Male Infertility

Male infertility refers to a male’s inability to cause pregnancy in a fertile female
The number of men, who are denied of the right of fatherhood, is increasing at an alarming rate.
50% of the total infertility is due to the reasons connected to males.

• Poor sperm production
• Less motility of sperms
• Structural aberrations of them
• Hormonal imbalance, etc. contribute their own shares to the male infertility
• Azoospermia – the state of absence of sperms. In case of azoospermia, if germinal epithelial cells are detected with the help of testicular biopsy, then homoeopathic treatment is highly hopeful.
• Oligospermia – meager number of sperms.
• Astheno sperm – sperms with feeble mobility. This may be sometimes due to the dilated and tortuous condition of the veins of the testis- varicocele. This can be managed very well with homoeopathic medicines by evading surgery.
• Teratospermia – structural malformations of the sperms.

FACTORS INFLUENCING SPERMATOGENESIS

• Undressed testes
• High temperature of the abdominal cavity (tight under garments)
• Smoking, alcoholism
• Certain diseases , such as mumps, may cause an inflammation of the testes (When the mumps gets bad, inflammation doesn’t confine itself to parotid gland . Inflammation of the testes can also happen. And, for the post-pubescent, the virus can go for the endocrine glands – the mammary glands and the ovaries in women, and the testes in men. Women can be rendered infertile by severe inflammation, but it’s rare. Men who develop orchitis, inflammation of the testicles, are slightly more likely to be rendered infertile. This does not happen to the majority of men infected with mumps, but it can happen. Many men who get the mumps experience some negative fertility effects. One out of ten men will have a drop in their sperm count, and about half will notice some shrinkage of their testicles
• Even though a single sperm cells is needed to fertilize an egg cell, the presence of many sperm is required for the successful completion of the process, which is a complex set of events. Thus some sperm secrete proteinases that expose the egg cell for fertilization and others are involved in various steps of initiation.

SAMPLE COLLECTION INSTRUCTIONS

• Should be collected after 2-5 days abstinence from sexual intercourse or masturbation
• Collected at the laboratory by masturbation
• Should be delivered within 1 hour of collection if collected outside the laboratory
• Coitus interrupts, though not satisfactory, may be acceptable where the subject cannot masturbate. With coitus interrupts, the first portion of the ejaculate, which contains the highest concentration of spermatozoa, may be lost.
• Use of condom is not acceptable unless the condom is clean and plain with no spermicides or lubricants.
• If any portion of the ejaculate is lost or if the container leaks during transportation, the sample should not be used for analysis.
• During the transportation of the sample, it should not be exposed to extremes of temperatures (not less than 200C or more than 400C).
• 2 to 3 specimens should be collected on weekly or biweekly intervals. The examination of a single specimen is not adequate because of the variations in sperm production

COLOUR
• Normal semen is creamy-white in colour.
• Red or Brown Colored semen suggests the presence of blood which can be due to infection, trauma and rarely, cancer.
• Yellow or greenish colour suggests the presence of infection due to sexually transmitted disease, gonorrhea

PH
• Normally the pH of semen is alkaline (7.1-8.0).
• An acidic pH suggests either absence of the seminal vesicles, or an ejaculatory duct obstruction

ODOUR
Foul smelling semen may be due to inflection

SPERM COUNT
WHO recommends that men with sperm counts ranging from15-200 million/ml are in the fertile range.
• A low sperm count may result from over work, emotional stress, fatigue, excess tobacco and alcohol consumption, tight fitting clothes and excess exercise
• Sperm production also declines with age

VOLUME
• Volume should be 2-5ml after 2-5 days abstinence
• Decreased volume of semen may be due to blockage or absence of the seminal vesicles, repeated sex

FRUCTOSE LEVEL
• Fructose is produced by the seminal vesicles.
• It provides energy for sperm motility
• The normal range is 3 mg/ml of ejaculate
• Absence suggests a block in the male reproductive tract

VISCOSITY/LIQUEFACTION
• Normal Semen is a cloudy white fluid, which becomes runny and clear in 30 Minutes.
• Increased persistent viscosity may inhibit the motility of the spermatozoa

SPERM MORPHOLOGY
• A normal sperm measures 50-70¬mm in length. It has a large oval head, which measures about 3 – 6 x 2 – 3mm, a short middle piece and a long tail
• Normal semen may contain up to 20% abnormal forms.

MOTILITY
• A normal sample will show32% or more motile spermatozoa with the majority exhibiting good to excellent forward progressive movement up to 3 hours after ejaculation.
• Excellent forward + good forward = 32-50%
• Unusual motility pattern (e.g., circular movements) should be noted.

ANTISPERM ANTIBODIES
• Antibodies to sperm have been shown to impair fertility and may account for up to 10% of the incidence in couples whose infertility is unexplained
• Infection of the genital tract, varicocele, testicular torsion and autoimmune diseases are some of the conditions associated with antisperm antibodies.

All the above factors affecting male fertility can be fruitfully treated with Homoeopathic medicines. In case of complete absence of sperms (Azoospermia), if germinal epithelial cells are detected with testicular biopsy, then homoeopathic treatment is highly hopeful.In most of the cases FSH, LH, PROLACATIN, TESTOSTERON levels can be normalize by Homoeopathic medicines.