Infertility is a medical condition that can cause psychological, physical, mental, spiritual, and medical detriments to the patient. The unique quality of this medical condition involves affecting both male and female. Infertility becomes emotional roller coaster for many women, and for Indian women, the hell is multiplied, for the fact that infertility is often blamed on them!
Infertility is not just a disease that affects women—men suffer as well. In fact, new studies show that in approximately 40 percent of infertility couples the male partner is either the sole cause or a contributing cause of infertility. In India, within one year of marriage, a couple is expected to have a baby. In-laws expectations to have grandchildren and peer pressure on seeing friend’s/cousin’s babies on social media create more hype and pressure on couples. The pressure of conceiving is greater on the woman. More often, when pregnancy doesn’t come through in 3-5 years of marriage, a woman is advised to visit a fertility clinic!
Couple infertility may be due to male factors, female factors or a combination of male and female factors therefore parallel evaluation of both partners is always required. A male in an infertile couple should have an initial Semen Analysis and male reproductive history evaluation. The reproductive history assessment provides important information about functional sexual, lifestyle and medical history including medications that can contribute to reduced fertility or sterility. The Semen Analysis is an important component in the initial clinical evaluation of the male and his reproductive health.
1. For initial infertility evaluation, both male and female partners should undergo concurrent assessment.
2. Initial evaluation of the male for fertility should include a reproductive history. Initial evaluation of the male should also include one or more semen analyses (SAs).
3. Men with one or more abnormal semen parameters or presumed male infertility should be evaluated by a male reproductive expert for complete history and physical examination as well as other directed tests when indicated.
4. In couples with failed ART cycles or recurrent pregnancy losses (RPL) (two or more losses), evaluation of the male should be considered.
How men can be infertile if they are ejaculating good enough! Truth – It’s not the ejaculation that decides the fertility, it’s the sperm count and healthy motility of sperms that decides male fertility.
For natural conception, men should have –
- Normal sperm count- at least 15 million per mL
- 1.5 mL of semen on ejaculation
- At least 4% sperm of normal
- At least 32% sperm swimming rapidly forward
Even laboratory sperm insemination treatment can be successful when the sperm motility is at least 30% and the total motile sperm count is above 5 million per mL. If men do not meet these sperm parameters, they are likely to be the one who are responsible for conception issues.
Many factors affect the sperm production. Smoking and drinking are biggest killers of sperm! Hedonistic lifestyle, no exercise, stress at work and poor diet often result in low sperm count. For women above 30, with poor lifestyle and diet- egg quality gets affected and fertility steeply declines after 35 years of age.
The evaluation and management of men in a couple with infertility involves a step-wise process of evaluation and consultation regarding treatment options. An increasing understanding of general health conditions associated with male infertility is valuable for counselling, as well as diagnosis of the underlying cause of the fertility. Evaluation should proceed in parallel for both male and female members of a couple to optimize treatment success. Let us not put the women in a difficult position or play the blame game! Male infertility is complex but can be treated with timely medical assistance and intervention. To know more information and book an appointment with your trusted doctor at Aaradhya Fertility at https://bit.ly/3nHO7Ou