Modern approach to Male Sub-fertility

IUI Procedure

Male factor is a sole causative factor of infertility in about 30% of infertile couples, whereas in additional 20% of cases male as well as female causative factors are identified. Therefore, male factor is at least partly responsible for difficulties in conception in approximately 50% of these couples. Semen analysis is the most basic and important test to be performed to evaluate male subfertility and is a good marker of male subfertility.
Semen analysis is the quantitative mark of sperm function. Even with a normal semen analysis report, the quality of sperm and the ability of sperm to fertilize an egg is not known.80% of the male infertility is idiopathic i.e. no specific cause is identified .In these cases it has been found that the damage to the sperms due to oxidative stress is high.
Oxidative damage means the presence of excess of reactive oxygen species.(ROS).
ROS is a type of unstable molecule that contains oxygen & it easily reacts with other molecules in the cell and damages the DNA of the cells. ROS can be excessive in lifestyle disorders like smoking, alcohol ,obesity ,stress ,advanced age ,poor diet or environmental factors like heat ,pollution or chronic infections of the genito urinary tract or chronic diseases like diabetes ,chronic renal failure etc.

Treatment for male infertility can be medical, surgical and assisted reproduction.
Classical treatment of male infertility
1) Stop toxic factors- avoid sauna hot baths, toxic products like tobacco, smoking, alcohol consumption
2) Treatment of systemic diseases –diabetes
3) Treatment of prostatitis and antisperm Antibodies
4) Evaluation and treatment of sexual dysfunction
5) Medical treatment – The main aim is to improve the quality of sperms which helps us in achieving higher pregnancy rates. The semen analysis parameters like count and motility may or may not improve. Antioxidants containing Vitamin C, Vitamin E, CoQ, selenium, zinc, lycopene, arginine, glutathione etc. have emerged as a mainstay of treatment. They help reduce DNA damage to the sperms thus improving the quality of sperms.

II. Optimization of female fertility – The quality of eggs, ovulatory dysfunction, endometrial receptivity need to be evaluated and improved upon so that borderline male subfertility can be compensated.

III ART- procedures like IUI,IVF & ICSI.

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