Male infertility is one of the important health problems increasingly encountered in clinics in recent years. Along with industrialization and technological development in the past century, changes have occurred in human biology as well as in social life. This change has had a negative effect on reproductive functions.
On the other hand, great success has been achieved in pregnancy and live birth rates with brand new techniques developed both in natural conception and in assisted reproductive techniques such as insemination and IVF.
In this article, we have compiled all the medical information about male infertility in an easy and understandable language, guided by your frequently asked questions. If you send us your questions, we can enrich the article by adding them.
What is Male Infertility?
The condition where sexually active couples fail to achieve pregnancy within 1 year despite having unprotected intercourse is called infertility.
How is Male Infertility Diagnosed?
In patients presenting with male infertility, the following tests are usually needed after a detailed history and physical examination in order to make a diagnosis and initiate treatment.
- Sperm test
- Blood tests (especially hormones)
- Microbiological tests (if needed; especially in cases with inflammatory progression)
- Ultrasonography (scrotal, transrectal, or Doppler; decided based on the patient)
- Testicular biopsy (searching for sperm in the testis; for both diagnostic and treatment purposes when the patient’s partner is ready for IVF treatment)
How Common is Male Infertility?
The rate of inability to achieve pregnancy despite unprotected intercourse within one year is approximately 15% in the population.
What is the natural pregnancy rate after one year?
- In the second year, this chance is 50%
- In the third year, it is 14%.
Causes of Male Infertility
- Congenital or acquired urogenital anomalies
- Cancers
- Urinary tract infections
- Sexually transmitted diseases
- Increased testicular temperature (varicocele)
- Endocrine disorders
- Genetic disorders
- All of these immunological factors contribute to male infertility.
Can the Cause of Male Infertility Be Fully Understood?
Despite all investigations, analyses, tests, and imaging studies, no cause can be identified in approximately 30-40% of patients.
This group of patients is called the idiopathic infertility group. In other words, no cause can be identified in approximately one out of every three men who present to the clinic to have children, based on current medical data.
Male Infertility Factors
- Partner’s (female) age
- Partner’s (female) fertility potential
- Duration of inability to have children
- Having no children at all, or secondary/tertiary infertility
- Spermiogram results
Why is Female Age Important in Having Children?
Studies have shown that;
Compared to age 25, a woman’s fertility potential:
- At age 35, 50%
- At age 38, 25%
- After age 40, it gradually decreases to less than 5%.
Important Questions in Male Infertility
- Your age, your partner’s age, has your partner been evaluated by a gynecologist before?
- Did the gynecologist state that your partner is normal?
- If any disease was detected in your partner, what is the name of the disease and the treatment started?
- How many years have you been married?
- How long have you been having unprotected intercourse?
- If you used protection, what method did you use?
- Has pregnancy or miscarriage occurred?
- If you are unable to have children after your first child, how many years have passed?
- Has there been any trauma to the testicles requiring hospital admission (impact, blow, kick, ball strike, etc.)?
- If there was trauma, what treatment was applied?
- Are both testicles in their normal position below and palpable at normal size?
- Have you had any surgery related to that area, such as undescended testicle, hernia, etc.?
- Did you have mumps as a child? If so, was there testicular involvement during that time?
- Are there any close relatives in your family who, like you, have been unable to have children?
- What is your occupation?
- What are your habits? (Tea, coffee, smoking, alcohol, recreational substances, etc.)
- Do you have any chronic diseases up to this age?
- Are you on any regular medications?
- Have you ever received specialized treatments such as chemotherapy or radiotherapy for any reason?
- Have you previously had any sperm test, blood test, or ultrasonography? If so, do you have your results with you?
- Do you have any sexual problems? Do erection and ejaculation occur normally?
Which Genetic Tests Are Performed for Male Infertility?
- Chromosome analysis
- Y chromosome microdeletion
- AZFc
- AZFa
- AZFb
These genes can occur alone or in combination with each other. Gene deletions may be incomplete or complete.
How is Male Infertility Treated?
Five fundamental factors are at the forefront in male infertility treatment:
- Recommendations and lifestyle changes
Recommendations such as changing eating and drinking habits, adding fertility-enhancing foods and antioxidant nutrients to the diet, and avoiding harmful habits such as smoking and alcohol
- Medication treatment for infertility
Treatment of the condition with empirical medications and hormonal medications
- Surgical treatments using surgical methods for infertility
Primarily varicocele surgery and mikroTESE along with other applied surgical methods
- Assisted reproductive techniques
Insemination and IVF applications
- Sperm freezing and storage
In some cases, freezing and storing sperm and thawing and reusing them when needed
Recommendations for Male Infertility Treatment
- Weight loss, combating obesity
- Quitting smoking
- Quitting alcohol use
- Staying away from drugs or recreational substances
- Avoiding excessive exercise
- Not using steroid-derivative medications
- Avoiding random medication use
- Avoiding heat exposure to the testicles (sauna, hot water baths, thermal pools)
- Regular and balanced nutrition
- Establishing regular sleep habits
- Acquiring basic anatomical and physiological knowledge about reproductive and sexual health
How Long Does It Take for Medications Used in Male Infertility Treatment to Take Effect?
In normal men, the sperm ejaculated during ejaculation were first produced approximately 72-74 days prior. Therefore, while male infertility medications can immediately affect sperm that have already entered the production line, approximately two and a half to three months is required for newly forming sperm.
AZFc Gene Deletion in Male Infertility Treatment
AZFc deletion is a deletion seen on the Y chromosome and is a genetic disorder. Patients with this deletion constitute a higher-risk group in terms of having children compared to patients without genetic disorders.
ROSI technique in male infertility treatment
In male infertility, ROSI technique treatment has recently started being applied. Burada that have fertilization potential but lack a neck and tail, round immature precursor sperm cells are used for treatment.
Things to Consider for Male Infertility Treatment
- Weight loss, combating obesity
- Quitting smoking
- Quitting alcohol use
- Staying away from drugs or recreational substances
- Avoiding excessive exercise
- Not using steroid-derivative medications
- Avoiding random medication use
- Avoiding heat exposure to the testicles (sauna, hot water baths, thermal pools)
- Regular and balanced nutrition
- Establishing regular sleep habits
- Acquiring basic anatomical and physiological knowledge about reproductive and sexual health
Male Infertility Treatment Prices
You can learn the male infertility treatment prices directly from the healthcare institution where you are examined. For the treatment fees we apply, please call 0533 725 62 80 at our private clinic located in Kale Ofis Plaza in the Cukurambar district of Ankara.
Does Severe Male Infertility Prevent Having Children?
Advanced male infertility refers to a sperm count below 5 million per ml. The absence of any sperm is called azospermi denilmektedir. Her iki durum da poses an obstacle to having children naturally, it is not impossible. Both with medications and IVF treatmentsi ile this obstacle can be overcome.
What Are the Effects of Smoking on Infertility?
Smoking has negative effects on male infertility. Numerous studies have shown that sperm count, motility, and morphology are negatively affected by smoking.
Can Female Eggs Be Frozen During Male Infertility Treatment?
Age is one of the important issues for women who cannot conceive due to male infertility. Especially since treating men with azoospermia requires time, during this period, if there is concern about egg loss or if medication use for reasons such as cancer becomes necessary, requests for egg freezing come from women.
The gynecologist working at the IVF center is the one who makes this decision. In most cases, the couple’s situation is evaluated by both the urologist hem de gynecologist together, and a joint decision is made. The topic of egg freezing is entirely under the authority of the gynecologist.
Which Hormones Are Investigated for Male Infertility Diagnosis?
While varying according to need and the patient’s specific characteristics, the commonly requested hormones are listed below:
- FSH
- LH
- Es****d
- Total te*****n
- TSH
- Prolaktin
Does Male Infertility Occur Together with Varicocele?
Male infertility is accompanied by varikosel which is the enlargement of veins carrying deoxygenated blood in the testicles. With varicocele treatment, improvement in sperm parameters and pregnancy and an increase in live births occurs.
Does the Cost of Varicocele Surgery Differ When the Microsurgical Method is Applied in Terms of Infertility?
Today, when varicocele surgery is mentioned, the microsurgical method is applied as standard, so no additional fee is charged. The surgical method is not chosen based on patient request. The microsurgical method is applied as standard to all patients.
What is the Relationship Between Male Infertility and Sexual Function?
There are various studies in the literature examining male infertility and sexual functions. Sometimes due to hormonal deficiencies (testosterone hormone deficiency) and sometimes as a result of psychological factors (anxiety, depression, loss of self-confidence), adverse effects on sexual functions may be observed.
The partners of infertile men are also affected by this situation, and sexual dysfunction can be observed in them as well. For detailed information, sexual health center page.
What is Idiopathic Male Infertility (Male Infertility of Unknown Cause)?
Despite all examinations, analyses, tests, and imaging studies, the cause of infertility cannot be determined in a group of patients. This is called idiopathic male infertility. It means male infertility whose cause cannot be medically determined.
Surgeries Applied for Male Infertility
Various surgeries are performed for male infertility. Each of these surgeries has separate indications.
- Varicocele surgeries
- mikroTESE
- TESA
- PESA
- TESE
- MESA
- TURED
- Vazovazostomiler
- Epididymovasostomy are some of these surgeries.
Is MicroTESE Performed for Male Infertility?
MicroTESE surgery is performed especially in patients with azoospermia for the purpose of sperm retrieval. If sperm is found, it is transferred to the female egg in the same session. In some cases, the sperm found is frozen and stored for later use.
The Best IVF Center for Male Infertility
Many center names can be given as the best IVF center for male infertility. Successful work has been performed in many centers in our country for many years. These studies have made a considerable number of contributions to the medical literature.
Therefore, our country has become a popular center among all countries in the world in terms of health tourism for IVF.
International standards are maintained in IVF centers, which are under very strict supervision by our Ministry of Health, and high-quality service is provided in terms of treatment services in nearly all of these centers.
Can Infertility Treatment and IVF Treatment Be Conducted Together?
While it varies depending on the condition of the factor causing infertility, male infertility treatment can be conducted together with IVF treatment.
Is Consultation with a Geneticist Necessary for a Genetic Approach to Male Infertility?
Genetic tests are requested during the stages of determining male infertility. Some abnormalities are observed in some of these tests. When genetic disorders are detected, it is essential to seek help from a genetics specialist.
The Effect of Regular Exercise on Infertility Treatment
Weight gain, obesity, and sedentary lifestyle are accepted as important risk factors in male infertility. Testosterone hormone deficiency is also an important problem in these patients. Therefore, regular physical exercise, weight loss, and body mass index control are recommended during infertility treatment.
How is the Male Infertility Examination Performed?
A manual hands-on examination is essential. Usually, the patient stands and is asked to strain at intervals to increase intra-abdominal pressure, allowing vascular abnormalities to be detected.
Things to Watch Out for in Male Infertility
- Be prepared for lifestyle changes.
- Eat a balanced, regular diet with antioxidant-rich foods.
- Pay attention to getting regular sleep.
- Stay away from harmful habits such as smoking and alcohol.
- Stay away from environments containing chemical toxins.
- Be cautious about exposure to WiFi, cell phones, and electromagnetic waves…
- Do not use any medication without consulting your doctor.
- Do not neglect going to regular check-ups.
Conclusion
- Male infertility is observed with increasing frequency in society.
- Since problems are seen in 1/3 of men, 1/3 of women, and 1/3 in both, we can roughly say that 50% are male-originated and 50% are female-originated.
- On examination, undescended testicle, varicocele, and size difference between testicles are significant.
- Blood tests, hormones, and ultrasonography are important diagnostic tools.
- Male infertility may be of genetic origin. Genetic counseling may be required.
- Lifestyle changes, medication treatments, surgical treatments, and assisted reproductive techniques are used in treatment.
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