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Male infertility on the rise - Source: Times of India Dated: 15th Nov, 2013

Male infertility on the rise

ZEENIA F BARIA, TNN Nov 15, 2013, 12.00AM IST

Source: Times of India

Source URL: http://articles.timesofindia.indiatimes.com/2013-11-15/health/42573627_1_male-infertility-intracytoplasmic-sperm-injection-sperm-count

A recent health survey revealed some startling facts, a whopping 46% of Indians, between the ages of 31 and 40, require medical intervention to conceive as one or both partners suffer from fertility problems.

While polycystic ovarian disorder was the main reason in women, poor sperm count topped the list in men.

Gynaecologist and infertility specialist Dr Nandita Palshetkar says infertility is when a couple fails to conceive even after a year of unprotected intercourse. "Pregnancy is normally achieved within 12 months. Unfortunately, misconceptions about infertility are very common. One popular myth is that it is always the woman's problem. This could not be far from the truth. In fact, in nearly 30% of all infertility cases, the cause is attributed to a problem in the male. In an additional 30% of cases, the cause is attributed to both male and female factors," she says.

The basic test to determine male infertility is semen analysis. If there are any abnormalities, your doctor will ask you to repeat the test after some time.

Causes

"Male infertility is labelled only in cases of persistently abnormal semen analysis. There are many causes for it, including childhood infections, hormonal disorders, genetic factors and physical abnormalities. Men who smoke and drink alcohol have 13-17% lesser sperm count than teetotallers. And today, stress and lifestyle diseases have also added to infertility woes. Only after detailed examination and investigations can a diagnosis be made," adds Dr Palshetkar.

Consultant gynaecologist and infertility specialist Dr Rishma Pai says some other common causes of male infertility are sexually transmitted diseases like gonorrhoea or chlamydia, which may cause blockage of the tubes that carry sperms. "Mumps in childhood can cause testicular damage and failure, and the absence of sperms. A boy may also be born with congenital absence of vas deferens (the tube through which sperm passes from the testis to outside the body). Sometimes, the testes may not come down into the scrotum at birth (undescended testes). This can also cause damage to testes and failure of sperm production. Swelling of blood vessels around testes, surgery for hernia and hydrocoele can all lead to male infertility," she says.

Treatment options

IUI: Recent medical breakthroughs have helped even men with very few sperms to become fathers. "When the count is at least 10 million, Intrauterine Insemination (IUI) can be tried. Here, the semen is washed by special methods in a lab and a small quantity of sperms are placed, using a thin tube, inside the woman's womb. This is a simple, inexpensive procedure," says Dr Pai.

ICSI: If the count is very low, the procedure of choice is Intracytoplasmic Sperm Injection (ICSI), which is like a test-tube baby procedure. The woman's eggs are removed with a needle under sonography control and placed under a microscope. Each sperm is picked up with a needle and injected directly into the egg with a micromanipulator. The eggs then fertilise and divide and after two to three days, the embryo is placed in the womb," she adds.

PESA, TESA: In cases where there are no sperms in the semen, but the hormone test is normal, sperms can be removed directly from the testes using a tiny needle. These techniques, called PESA and TESA, need no cut or major surgery. The sperms thus obtained are injected into the egg using the ICSI procedure.

Donor sperms: "In some cases, there is complete testicular failure with abnormal hormones and no sperms. In such cases, the only option is to use donor sperms. These are taken from a semen bank, which stores samples after screening them for infections like HIV and Hepatitis. This semen is then injected into the woman. Through this simple and inexpensive technique, one can obtain a high rate of pregnancy," says Dr Pai.