Male Infertility

Male partners are the sole cause of infertility approximately in about 35% of infertile couples. 

Causes of Male Infertility:

  • Abnormal sperm production or function
  • Problems with the delivery of sperm due to sexual problems, such as erectile dysfunction, premature ejaculation, ejaculatory incompetence , retrograde ejaculation; or blockage of the part of the testicle that contains sperm (epididymis) or scarring from genital infections.
  • General health and lifestyle issues, such as poor nutrition, obesity, stress, or use of alcohol, tobacco and drugs.
  • Overexposure to certain environmental hazards and toxins, such as pesticides, lead, paint, radiation, radioactive substances, mercury, benzene, boron, and heavy metals.
  • Ageing Male. Men older than age 40 may be less fertile than younger men.

Diagnosis of Male Infertility

  • General physical examination
  • Semen analysis
  • Hormone testing
  • Doppler evaluation of the testis and Trans rectal Ultrasound.

Treatment of Male Infertility

Simple lifestyle changes.

General sexual problems. Addressing impotence or premature ejaculation can improve fertility. Treatment for these problems often is primarily with medication or behavioural approaches, though mechanical and surgical treatment are sometimes effective.

In low sperm counts:

Hormonal treatment is needed usually in 5% of men. Other treatments include surgical treatment of varicocele, ejaculatory duct incisions and sperm concentration methods through electro ejaculation.

In absent sperms:

The following treatment procedures are used in absent sperms:microsurgical bypass operations, micro epididymal sperm aspiration (MESA) and Bilateral testicular biopsies.

Therapeutic donor insemination (TDI) is a sound option for many causes of male infertility.

This treatment is carried out in cases of irreversible azoospermia, severe oligospermia, poor motility and abnormal morphology of sperm.Other cases include reproductive option after radiation or chemotherapy, severely Rh-sensitized and Rh-negative women with an Rh-positive partner.

Medical Management

Roshini Androcare Centre ensures that individual care and consistent progress is available for its patients. We facilitate treatments and medication to assure that appropriate medical care is provided from the very beginning till the end of the treatment.

Surgical management

Surgical sperm retrieval is indicated when there is no sperm in the ejaculate (azoospermia). This can result from an obstruction in the reproductive tract (obstructive azoospermia) or due to lack of sperm production (non obstructive azoospermia). Obstructive azoospermia may be due to failure of the sperm passages to develop blockage of the tubes transporting the sperm (due to infection or due to surgical blockage of the vas following the male sterilization). Surgical sperm retrieval techniques enable the urologist to recover sperm directly from the epididymis or even the testes of men with obstructive azoospermia so that the sperm can then be used to fertilize eggs by ICSI. The extra sperm and testicular tissue can be frozen for future attempts.

Sperm retrieval

  • Reproductive Surgery (micro Surgery)
  • Surgical sperm retrieval can be achieved by: PESA
  • Percutaneous Epididymal Sperm Aspiration (PESA)
  • Microsurgical Epididymal Sperm Aspiration (MESA)

Microsurgical epididymal sperm aspiration is performed as an open operation under the operating microscope. Individual tubules of the epididymis are isolated and micropuncture aspiration is taken. This approach has the advantages of reliable retrieval of large numbers of epididymal spermatozoa that can be readily frozen and thawed for subsequent attempts at fertility. Since MESA involves direct retrieval of spermatozoa from the epididymal tubule, it minimizes the contamination of the epididymal fluid by blood cells, which may affect spermatozoa fertilizing capacity during the IVF.

Testicular Sperm Aspiration (TESA)

Testicular fine-needle aspiration of the testis is done for the recovery of spermatozoa. Percutaneous puncture and aspiration of the testis can be performed using a 21-23-gauge needle connected to a 20cc syringe.

Testicular Sperm Extraction (TESE)

Under local or general anaesthesia, sperm retrieval is effected using an open testicular biopsy technique.