Male Infertility Treatment at Shree IVF Clinic, Mumbai

Male infertility refers to a male’s inability to cause pregnancy in a fertile female, primarily due to issues with his sperm production or delivery.

This condition can stem from a variety of causes, including low sperm count (oligospermia), poor sperm motility (asthenozoospermia), abnormal sperm morphology (teratozoospermia), and issues with sperm delivery due to blockages, erectile dysfunction, or premature ejaculation. In the majority of situations, it can be a combination of multiple such factors that may actually play a role in contributing to male fertility issues.

Recognising the signs of male infertility can be challenging, as oftentimes, there are no noticeable symptoms. However, some common indicators might include:

• Difficulty with ejaculation or changes in the volume of ejaculate
• Reduced sexual desire or difficulty maintaining an erection (erectile dysfunction)
• Pain, swelling or a lump in the testicle area
• Decreased facial or body hair or other signs of a chromosome or hormone abnormality
• Frequent respiratory infections, as the immune system in men with fertility problems might be weakened.

It is essential to consult a doctor if you have been trying to conceive for over a year without success or have any of these symptoms. A comprehensive evaluation can help diagnose and treat male infertility effectively.

The biggest challenge in the domain of male infertility is not the treatment of the disease. It is actually the acceptance of the disease. In a country like India, due to a high amount of male ego, it is extremely difficult for them to go ahead and accept the fact that they are otherwise infertile despite having other parameters of the body that are physically absolutely normal.

Due to the societal pressure, a lot of other issues may also pop up, which may prevent or inhibit them from taking the actual treatment, which is warranted by them.

Early diagnosis and intervention in cases of male infertility are crucial for increasing the chances of successful conception, either naturally or through assisted reproductive technologies (ART) such as In Vitro Fertilisation (IVF).

Timely evaluation can identify reversible causes that can be treated medically or surgically, significantly improving outcomes. Additionally, understanding the underlying cause of infertility can provide valuable information for a couple’s future family planning decisions.

Male infertility can stem from several factors, each affecting the reproductive process in unique ways. Understanding these causes is essential for diagnosis and treatment.

Varicocele

Varicocele refers to the enlargement of veins within the scrotum, akin to varicose veins seen in the legs. This condition can lead to decreased sperm quality and quantity by affecting testicular temperature regulation. Treatment often involves surgery to seal off the affected veins, thereby potentially improving fertility.

Hormonal Imbalances

Hormones regulated by the hypothalamus, pituitary, and testicles play a crucial role in sperm production. An imbalance in these hormones can significantly impact sperm creation, leading to infertility. Treatment options might include medications to correct these imbalances or hormone replacement therapies.

Testicular Conditions

Conditions such as undescended testicles, testicular cancer, or surgery on the testicles can impair sperm production. Even after surgical correction or cancer treatment, fertility might not return to normal, necessitating assisted reproductive technologies (ART) for conception.

Ejaculation Issues

Problems such as retrograde ejaculation, where semen enters the bladder instead of exiting through the penis during orgasm, can cause infertility. Erectile dysfunction and premature ejaculation also fall into this category. Medications and therapies aimed at treating these conditions can sometimes restore fertility.

Antibodies That Attack Sperm

Autoimmune conditions might lead some men to produce antibodies that mistakenly identify sperm as a potential threat and attack them. This can significantly impair sperm movement and function, making it difficult for them to reach and fertilize an egg.

Blockages

Any obstruction in the tubes that transport sperm can prevent its delivery. These blockages can be congenital or result from infections, surgeries, or traumatic injuries. Surgery to remove the blockage is often required to restore fertility.

Lifestyle and Environmental Factors

Factors such as obesity, smoking, excessive alcohol use, exposure to toxins, and stress can negatively affect sperm production and quality. Lifestyle changes to address these factors can improve fertility in some cases.

Each of these causes presents its own set of challenges in diagnosing and treating male infertility. A thorough examination by a male infertility specialist is crucial for identifying the specific cause and determining the most appropriate treatment plan.

At Shree IVF, the first step in addressing male infertility involves a thorough and comprehensive evaluation. This initial phase is crucial for understanding the underlying causes of fertility issues. It typically includes:

• Semen Analysis: This test evaluates several key factors of a man’s semen and the sperm contained within, such as count, motility (movement), and morphology (shape).

• Hormone Testing: Hormonal imbalances can significantly impact sperm production and health. Testing levels of testosterone and other hormones can provide insights into potential issues.

A lot of importance is to be given to the hormonal and endocrinology evaluation of the male partner because correct evaluation is important in a situation where there could be a system like unexplained infertility or GED. Semen parameters are extremely beneficial in planning any form of injectable hormonal therapy for any of the male partners.

• Physical Examinations: A detailed physical examination helps in identifying varicoceles (abnormal enlargement of veins within the scrotum) and other possible physical causes of infertility.

Our goal at Shree IVF & Endometriosis Clinic is to offer a comprehensive range of treatment options tailored to address the specific causes of infertility identified during the evaluation process. These options include

• Medication Therapy: Depending on the underlying cause of infertility, different medications may be prescribed to improve hormone levels, enhance sperm production, or address other specific issues.

• Surgical Procedures: For conditions like varicoceles, obstructive azoospermia, or other anatomical abnormalities, surgical interventions may be necessary. These procedures aim to correct anatomical issues or retrieve sperm directly from the testicles or epididymis.

• Sperm Retrieval Techniques: In cases where ejaculation is not possible or if no sperm are present in the ejaculate, various techniques such as Testicular Sperm Extraction (TESE) or Percutaneous Epididymal Sperm Aspiration (PESA) are available. These methods involve the direct extraction of sperm for use in assisted reproductive technologies (ART), like IVF or ICSI.

• Lifestyle Modifications: Recommendations may include dietary changes, adopting a healthy exercise routine, avoiding harmful substances, and reducing stress levels to improve overall sperm health and fertility.

• Varicocele Treatment: If varicoceles are identified as a contributing factor to infertility, treatment typically involves surgical correction to improve blood flow and reduce the impact on sperm production and quality.

At our clinic, we prioritize creating individualized treatment plans that are meticulously tailored to each patient’s unique diagnosis and circumstances. Recognizing that each case of infertility is distinct, with its own set of challenges and requirements, our approach is to collaborate closely with our patients.

This personalized strategy ensures that the treatment path chosen not only addresses the specific medical issues at hand but also aligns with the patient’s lifestyle, preferences, and emotional well-being.

Our team is committed to providing support and guidance through every step of the treatment process, ensuring that our patients feel informed, involved, and empowered in their journey towards parenthood.

Shree IVF Clinic prides itself on its transparent and high success rates in treating male infertility. With a comprehensive range of diagnostic tools and treatment options, our clinic has achieved remarkable outcomes.

• Overall Success Rate: Our clinic boasts an impressive overall success rate of 85% in achieving pregnancy through assisted reproductive technologies for couples dealing with male infertility.

• TESE Success Rate: For men undergoing Testicular Sperm Extraction (TESE), we have observed a sperm retrieval success rate of 72%, which is significantly higher than the national average.

• Varicocele Surgery Outcome: Patients treated for varicoceles at our clinic have shown an 80% improvement in sperm quality and quantity, with 55% of these couples successfully achieving pregnancy naturally or through ART.

It’s important to note that while these statistics are encouraging, success rates can vary based on numerous factors, including the cause and severity of infertility, the age of the partner, and underlying health issues. At Shree IVF, we ensure patients are provided with realistic expectations based on their health profile and infertility diagnosis.

Our commitment to research, cutting-edge techniques, and personalized care continues to be the foundation of our success in helping couples achieve their dream of parenthood.

1. Varicose veins are much more common on the left side of the testis.

2. The majority of the time, unless it is clinically palpable and causing any type of pain, most males do not require any form of treatment unless they are suffering from unexplained infertility.

3. The surgery does not offer a 100% guarantee of correction.

4. In the majority of the situations, approximately 30 to 40% of the males will clinically benefit after the surgical procedure for varicocele is done.

5. The surgery is otherwise a small procedure, and it does not require any major bed rest after the procedure. The majority of males get back to work within 2 to 3 days of the procedure.

6. If you are experiencing poor motility of the sperm, which is called asthenozoospermia, then you may not experience any major benefit after doing this procedure

7. We prefer to do a clinical examination of the test as compared to doing a scrotal Doppler because in the majority of situations, the scrotal Doppler is done in a supine or lying-down position, and it may not give you the clear picture of the exact nature and the dimension and the size of the disease.

8. Even our unit strongly encourages the male patient to have a detailed discussion with me regarding the actual effectiveness of doing the varicose surgery on them.

1. A wide variety of antioxidant therapy is available if you are a male patient in all the faculties of medicine, that is, in allopathic, homeopathic, and Ayurvedic literature.

2. All of them are equally effective, but in my personal experience, I have found that medication available with antioxidant content in the Ayurvedic literature is much more effective as compared to the commercially available antioxidant, and as a result of this, I normally prefer to give my patients something called Chavanprash.

It is a simple antioxidant, which contains 32 ingredients and is greatly beneficial for male fertility as well as for overall vitality. One can easily take one spoon in the morning without experiencing any long-term side effects. This is a preparation that is easily available across our country of India.

3. The minimum time that somebody must use antioxidant therapy is for approximately 3 to 6 months; however, one must realise that for sperm counts which are less than 5 million, no form of antioxidant therapy is going to work on them. The majority of these mails will also require supplementation with either injectable hormones or may require any form of assisted reproduction.

4. The biggest problem in India is that the majority of the male partners continue to have antioxidant therapy for a prolonged period of time without any monitoring, and as a result of this, they go to you, and you continue the same therapy with different brands without experiencing any significant outcome. The same happens when they visit practitioners of homeopathy as well as Ayurveda. If you are a patient, very strongly consult a super specialist before you put your foot into any of these therapies.

5. If anybody at all is providing you with any form of false hope, then it is better that you get it in writing from them. The majority of practitioners will not be in a position to give you anything in return, and that is your time to not continue the treatment with them, especially in a country like India, where they do not exist. Any form of dedicated guidelines for the treatment of subclinical male infertility.

1. The entire hormonal therapy for Mule fertility is based upon classification of males into separate categories, which is called the APHRODITE criteria.

2. This is a simple classification system that allows us to divide males into separate classes, where we can identify which category they fall into and what the best treatment is that we can offer them.

Category 1:

These are males who are suffering from hypogonadotropic hypogonadism. This could be either primary or secondary in nature, and it is characterized by low FSH and low LH values. Both of them being typically less than 0.2, these are the males who suffer from extremely low sperm counts as well as temporary but reversible azoospermia.

Most of these males require long-term therapy with injection, HMG, and injection HCG, which is to be taken for a period of around 18 to 24 months. The earlier the treatment is initiated, the better it is for these patients.

The majority of them will get back to a normal sperm count and will end up having a normal conception, provided the female partner is absolutely normal.

Category 2:

These are males in whom there is a deteriorated semen parameter, but they have normal values of FSH and normal values of testosterone. Recent development and papers have shown that these males will benefit extremely well if they are given well-defined and curated therapy with recombinant FSH for a period of approximately six months.

If the female parameters are normal, then the couple will benefit extremely well. In this situation, the majority of the semen parameters would improve drastically.

Category 3:

These are males in whom there is hypogonadism with deranged semen parameters as well as a reduced value of testosterone, but the FSH is normal. In this situation, I strongly recommend doing a clinical examination and the scrotal Doppler and ultrasound in order to find out the actual volume of the testis.

These are male patients who will greatly benefit from the hormonal therapy of injectable HCG 5000 international units to be administered intramuscularly once every week. Intramuscularly, a strong recommendation is against giving an injection of testosterone in this situation because it can go and negatively affect the long-term feedback loop of sperm production.

Category 4:

These are males in whom there is compensation that has already occurred from the body where there is a deranged sperm parameter, and this is usually going to be in the range of non-obstructive azoospermia, and along with that, there is an elevated FSH value as well as reduced testosterone. The majority of these males will usually not have a great long-term benefit, even if hormonal therapy is indicated for them. They may usually end up with something called microTESE, which typically involves surgical retrieval of the sperm

Category 5: Unexplained Male Fertility 

This is a very big category, which includes a huge number of males who are suffering from infertility because quite a lot of them actually have normal sperm parameters. Their wives also have normal parameters, and despite that, they are unable to conceive after having no form of sexual dysfunction. This category is very difficult to treat.

However, the role of recombinant FSH injection in this category is emerging very rapidly. It has to be remembered by you as a patient that in order to have normal production of sperm from your testis, both the FSH and LH hormones are important to drive this correctly.

As a result of this, there could be a certain number of corrections that could be possible in these males. This can be done by injectable therapy, and quite a lot of them would actually end up benefiting. A lot of new data has shown that a six-month therapy with these hormonal injections would do a world of benefit to these males.

1. First of all, it is important to understand that accepting this therapy is very important for you to have peace of mind.

2. The majority of the commercial clinics will be pushing you into some of the other forms of treatment because they need to show numbers so that they can get the appropriate appraisal from their investors.

3. Please have categorical information in writing as far as the success rate of your situation and your case is concerned, because even in the best of situations, the live birth rate does not exceed approximately 40%.

A lot of times, assisted reproductive therapy may be indicated in your situation because the female partner may also be going through challenges.

4. A variety of techniques are available in order to ensure that the sperm that has been selected is the highest possible selection. These need to be followed in the clinic where you are performing your treatment, and as a result of this, kindly go down and dig deep into those types of questions before you pay the money and book the therapy.

1. DNA fragmentation index, or DFI as it is commonly called, is a very important test that your doctor will ask you to do, especially if you are a patient who has had previous IUI failures or previous IVF failures or prolonged infertility or deranged semen parameters.

2. However, it is very important for you to understand as a patient that this expensive test is going to cost you approximately ₹14-₹15,000, and you need to get it done from a good place to make sure that you have the appropriate report in order because a lot of things are going to be dependent on this report for you.

3. It is ideal to get this reporting done on a computer-based platform so that there is no human error involved.

4. This is one of those tests that does not require you, as a male partner, to have any form of abstinence before you visit your doctor.

5. If the DNA fragmentation index, or DFI, is less than 15, then it is no problem. We usually do not recommend any form of treatment to these guys. Treatment of DFI > 30 is based upon multiple other clinical parameters, which I decide after examining the male partner.

Taking the first step towards your dream of parenthood is crucial.

At Shree IVF Clinic, we’re ready to support you on this journey. To schedule a consultation and learn how our treatment options can assist you, simply contact us at 1800-268-4000 or email [email protected].

Our team will guide you through the process and help you book an appointment at your convenience. Embark on your path to parenthood with us, where every question is answered, and every concern is addressed with the utmost care and confidentiality.