally speaking, there is a saying: "When one is well-fed and warm, thoughts of lust arise." In professional terms, this means that the reproductive system only begins to function when the body is at ease and life is not threatened.
Conversely, any abnormalities in the body or irregularities in lifestyle will primarily affect the reproductive system.

For semen analysis, the standard procedure is to abstain for 3-5 days, and the sample should be delivered to the laboratory for testing within one hour.
The sperm count should be over 60 million; in your case, 5 million is neither too much nor too little.
I believe you can start by improving your quality of life, and after about three months, there should be a significant increase in sperm count (note: sperm production takes approximately 71 days).
You may also consider taking a multivitamin containing zinc (Zn), with 1-2 capsules per week being sufficient.

There are many other methods, such as directly injecting semen into the uterus using a syringe.
Of course, in vitro fertilization (IVF) is also an option.
Currently, in many countries, conception can occur with just one viable sperm.
Artificial reproduction is an expensive and time-consuming process, so natural methods are often the most convenient and safest.
Wishing you all the best.

Director of Urology, Taitung Hospital, Department of Health, Executive Yuan, Xu Weikai.

Reply Date: 2004/12/23

More Info

Understanding male infertility is crucial for couples who are trying to conceive but facing challenges. Male infertility can stem from various causes, including hormonal imbalances, genetic factors, anatomical issues, lifestyle choices, and environmental influences. In your case, the diagnosis of oligospermia, or low sperm count, with only 500 million sperm, is a significant factor that can affect fertility.

Causes of Male Infertility
1. Hormonal Imbalances: The hypothalamus, pituitary gland, and testicles must work together to produce sperm. Any disruption in this hormonal axis can lead to reduced sperm production.

2. Genetic Factors: Conditions like Klinefelter syndrome or Y chromosome microdeletions can affect sperm production and quality.

3. Anatomical Issues: Problems such as varicocele (enlarged veins in the scrotum) or blockages in the reproductive tract can impede sperm delivery.

4. Lifestyle Factors: Poor diet, obesity, smoking, excessive alcohol consumption, and drug use can negatively impact sperm production and quality.

5. Environmental Factors: Exposure to certain chemicals, heavy metals, and radiation can also affect fertility.

6. Medical Conditions: Conditions such as diabetes, infections, and certain medications can impact sperm production and function.

Impact of Stress and Sleep on Fertility
You mentioned experiencing sleep deprivation and high stress levels. Both factors can indeed affect fertility. Chronic stress can lead to hormonal changes that may inhibit testosterone production, which is essential for sperm production. Sleep is also crucial for maintaining hormonal balance; insufficient sleep can lead to lower testosterone levels and reduced sperm quality. Therefore, addressing these lifestyle factors is essential for improving your fertility potential.

Diagnostic Testing
A semen analysis is the primary test for assessing male fertility. It evaluates sperm count, motility (movement), morphology (shape), and overall semen quality. If your analysis shows low sperm count, it is advisable to repeat the test after a few weeks, as sperm production can fluctuate due to various factors, including stress and health changes.

Treatment Options
1. Lifestyle Modifications: Improving your diet, exercising regularly, reducing stress, and ensuring adequate sleep can positively impact sperm health. Avoiding tobacco and limiting alcohol intake are also beneficial.

2. Medical Treatments: Depending on the underlying cause, treatments may include hormonal therapy, medications to address infections, or surgical interventions for anatomical issues like varicocele.

3. Assisted Reproductive Technologies (ART): If lifestyle changes and medical treatments do not yield results, options such as Intrauterine Insemination (IUI) or In Vitro Fertilization (IVF) may be considered. IVF, in particular, can be effective for men with low sperm counts, as it allows for the selection of the healthiest sperm for fertilization.

4. Sperm Retrieval Techniques: In cases where sperm production is severely compromised, techniques such as Testicular Sperm Extraction (TESE) can be employed to retrieve sperm directly from the testicles for use in IVF.

5. Counseling and Support: Given your concerns about mental health and the desire to have children, seeking counseling can be beneficial. It can help you manage stress and anxiety related to fertility challenges.

Conclusion
In summary, male infertility is a multifaceted issue that can often be addressed through a combination of lifestyle changes, medical treatments, and assisted reproductive technologies. It is essential to work closely with a healthcare provider specializing in male fertility to explore the best options for your specific situation. Remember, many couples facing similar challenges have successfully conceived with the right support and treatment.

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