Male Infertility - Causes and Treatment with Intrauterine Insemination (IUI). IUI infertility treatments are used for couples facing troubles and issues regarding naturally conceiving a baby
Intrauterine Insemination (IUI) process is one of the infertility treatments used for couples facing troubles and issues regarding naturally conceiving a baby. Usually, it is started when the female discusses her issues and problems with her gynecologist and the doctor then examines her and suggests some tests to evaluate the cause. However, it is said and observed that in 40-50% of cases of couples facing problems in conceiving naturally is because of male factor infertility contribution. It happens that doctor and the couple may neglect the male side of infertility due to which the IUI treatment turns out to be unsuccessful. So, it is highly recommended that the doctor and the couple should include the male partner as well for the series of examinations & Investigations right from the beginning, so that there are fair chances of successful IUI treatment and all the factors that may be contributing towards the infertility are considered and examined carefully.
So, careful and close tests are required to be conducted for the males as well, the primary test is the “semen analysis” and it is recommended that no further IUI procedure or any other infertility treatments depending upon the severity, should be started without knowing the result of semen analysis. In most cases, men tend to get chary towards getting tested, however, it is necessary to know that even if the results are not as expected most of your sexual problems can be effectively treated by medications with the help of your doctor, so it should not create any dilemma for the male partner to get his semen tested.
Read further to know about what various malefactors of infertility are and how they are caused. Also, know all important details about IUI techniques and why one should opt for IUI for male infertility as the first treatment process before moving on towards further deep treatments of infertility:
The semen analysis process requires only one thing to conduct this test and i.e. the semen sample of the male partner, is then sent to the laboratory to get tested. Usually, most of the clinics have collection rooms for the sample while others collect it from the home of the male partner; the latter collection process is encouraged by most of the doctors. After the collection of the semen sample is done the doctor sends it to the laboratory where it is closely examined and studied to carry out the factors which are affecting the infertility of the male partner and the time taken for the same is about 2-4 hours. Further are the major factors that are examined in the semen analysis process:
Volume of Ejaculate – The semen consist of many other fluids, enzymes, and acids like amino acid secreted by the male reproductive system other than just sperms and if any of these secretions of the reproduction is lacking in the semen then the volume of ejaculate is considered low. These secretions play their own major roles in the process of fertilization so it results in a factor of infertility in the males if these are lacking in semen. Often, it is also considered as the signal of blockage in the pathway of semen. This is one of the factors to take care of and look closely for while examining the semen.
Sperm Count – Another major factor to be examined closely and carefully while examining the semen sample of the male partner is the sperm count. Sperm count refers to the concentration of sperm in the semen sample. If the semen analysis results in low sperm concentration then the problem is in the male testicles or male hormones that are creating an issue for the testicles to produce the required number of sperms. For IUI success with male factor infertility requires at least 20 million sperms per milliliter and a total volume of 2 ml.
Sperm Motility – Motility of sperm means how fast is the movement of the sperm while traveling towards the egg or how fast the sperm can swim to reach its destination. If the sperm motility is low or poor in the semen i.e. if the sperm movement is lower than what is required then it can affect the swimming ability of the sperm towards female eggs, which will further result in male factor infertility. The required sperm motility rate to carry IUI procedure successfully is > or = 30% and the total count of motile sperms should be > or = 5 to 10 million.
Morphology – This term is used to examine the shape of the sperm closely as it is another major factor that can contribute to malefactors of infertility. The required shape is with a proper head and the tail. The head of the sperm helps in successfully penetrating and fertilizing the egg while the tail helps the sperm to swim towards the egg effectively at the required motility rate. If due to any of the two important shape factors, the sperm is not in shape, it signals that the sperm is lacking proper enzymes to successfully carry out the fertilization process.
It is roughly estimated that nowadays the percentage of couples suffering due to infertility issues is around 15% out of which if we calculate are 20% of couples who are suffering from infertility are due to single male factor of infertility and nearly 40% couples are facing combined male and female infertility issues. The help of sperm analysis and other evaluation processes makes it easier to identify the causes of infertility and if it is treatable then there is also a chance for the couple to naturally conceive a baby.
Broadly if we talk about causes of male factor infertility then we can divide them into three categories- one is the sperm production-related problems and the other one is the structural issues, Another one is Sperm Mobility. There can be many causes that fall into these categories that can adversely be a reason of male factor infertility like, infection, some genetic flaw, any prior medications and also a very common reason these days is the intake of bodybuilding steroids. These steroids are harmful to the male reproductive system and result in an adverse cause of male factor infertility. There can be some environmental causes for the male factor infertility as well like, exposure to excessive heat or some type of chemical like pesticide, etc. If the male partner has had any kind of surgeries in the past or has been through infections can result in scarring, which can further cause blockage in the pathway of the sperm hindering ejaculation of the semen. In some cases, men are already born with structural issues which make it a cause since their birth.
We talked about testing and analyzing sperm in the above section A similar process comprising of detailed study of the sperm specimen and some physical tests done by the doctors can help you identify the cause of the male factor infertility. Many structural issues can be dealt with with the help of various surgeries whereas the sperm production-related problems can be cured with the help of medication and further improve your semen analysis result. However, it is possible in some cases that the cause of the male factor infertility cannot get identified.
IUI procedure for treating male factor infertility is used when the causes for infertility in the male partner of a couple are mild. If the results of the semen analysis are mild i.e. the result of the analysis unveil slight issues in one or two factors mentioned above, then even the doctors tend to suggest that IUI is the first and foremost infertility treatment as it is a safe, painless, and extremely affordable medical treatment for infertility. IUI is said to be a considerable treatment especially for the male factor infertility because in this treatment the sperm is physically placed into the uterus and before that is the step where it is closely prepared for the placement. The process of preparing the sperm is called “washing” while washing the sperm sample the doctor takes care of the perfect shape and motility of the sperm for higher chances of pregnancy. For carrying out the whole process the sperm is placed in a centrifuge and gets spun to extract the final healthy and clean sperm sample which is then with the help of a tube or catheter is placed in the uterus.
Though, IUI can treat mild male factor infertility but the men who have low sperm motility i.e. required movement of sperm to reach and meet eggs and low sperm count i.e. the required amount of sperm has low IUI success rate in male infertility. For a successful IUI fertilization, the sperm motility should be at least 5 million or more and the sperm count should be more than 5 million whereas the processed sperms should have more than 1 million motile sperm cells.
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