DNA Fragmentation And Male Infertility
Introduction To Male Infertility
Male infertility refers to a man’s inability to cause pregnancy in a fertile female partner. It affects approximately 7% of all men and contributes to 30-40% of all infertility cases. Understanding the types, causes, and available treatments is crucial for effective management and resolution.
Types Of Male Infertility
- Azoospermia: Absence of sperm in the ejaculate.
- Obstructive Azoospermia: Caused by blockages in the reproductive tract.
- Non-Obstructive Azoospermia: Due to impaired sperm production.
- Oligospermia: Low sperm count.
- Mild Oligospermia: Slightly below normal sperm count.
- Moderate Oligospermia: Significantly low sperm count.
- Severe Oligospermia: Extremely low sperm count.
- Asthenozoospermia: Poor sperm motility (movement).
- Teratozoospermia: Abnormal sperm morphology (shape and structure).
- Oligoasthenoteratozoospermia (OAT): Combination of low sperm count, poor motility, and abnormal morphology.
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Causes Of Male Infertility
Hormonal Causes
- Hypogonadism: Low testosterone levels affecting sperm production.
- Primary Hypogonadism: Testicular failure.
- Secondary Hypogonadism: Pituitary or hypothalamic dysfunction.
- Hyperprolactinemia: Elevated prolactin levels interfering with testosterone production.
- Thyroid Disorders: Both hyperthyroidism and hypothyroidism can affect fertility.
Genetic Causes
- Klinefelter Syndrome: Extra X chromosome affecting testicular function.
- Y Chromosome Microdeletions: Genetic deletions on the Y chromosome affecting spermatogenesis.
- Cystic Fibrosis: CFTR gene mutations causing congenital absence of the vas deferens.
Structural Causes
- Varicocele: Enlarged veins in the scrotum impairing sperm production and quality.
- Obstructions: Blockages in the vas deferens or epididymis.
- Cryptorchidism: Undescended testicles leading to impaired sperm production.
Lifestyle And Environmental Causes
- Smoking: Reduces sperm count and motility.
- Alcohol and Drug Use: Negatively affects sperm production and function.
- Obesity: Hormonal imbalances affecting fertility.
- Heat Exposure: Frequent exposure to high temperatures affecting testicular function.
- Radiation and Toxins: Exposure to radiation and environmental toxins can impair fertility.
Medical Conditions And Infections
- Infections: Sexually transmitted infections (STIs), mumps orchitis, and other infections affecting the reproductive tract.
- Chronic Illnesses: Diabetes, cancer, and other chronic conditions affecting overall health and fertility.
Diagnosis Of Male Infertility
- Medical History and Physical Examination: Assessing overall health, lifestyle factors, and physical abnormalities.
- Semen Analysis: Evaluating sperm count, motility, and morphology.
- Hormonal Testing: Measuring levels of testosterone, FSH, LH, prolactin, and thyroid hormones.
- Genetic Testing: Identifying genetic abnormalities like Klinefelter syndrome or Y chromosome microdeletions.
- Imaging Tests: Ultrasound of the scrotum and abdomen to detect structural issues.
- Testicular Biopsy: Examining testicular tissue to diagnose sperm production issues.
Dr. Kembavi Srinivas
MBBS, MS (GENERAL SURGERY)
Senior Professor of Surgery,
Senior Consultant General Surgeon &
Senior Consultant in Andrology.
Sexology and Male Infertility
Dr. Abhinav Kembhavi
MBBS, MS (GENERAL SURGERY)
Andrologist, General Surgeon,
DIPLOMA IN ANDROLOGY,
Specialist in
Sexual Medicine,
Assistant Professor of Surgery
Treatment Of Male Infertility
Medical Treatments
- Hormonal Therapy: Treating hormonal imbalances with testosterone, gonadotropins, or medications to lower prolactin levels.
- Medications: Antibiotics for infections, and other medications to treat underlying medical conditions affecting fertility.
- Lifestyle Modifications: Quitting smoking, reducing alcohol and drug use, losing weight, and avoiding heat exposure.
Surgical Treatments
- Varicocelectomy: Surgical correction of varicocele to improve sperm production and quality.
- Vasovasostomy and Vasoepididymostomy: Reversal of vasectomy or correction of blockages in the vas deferens and epididymis.
- Testicular Sperm Extraction (TESE): Retrieving sperm directly from the testicles for use in assisted reproductive technologies (ART).
Assisted Reproductive Technologies (ART)
- Intrauterine Insemination (IUI): Placing washed and concentrated sperm directly into the uterus.
- In Vitro Fertilization (IVF): Combining eggs and sperm outside the body to form embryos, which are then implanted into the uterus.
- Intracytoplasmic Sperm Injection (ICSI): Injecting a single sperm directly into an egg during IVF, especially useful in severe male infertility cases.
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