31.35 : Infertility in Males

Male infertility affects millions of couples worldwide, arising from various factors that impact different stages of the reproductive process. An endocrine imbalance resulting from conditions like hypogonadism, Klinefelter syndrome, or pituitary disorders can disrupt hormone levels and reduce sperm production. Testicular defects, such as tumors, cryptorchidism, atrophic testes, abnormal sperm morphology, and low sperm count or motility, may arise due to genetic factors, structural abnormalities, or infections, though the specific cause depends on the condition. Conditions like epididymitis, obstruction of the vas deferens or ejaculatory duct, and retrograde ejaculation can impede sperm transport.

In some cases, male infertility may persist despite normal sperm count, morphology, and motility. These instances, where no specific cause can be identified even after thorough evaluation, are referred to as idiopathic male infertility, though infertility may involve contributions from both partners. Certain causes, such as varicocele, can be addressed with surgical procedures like varicocelectomy, while medications, including gonadotropins or selective estrogen receptor modulators (SERMs), may stimulate spermatogenesis.

Furthermore, lifestyle modifications play a crucial role in improving fertility. Adopting a nutritious diet, managing weight, engaging in regular exercise, and refraining from smoking and excessive alcohol consumption can significantly enhance fertility. In severe cases of male factor infertility, assisted reproductive techniques such as intrauterine insemination (IUI) or intracytoplasmic sperm injection (ICSI) may provide viable options for achieving pregnancy.