Male Infertility

When a couple has trouble having a baby, there’s about a 50-50 chance that the man has a problem contributing to the pregnancy…

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What is infertility?

Infertility is “the inability to conceive after 12 months of unprotected intercourse.” This means that a couple is not able to become pregnant after a year of trying. Most (85%) couples with normal fertility will conceive within a year of trying.

The chance of a normal couple conceiving is 20% to 37% by three months, 75% by six months, and 90% at one year. Of those couples that do not conceive in the first year, as many as 50% will conceive in the next year. Couples that have tried without success to conceive should see a fertility specialist.

How often should a couple have intercourse?

Surprisingly, long periods of abstinence can decrease the quality of sperm. Couples should have intercourse (sex) at least two to three times a week during the fertile period. A couple has more chances for pregnancy if they have intercourse every one to two days during the fertile window, and a pregnancy is most likely if a couple has intercourse within the six-day time frame that ends on the day that an egg is released (ovulation).

Fertility in the aging male

Sperm quality deteriorates somewhat as men get older, but it generally does not become a problem before a man is in his 60s. Despite these changes, there is no maximum age at which a man cannot father a child. As men age, their testes tend to get smaller and softer, and sperm morphology (shape) and motility (movement) tend to decline. Aging men may develop medical illnesses that adversely affect their sexual and reproductive function.

Male factor

When a couple has trouble having a baby, there’s about a 50-50 chance that the man has a problem contributing to the pregnancy. He might:

  • Produce too few sperm to fertilize an egg
  • Make sperm that are not shaped properly or that do not move the way they should
  • Have a blockage in his reproductive tract that keeps sperm from getting out

If you might have a fertility problem, your doctor will want to perform a complete history and physical, as well as several tests to find out what may be causing your infertility.

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Semen analysis

Semen analysis is probably the first test you will be asked to perform. Semen is the fluid that is released when a man has an orgasm. Semen carries the sperm in fluids that should nourish and protect it. You will typically be asked to provide a semen sample by masturbating into a sterile glass jar. The semen analysis provides a lot of information about the quantity and quality of both semen and the sperm it contains. Some of the things that are measured are:

  • How much semen a man produces (volume)
  • The total number of sperm in the semen sample (total count)
  • The number of sperm in each milliliter of semen (concentration)
  • The percentage of sperm that are moving (motility)
  • If the sperm are the right shape or not (morphology)

The analysis can also suggest if you have an infection in your reproductive system.

Hormone levels and reproduction

Important chemicals in your body, called hormones, control sperm production. They also affect your interest in sex and your ability to have sex. Too much or too little of these hormones can cause problems with sperm production or trouble having sex. Two important hormones for reproduction are follicle-stimulating hormone (FSH) and testosterone (T). Your doctor may do blood work to check to see if you have the right amount of these hormones. If indicated, your doctor may check other hormone levels, including luteinizing hormone (LH), estradiol, and prolactin.

Counseling

Infertility is a medical condition that touches all aspects of your life. It may affect your relationships with others, your perspective on life, and how you feel about yourself. How you deal with these feelings will depend on your personality and life experiences. Most people can benefit from the support of family, friends, medical caregivers, and mental health professionals.

Are boxers shorts or briefs better?

Some studies suggest that wearing brief underwear may raise the temperature around the scrotum and cause a decrease in sperm quality. Choosing boxer underwear is one way to avoid this. The evidence from these studies is inconclusive. Regardless, avoiding situations that raise scrotal temperature (like hot tubs or using laptops on your lap) might improve sperm quantity and quality. Some medications, along with chronic medical conditions and high fevers, may impair the body’s ability to make sperm. Ask your doctor how your medications or conditions affect your fertility potential.

How can I improve our chances of conceiving naturally?

Like many aspects of our health, a man’s fertility is improved by adopting a healthy lifestyle. Maintaining an ideal weight, a diet rich in antioxidants (found in fruits and vegetables), as well as multi-vitamins may improve the quality of sperm. Reducing stress and controlling chronic medical conditions such as high blood pressure and diabetes may also improve a man’s chances of impregnating his partner. Remember that any such changes in the man’s lifestyle will take almost three months to show an improvement in sperm. Couples with underlying medical or genetic conditions should see a doctor so that they can increase their overall health before conceiving.

When Do I Need To See An Infertility Counselor?

Consider counseling if you are feeling depressed, anxious, or so preoccupied with your infertility that you feel it is hard to live your life productively. You also may want to seek the assistance of a counselor if you are feeling “stuck” and need to explore your options. Signs that you might benefit from counseling include:

  • persistent feelings of sadness, guilt, or worthlessness
  • social isolation
  • loss of interest in usual activities and relationships
  • depression
  • agitation and/or anxiety
  • mood swings
  • constant preoccupation with infertility
  • marital problems
  • difficulty with “scheduled” intercourse
  • difficulty concentrating and/or remembering
  • increased use of alcohol or drugs
  • a change in appetite, weight, or sleep patterns
  • thoughts about suicide or death

Male Infertility Specialist

An Urologist and a Reproductive Endocrinologist are trained to evaluate infertility in men. Their services may be offered in a fertility clinic depending on the specific challenge affecting the man. Also, although Gynecologists and Obstetricians are readily equipped to manage female infertility, they can also be involved in the fertility management of men. After evaluation, they will decide on the best way to assist you.

 

 

Information from American Society for Reproductive Medicine was used in this article.

Erectile Dysfunction

Is it time for a sexual function,
And then there is penile malfunction?
Have you lost your vigour
in such a way you can’t figure?
This is just a hiccup,
it isn’t time to give up

Erectile dysfunction (ED) is a man’s inability to achieve or maintain an erection suitable for satisfactory sex. Normally, when a man is sexually aroused, the penis fills with blood after a series of nerves send signals from the brain. A man that can’t achieve this important feat may be said to be impotent.

Problems with erections tend to become more frequent as a man gets older. Many people associate erectile dysfunction (ED) with older men, but it’s something younger men should take seriously, too. Several medical conditions, habits, psychological factors have been implicated. Listed below are conditions that can cause this problem

  • Diabetes
  • Stroke
  • Spinal cord injury
  • High cholesterol
  • Relationship problems
  • Performance anxiety
  • Past sexual trauma
  • Stress, depression, or anxiety
  • Medication side effects
  • Excessive drug or alcohol use

In clinical practices, the commonest causes are diabetes, hypertensive related diseases and  both of these diseases affect the nerve signals and blood supply to the penis respectively. Also, other common causes include stress and chronic fatigue syndrome, when a man feels exhausted in such a way that can’t be reasonably explained. Symptoms may also include muscle and joint pain, headaches, and trouble concentrating or remembering things. Resting and sleep usually doesn’t help.

Also, several medications have been implicated in making this condition worse. Sexual problems, such as decreased libido, orgasm difficulties, erectile dysfunction in men, and vaginal dryness in women, are common side effects of certain medications. The following list, while not exhaustive, gives the most common types of drugs known to have sexual side effects.

• Anti-anxiety drugs
• Antiepileptic drugs
• Antidepressants
• Antihistamines
• Antipsychotics
• Blood pressure medications, including diuretics (water pills)

How does erectile dysfunction (ED) affect a man’s self-esteem?

Many men associate erections with their identity. Erections are tied to their masculinity and feelings of self-worth. So when erectile dysfunction (ED) occurs, they may lose confidence in themselves and in their abilities to please their partner. Depression and anxiety are common in men with ED and can affect not only the sexual relationship but social and work activities as well. Partner support can also help men with ED-related self-esteem problems.

sexual dysfunction
sexual dysfunction man

How important are partners in the treatment of erectile dysfunction (ED)?

Studies have shown that treatment for erectile dysfunction (ED) is more effective when the patient has a supportive partner.

How can a partner be supportive? Here are some ideas:

  • Attend doctor’s appointments with the patient. A partner can provide additional insights and may think of questions that the patient overlooks.
  • Help the patient decide on a treatment plan.
  • Communicate. Help the man feel comfortable discussing ED, from the physical aspects to the emotional matters.
  • Be encouraging and upbeat.
  • Understand that overcoming ED takes time. Some men need to try different treatments before they find what works best for them. Patience and a willingness to try other ways of being intimate – aside from intercourse – can take pressure off the man and make him feel like he is still desired.

Working together as a team, both partners can cope more easily with ED treatment and, in turn, strengthen their relationship along with their sex lives.

Preventing (ED)

Men who eat foods high in antioxidants have a lower risk of erectile dysfunction (ED) than those who don’t. Foods like citrus fruits, blueberries, strawberries, apples, pears, cherries, and blackberries. Some teas, coffee, and herbs also have antioxidants in them. Diet should include vegetables, whole grains, and olive oil. Nuts and fish are good additions.

A man’s doctor can help him decide which dietary changes to make. However, men who are having trouble with erections should be sure to mention it. Many factors can contribute to ED and it’s best to have a complete medical checkup.

Here are the risk factors:

Smoking. Research has shown that men who smoke are at higher risk for ED. Often, erection problems are worse for men who smoke heavily and those who have smoked for a long time. Secondhand smoke may also interfere with erections. Smoking can also decrease amounts of nitric oxide, a compound that plays an important role in erections.

Obesity. For some men, obesity is linked to low testosterone, which can interfere with a man’s erections. Obesity also raises a man’s risk for heart disease and diabetes, which are common in men with ED.

High blood pressure (hypertension). High blood pressure is another condition that can cause atherosclerosis and restrict blood flow to the penis.  In addition, some medications used to treat hypertension are associated with ED.

Sedentary lifestyle. Exercise is important for good health on so many levels, including erections. It helps keep blood flowing smoothly throughout the body and to the penis. It also helps a man maintain a healthy weight.

As noted above, these risk factors are modifiable. There are things men can do to reduce their impact. Some actions include:

• Quitting smoking.
• Losing weight.
• Eating healthier food.
• Getting more exercise.

Men and women who suspect that a drug is affecting them sexually should first see their doctor. There are several options to consider: Give the medication more time, change the dosage, change the medication and in some cases, switching to an entirely new medication may help or adding another medication.

Any changes in medication should be made under a doctor’s supervision. Patients should not stop taking their medications as prescribed until they have discussed it with a healthcare provider.

What are some of the treatments for ED?

There are many treatment options available:

  • Oral medications. Phosphodiesterase-5 inhibitors help increase blood flow to the penis.
  • Penile injections. Men can learn to inject medication into the penis. This medication helps blood vessels dilate, allowing more blood for erection.
  • Urethral suppositories. These medications are inserted into the urethra at the tip of the penis.
  • Penile implants. Implants are surgically placed inside the penis and allow a man to get an erection when he wishes. There are several types of implants, from malleable rods that the man raises and lowers himself to inflatable devices controlled with a pump.

Consult a doctor, specifically an Urologist to help you choose the best option.