Dealing With Male Infertility-The Case Of Quantity And Quality (part 2)

Having dealt with how sperms are produced, we shall now look at male infertility in toto. Approximately one in every five couples in the Ghana seeks infertility care. Surprisingly, only half of couples who are trying to become pregnant achieve pregnancy easily and about one in ten Ghanaian couples of reproductive age are involuntary infertile; male infertility accounts for half of these cases.

Despite the relative cause of infertility in marriages due to the male, infertility evaluations have traditionally focused on women, because women tend to seek gynecological care and because men often are reluctant to seek advice. A variety of disorders ranging from hormonal, physical, psychological problems can cause male infertility. Although many treatment options are now available, in many cases treatment may not work.

Infertility can be Primary (you are unable to support a pregnancy after a minimum of 1 year of having unprotected sex) or secondary (you have been able to get a female pregnant at least once, but are now unable). Depending on your situation, there is a way forward. The following factors puts one at risk of developing male infertility: Smoking, excessive alcohol intake, drug abuse, Overweight, Exposure to toxins, Overheating or trauma to the testicles, past or present infections, History of undescended testicles, Family history of fertility disorder, Certain medical conditions, including tumor and sickle cell disease, Certain medications.etc.

Most at times male infertility from sperm disorders can be overcome with a few healthy lifestyle changes such as; drinking less alcohol and less coffee, avoiding drugs that decreases testosterone levels, Wearing loose underwear and clothing, avoiding the frequent use of hot tubs or hot baths, getting tested for STD's and receiving the appropriate treatment, avoiding smoking, decreasing the stress in your life and maintaining a healthy diet. Making healthy choices can increase the fertility of sperm and help to increase low sperm counts. Moreover, fertility reflects a man’s overall health. Men who live a healthy lifestyle are more likely to produce healthy sperm. Some lifestyle choices that negatively impact male fertility includes Smoking; which significantly decreases both sperm count and sperm cell motility, Prolonged use of marijuana, Chronic alcohol abuse, Anabolic steroid usage which causes testicular shrinkage and infertility. Overly intense exercise as in the case of body builders: this produces high levels of adrenal steroid hormones which cause a testosterone deficiency resulting in infertility. In addition, inadequate vitamin C and Zinc in the diet, wearing of tight underwear; which increases scrotal temperature which results in decreased sperm production and excessive stress are all some possible cause of male infertility. Modifying these behaviors can improve a man’s fertility and should be considered when a couple is trying to achieve pregnancy.In many instances, male infertility is caused by testicular damage resulting in an inability of the testicle to produce sperm. Once damaged, the testicle will not usually regain its sperm-making capabilities; this aspect of male infertility is same as menopause (for women and cannot usually be treated. Despite medicine’s limited ability to treat male infertility, many successful treatment options are available for its many causes. Besides testicular damage, the main causes of male infertility are low sperm production (low quantity) and poor sperm quality.

Diseases such Mumps, tuberculosis, brucellosis, gonorrhea, typhoid, influenza, smallpox, and syphilis can cause testicular atrophy and thereby lead to male infertility. A low sperm count and low sperm motility are indicators of this condition. Also, elevated FSH (Follicle stimulating hormone) levels and other hormonal problems are indicative of testicular damage. It’s also common knowledge that most men with fertility problems have had a history of STDs like gonorrhea and chlamydia which causes infertility by blocking the epididymis or tubes. These conditions are usually treated by hormonal replacement therapy and surgery in the case of tubular blockage.

Furthermore; Retrograde Ejaculation; a condition in which semen is ejaculated into the bladder rather than out through the urethra because the bladder sphincter does not close during ejaculation is another culprit in male infertility. It is very common in most men with a history of Masturbation. If this disorder is present, ejaculate volume is small and urine may be cloudy after ejaculation. This condition affects 1.5 percent of infertile men and may be controlled by medications like decongestants which contract the bladder sphincter or surgical reconstruction of the bladder neck can restore normal ejaculation.Several sexual problems exist that can affect male fertility. These problems are most often both psychological and physical in nature making it difficult to separate the physiological and physical components. For instance; Erectile Dysfunction (ED), Also known as impotence, affects most Ghanaian men. ED is as a result of a combination of multiple factors. In the past, ED was thought to be the result of psychological problems, but now research indicates that 90 percent of cases are organic in nature. Many of the common causes of impotence include: diabetes, high blood pressure, heart and vascular disease, stress, hormone problems, pelvic surgery, trauma, venous leak, and the side effects of frequently prescribed medications. Luckily, many treatment options exist for ED depending on the cause. In most cases EDs coexist with Premature Ejaculation; which is the inability of the man to control the ejaculatory response for at least thirty seconds following penetration. Premature ejaculation becomes a fertility problem when ejaculation occurs before a man is able to fully insert his penis into his partner’s vagina. Premature ejaculation can be by using a behavioral modification technique called the “squeeze technique” which desensitizes the penis.

Some men especially those with a history of Masturbation suffer a rare condition called Ejaculatory Incompetence: This condition prevents men from ejaculating during sexual intercourse even though they can ejaculate normally through masturbation. Such cases may responds well to the intervention of a behavioral therapist.

In part 3 of these series we shall look at how male infertility is assessed, evaluated and diagnosed.