Male Infertility
Male infertility refers to a man's inability to cause pregnancy in a fertile female partner, despite regular unprotected intercourse over a period of at least one year. It is a significant and often underacknowledged issue — male factor infertility accounts for roughly half of all cases of difficulty conceiving, either as the sole cause or as a contributing factor alongside female-related issues.
Causes
The majority of male infertility cases relate to problems with sperm production or function. These include a low sperm count (oligospermia), poor sperm motility (the ability of sperm to swim effectively), abnormal sperm morphology (size and shape), or a complete absence of sperm in the ejaculate (azoospermia). Underlying causes are varied: varicocele (enlarged veins in the scrotum that raise testicular temperature), previous infections such as mumps or sexually transmitted infections, hormonal imbalances affecting the pituitary or thyroid, genetic conditions such as Klinefelter syndrome, undescended testes, previous surgery or injury, certain medications, exposure to environmental toxins, and lifestyle factors such as smoking, excessive alcohol use, anabolic steroid use, obesity, and chronic stress.
Diagnosis
The primary investigation is a semen analysis, which assesses sperm count, motility, and morphology. Blood tests to measure hormone levels (including FSH, LH, testosterone, and prolactin) are also important. A physical examination may identify a varicocele. In some cases, genetic testing, testicular biopsy, or imaging may be required to determine the underlying cause.
Treatment
Treatment depends on the underlying cause. Varicocele can be surgically repaired, which improves sperm parameters in many men. Hormonal treatments may help where deficiencies are identified. Lifestyle modifications — stopping smoking, reducing alcohol, maintaining a healthy weight, and avoiding excessive heat to the testes — can also improve sperm quality over time. Where natural conception remains unlikely, assisted reproductive techniques such as intrauterine insemination (IUI) or in vitro fertilisation (IVF) with intracytoplasmic sperm injection (ICSI) offer effective alternatives.
Choosing where to be treated
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