Tag: Male Infertility

WHAT  are the causes of  male infertility?

Experts in Assisted Reproductive Technology (ART) have attributed the problem to bad sperm, abnormal sperm, and weak sperm.

Infertility is a condition of the reproductive system that prevents  conception.

Though there are no figures, the experts believe the number of men with low sperm count is on the increase. Besides, they say, most male infertility cases are due to either low sperm count or poor sperm quality or both.

According to Dr Abayomi Ajayi of Nordica Fertility, men are finding it difficult to make babies because they suffer from declining testosterone levels.

He explained that high doses of estrogen given for treatment of prostatic cancer or modulation of reproductive function, for instance, not only reduce testosterone secretion, but also interact with the liver, changing the secretion of various plasma proteins and causing side effects.

Environmental and lifestyle factors are more responsible for the downward trend of sperm counts globally.There are many things in the environment causing what is described as oestrogenisation of men. Things, such as paint, heavy metal poisoning (like lead, mercury, antimony), and exposure to petroland even insecticides can affect sperm health. People working in the fuel stations and those with unhealthy habits like smoking could suffer from low sperm counts.

According to him, sperm motility is the sperm’s ability to move. If movement is slow, not in a straight line, or both, the sperm will not be able to fertilise an egg because it would not be able to invade the cervical mucous or penetrate the hard outer shell of the egg.

To impregnate a woman, a man must have sperm count of at least 15 million and have sperm motility (movement) of more than 60 percent.

Below 30 percent sperm motility is undesirable. Also, a man is most likely to be fertile when more than 12 percent of the sperm has a normal shape and structure. He also likely to be fertile when fewer than nine percent of the sperm has normal appearance.

The morphology or the shape and structure of the sperm, is sometimes considered more important than the sperm count or sperm motility in determining potential fertility. An abnormally shaped sperm cannot fertilise an egg. At least, 60 percent of the sperm should be normal in size and shape for adequate fertility. The perfect structure of healthy sperm is an oval head and long tail.

Abnormally shaped sperm may include some variations ranging from a very large round head, an extremely small pinpoint head, a tapered head, a crooked head, two heads and a tail with kinks and curls. Essentially, quality of sperm is determined by its motility and its morphology. The quality of the sperm is often more significant than the count of the sperm.

A co-pioneer of IVF treatment in Nigeria, and a professor of reproductive endocrinology, Prof Oladapo Ashiru said up to one-fifth of men find themselves with a low sperm count, which is defined as having fewer than 15 million sperm per millilitre of semen.

Ashiru, who is the Managing Director/CEO of Medical Art Centre, Maryland, Lagos, said infertility is the inability of a couple to have their biological baby after two years of living together. But in some couples, they are advised to come before two years, especially those that are of age.

‘’A woman who got married at 35 and above is advised to come at least for six months ovulation monitoring, and assessment, with the husband who finds it difficult to have a baby. In our society, infertility puts a lot of pressure on people because of the way paternity is viewed.

“Mothers pressure, the families’ pressure, wanting the wife to have a baby immediately after wedding, because as a woman, you are supposed to be pregnant. But these people don’t know that there are some male factors that can cause infertility. Everybody is focused on the woman and the society sees that pressure on the woman as the cause of the infertility.

“In our society, we have noticed that men have issues with low sperm count, which is having fewer than 15 million sperm per millilitre of semen. We do sperm analysis for men, test the women, do the men pelvic test, access both of them. Low sperm fewer than 15 million sperm per millilitre of semen, might not be able to get a woman pregnant. In women, we look at the ovulation factors. Some women do not ovulate and also have tube issues. Tube issue is the fallopian tube, which transports the egg from the ovary that is not open. There are things that can cause a tube to be closed.

“Today, we have Pelvic Allison infection, sexually transmitted infections, such as gonorrhea, and clamedia and once they get there, they cause obstructions so the egg and sperm will not meet for the women to conceive. The diagnosis of male infertility is not the end of the road for the couple. We encourage both partners to seek treatment together,”  Ashiru added.

Lagos State Commissioner for Health, Dr Jide Idris said: “Male infertility as a factor in infertility can be tackled through advocacy, enlightenment, and sensitisation. A lot of myths are based on perception, which most times may be wrong. I will educate at this time that any couple having issues with infertility should walk into government hospitals where there are qualified specialists to examine them, and stop relying on rumours, assumptions that the women are responsible totally for the condition.

“The specialists in infertility treatment based their findings on scientific facts. And emerging facts are revealing the underlying causes for infertility are traceable to the men themselves. Education and counselling are essential to tackle these. So, I encourage men to do go to the hospital with their wives to be jointly screened, and treated,” Idris said.

 

Last week, we dealt with the causes of male infertility. In this week, let’s take a look at the solutions to the complex issues of male sterility.

Once again, I want to emphasise that men are responsible for about 35 per cent of infertility in a couple and in 35 per cent of the cases, the couple share the burden.

Women have, for long, in different cultures and Africa in particular, been blamed for failures to conceive. This is not true as women are only responsible for a third of infertility difficulties.

Now that we have discussed and outlined the various events that often give rise to sterility in men, you might ask, what can we do about it?

The first step is to help yourself – Do it yourself (DIY). There are several things that the sufferer can do to relieve the challenges of men sterility. They are: Stop smoking. Stop unreasonable alcohol consumption. Don’t “cook” your testes via the tight pants that you wear. Avoid frequent long distance journeys that provide heated environment on driving seat for “cooking” the testes.

Heat is bad for sperm production. Cool down. Also, fever is bad for your fertility.

Lose weight and try to be within the normal range of Body-Mass-Index ratio. Obesity works in both men and women against fertility. By all means possible, avoid trauma and injuries to your testes.

All infections, without exception, are threats to your health and life. Mumps and tuberculosis can severely damage your health and fertility.

You can get vaccinated as soon as possible against these deadly diseases. Use the same opportunity to vaccinate your family. If you are taking medications that may impair your health and fertility, have a discussion with your doctor as a matter of top priority.

In our environment, many of our folks often use traditional herbs or other preparations. While I do not disprove their usage or doubt their efficacy as they have been in use for generations, clinicians like myself cannot scientifically prove their dosage, expiry date, side effects and what to use as an antedote in case of accidental use. We often do not know their impact on other organs such as on the delicate process of sperm production.

In disease states that affect the testes, it’s crucial that a doctor that specialises in the field be allowed to intervene to correct the clinical error. I will urge the readers to exercise caution in their dealing with infertility issues. When in doubt about certain treatment, I will advise that patients should seek a second opinion of a qualified expert in the field so as to avoid clinical injuries and mistakes.

What can one do about diseases that impair transport and ejaculation? The starting point is to see a doctor that specialises in reproductive medicine for assessment. Alternatively, keep an appointment with an urologist who will provide detailed assessment and offer necessary investigations as well as treatment.

In many ways, the ultimate decision may be with the doctor who will follow what the infertile couple wants.

Technology has advanced to the point in which sperms can be taken from the testes and to be used for in-vitro fertilisation (IVF). Where cost is a major reason for avoiding IVF, a lesser but effective means, such as intra-uterine insemination (IUI) can be used. IUI is useful if there are no physical barriers to fertilisation in the woman. The man’s sperm can be collected, processed in the laboratory before transporting the sperms into the woman.

In some situations where sperm quality is very poor, a sperm can be processed and injected into an egg during an IVF procedure. This is called intra-cytoplasmic sperm injection (ICSI). This process often yields a higher rate of pregnancies in couples who could otherwise find it difficult to conceive.

I have been asked if there are foods and nutrients available that can boost sperm quality. The  long and short answer is “no” and “yes”. “No” in the sense that, the cause of the poor sperm quality must first be determined. Food and nutrients are of no use if there is a blockade to sperm transport, for example.

Besides, the reasonable approach is to eat balanced diet and supplement the food with multivitamins, especially folic acid, that contain zinc, an anti-oxidant. And that is the reason for the “yes”. If the explanations and terms that had been used here are a challenge to the reader, we are organising a free seminar to address this intricate and widespread problem.

In summary, once again, men are often partly responsible for infertility that afflicts their family. At the same time, there are preventable actions that could be applied as outlined.

Where such actions are not suitable, specialist doctors should be consulted.

Infertility is a condition in which a man and woman try to have children but the woman does not become pregnant. Primarily, infertility affects 15% to 20% of couples who wish to conceive. Approximately one-third of cases result from male factors, one-third from female factors, and one-third from combined factors. It is therefore crucial to evaluate both partners before deciding on any form of natural or artificial intervention.

Such evaluation is warranted if there is no pregnancy after 6 months of regular, unprotected intercourse. Hormonal profiles and detailed semen analysis are the cornerstones of laboratory investigations after the history and physical examination.

Investigations for causes in the male are safer and simpler; consequently, they are normally performed first to save cost and to save the woman a series of tests, if a cause can be found in the male. Unfortunately, most men do not submit themselves to fertility tests. Rather, they ascribe the shortcomings to their wife’s conditions only.

Men are sometimes unable to make their women pregnant because they have fewer sperm than is normal. This condition, scientifically called Oligospermia, is the presence of less than 20 million sperms per milliliter in the ejaculate; while Azoospermia is the total absence of sperm cells.

Causes of male infertility include testicular abnormalities, chronic infections such as Gonorrhoea, Chlamydia, Herpes, Staphylococcus, Trichomoniasis, Candidiasis, etc., as well as environmental factors (such as irradiation), nutritional imbalance, drugs, sexual habits, etc.

In trying to solve the problem of male infertility, it should be understood that spermatogenesis, that is, the process from sperm formation to maturation takes approximately 74 days. It is therefore necessary to go back to nature and observe events while exercising patience over a period of about three (3) months, before drawing conclusion on viability or efficacy of bio-medical intervention.

Thus, a repeat sperm analysis is only meaningful after three (3) months of intervention. It is also important to note that hormones and other medicines commonly given to men who cannot have babies almost never do any good; magic cures are not likely to help either.

Unfortunately, most men with problem of infertility would want it solved overnight; thereby patronizing phony, unscientific and self-acclaimed instant healers! Be careful not to waste your money on things that will not help.

Education, with respect to the proper timing for intercourse in relation to the female’s ovulatory cycle as well as the avoidance of spermicidal lubricants is very important. In cases of toxic exposure or medication-related factors, the offending agent should be removed. Patients with active genitourinary tract infections should be treated appropriately.

Oligospermic and Azoospermic patients will benefit immensely from the holistic natural remedies scientifically formulated from herbal extracts of local plants such as Bombax buonopozense, Triumfetta cordifolia, Momordica charantia and Musa paradisiaca.

For further information and consultation on Holistic Lifecare research and services, especially on Blood Infections, Infertility, Sexually Transmitted Diseases, Chronic Debilitating Conditions as well as mental and social problems, please call  on: 0803-330-3897 or visit: Mosebolatan Holistic Lifecare Centre, Adeyalo Layout, Ogbere-Tioya, Off Olorunsogo Express Bridge, Ibadan. Website: www.holisticlifecare.com. Distance is no barrier, we can send remedies by courier if need be. We also have facilities for accommodation, admission and hospitalization in a serene and homely environment.