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• Testicular biopsy recanalisation of tubes for individuals who have Here, a single is injected directly into an egg; donors provide to sperm banks. All donor This test involves removing samples from the undergone a vasectomy in the past or those with this procedure is most commonly used to overcome sperm and derived from donated oocytes are congenital/acquired obstruction of the . male problems. frozen and quarantined as the donor undergoes Infertility with a needle. It may be used if shows no sperm at all. The results of the testicular • Assisted Reproductive Techniques Following egg retrieval, sperm is injected into the screening for infectious diseases such as HIV. biopsy will tell if sperm production is normal. Rapid advancements in the field have enabled egg. About 70 percent of eggs get fertilized. (Male) • Anti-sperm antibody tests individuals with variety of disorders to successfully Fertilization is confirmed 18-24 hours after retrieval. These tests are used to check for immune cells become proud parents, a situation relatively uncommon ICSI is a highly successful technique used to help (antibodies) that attack sperm and can affect their in the past. The various options available are: couples who have previously failed to achieve ability to function. In Vitro Fertilization (IVF) conception with standard IVF. • Vasography IVF is the most common assisted reproductive Electroejaculation technology method and is the treatment of choice if In some cases, contrast dye is injected into each vas In the past, men with ejaculatory dysfunction were both fallopian tubes are blocked. IVF is also widely deferens to see if they are blocked. considered infertile because they couldn't ejaculate used for conditions such as: • Specialized sperm function tests even though they produced sperm within their . • Endometriosis A number of different tests can be used to evaluate The nerves are stimulated to produce an . If • how well sperm survive after ejaculation, how well the specimen collected is of very good quality, it can be • Cervical factor infertility they can penetrate the egg membrane, and whether used for intrauterine (IUI)or ICSI. there's any problem attaching to the egg. • Male factor infertility • Ovulation disorders Semen Treatment of male infertility (the freezing of sperm) is a Intrauterine Insemination (IUI) Treatment has to be carefully selected keeping in mind way to store sperm for future use. Men who must the age, health of the female partner, preference, During this procedure, the partner's washed sperm undergo medical procedures that may leave them medical history and the exact cause of infertility. The is placed directly into the uterus near the time of sterile may wish to consider semen cryopreservation following modalities of treatment are available. ovulation. IUI is often performed in the case of a low e.g. cancer ,radiotherapy. Semen sperm count, abnormalities of ejaculation cryopreservation is also used before IVF to acquire For any further information contact 022-2444 7831 / 32 • Medical Treatment (, impotence, spinal cord multiple semen samples in men. or appointment cell 022 - 3981 8181 / 6766 8181 This consists of the administration of certain to ), when the cervix prevents sperm from entering improve . Clomiphene citrate, , the uterus, or with donor sperm or when the male Donor Sperm tamoxifen, injections, antibiotics, steroids partner has very low to nil sperm production. Donor sperm are recommended when sperm is not etc. are administered as per the indications. produced from the semen, often due to genetic Intracytoplasmic Sperm Injection (ICSI) • Surgical treatment causes, chemotherapy, radiation therapy or The introduction of Intracytoplasmic Sperm Injection YEARS Obstructions in the sperm pathway, , vasectomy. Donor sperm are also an option for Quality Healthcare for All undescended testes etc. can be treated surgically. (ICSI) has revolutionized the management of male single women, couples with genetic disorders, and infertility. couples in which the woman is Rh-sensitized and the Modern microsurgical techniques are used for P. D. Hinduja National Hospital & Medical Research Centre man is Rh-positive. In most cases, anonymous Veer Savarkar Marg, Mahim, Mumbai - 400 016 (INDIA) Tel: 2445 1515 / 2445 2222 / 2444 9199 Fax: 2444 9151 HINDUJA HOSPITAL

[email protected] www.hindujahospital.com HINDUJA HOSPITAL Male Infertility Causes of Male Infertility • Sexual issues muscle strength and growth can cause the testicles • Semen analysis There are many reasons for male infertility which Often treatable, problems with sexual intercourse or to shrink and sperm production to decrease. Men This is the gold standard for diagnosis of male Introduction include: technique may affect . Difficulties with who smoke may have a lower sperm count than do infertility. Physical characteristics of semen, the those who don't smoke. Passive may affect A phenomenon mostly considered as a female cause can • Hormonal disorders erection of the penis (), number of sperm present, any abnormalities in the premature ejaculation, painful intercourse male fertility. Stress may interfere with certain shape and structure (morphology) and movement surprisingly emerge as the male factor. As women serve Infertility can result from disorders of the testicles (dyspareunia), or psychological or relationship hormones needed to produce sperm. (motility) of the sperm are evaluated. The lab will also as the bearer of the child throughout the period of themselves, or an abnormality affecting the pituitary problems can contribute to infertility. check your semen for signs of problems, such as , the male factor for infertility is easily sidelined. and glands in the brain that produce • Environmental issues or blood. Often sperm counts fluctuate Infertility can be defined as the inability of a couple to hormones that control the testicles (the • Retrograde ejaculation Exposure to toxins, heavy metals, excessive heat etc. from one specimen to the next, so your doctor may become pregnant (regardless of cause) after 1 and a hypothalamus or pituitary glands). This occurs when semen enters the bladder during Certain Prescription medicines • want to evaluate a few different samples. If your half year of unprotected sexual intercourse (using no Genetic & familial disorders ejaculation rather than emerging out through the • • Medical conditions sperm analysis is normal, your doctor will likely birth control methods). penis. Various conditions can cause retrograde Genetic disorders of the testes such as Klinefelter's recommend thorough testing of your female partner ejaculation, including diabetes, bladder, or Various medical conditions that can cause infertility Facts say that the female factor could be the reason for syndrome ( male is born with two X and one Y before conducting further male infertility tests. urethral surgery, certain neurological diseases and include Diabetes, disease, 40% of the couples experiencing infertility. 30 – 40% of chromosome instead of one X and one Y ), microdeletion the use of certain medications. Hypothalamus disorder, Multiple sclerosis , Depending on initial findings, your doctor may the cases are due to the male factor. 20 – 30% amount for of chromosomes amongst many others cause abnormal Cushing's syndrome , . recommend additional, more specialized tests that the cases having both male and female as the cause. development of the testicles. • Misplaced urinary opening () • Idiopathic (cause not known) can help identify the cause of your infertility. Hence, the male factor contributes to approximately • Injury A birth defect can cause the urinary (urethral) opening to be abnormally located on the underside of the • . 50% of the cases of infertility in all. An equal partnership D i r e c t : Te s t i c u l a r o r P e l v i c Tr a u m a Evaluation of Male Infertility penis. If not surgically corrected, this condition can Ultrasound, which uses high-frequency sound to the inability to conceive. Hence, for the fertility process Indirect: Heat, radiation, radiotherapy, Some infertile couples have more than one cause of their prevent sperm from reaching the woman's cervix. waves to produce images of structures within your to proceed smoothly, both husband and wife should be chemotherapy, environmental toxins, smoking, infertility. In some cases, the cause of your infertility may be body, can help your doctor look for evidence of a healthy and normal. drugs, marijuana, tobacco, , blockage in the • Infections unclear, or it may take a number of tests to determine the cause. or obstruction of the . The good news is that the rapid research advances in . Sexually transmitted diseases (STDs), such as For a man to be fertile, the testicles must produce • Hormone testing the area of male reproduction have brought about • Previous surgery chlamydia and gonorrhea, are most often enough healthy sperm, and the sperm must be associated with male infertility. These infections can Hormones produced by the pituitary and dramatic changes in the ability to both diagnose and Inguinal, scrotal, retroperitoneal, bladder neck, ejaculated effectively into the woman's vagina. treat male infertility. The need of the hour is an open mind cause scarring and block sperm passage. If hypothalamus glands and the testicles play a key vasectomy, . Tests for male infertility attempt to determine whether any to diagnose, identify and act. (viral usually affecting young role in sexual development and sperm production. Varicocele • children)occurs after puberty inflammation of the of these processes are impaired. They include: Your doctor may recommend a blood test to Infertility versus Impotence In this, veins of the get enlarged and testicles can impair sperm production. Inflammation • Medical history determine the level of and other male Infertility and impotence are different entities. Impotence tortuous, much like in the legs. of the prostate (), or epididymis This includes questions about illnesses, disabilities hormones that affect fertility. means an inability to attain or sustain erections for • Undescended testes also may alter . and surgeries that could affect fertility. Medications • Genetic tests satisfactory sexual intercourse. Infertility, on the other Physiologically, it is important for testes to have a • Abnormal/low sperm count and sexual habits are also evaluated. Sexual These tests are used if your doctor suspects your hand, means an inability to produce children. It is thus temperature that is a few degrees lower than body development as a boy and whether one has had any • Lifestyle issues fertility problems could be caused by an inherited possible for a totally impotent man to be potentially fertile core temperature in order for sperm production to signs of low testosterone such as decreased body or sex chromosome abnormality. When sperm Alcohol and drugs, , Emotional and can allow such couples to occur normally. This is why nature has placed the facial hair are also looked for. concentration is extremely low, genetic causes could stress, Alcohol or dependency can cause conceive, provided the partner is normal. Most infertile testes outside the body - the higher internal core General Physical Examination be involved. A blood test can reveal whether there reduced fertility. Anabolic steroids taken to stimulate • men are perfectly normal in terms of potency. body temperature is deleterious to sperm are subtle changes in the Y chromosome. production. This also explains why many men with undescended testes are infertile.