Infertility in a man is mainly of two types – either he is unable to produce enough normal sperms and make it likely that one of them will fertilise an egg or he cannot successfully deliver the sperm into the vagina during sexual intercourse. The causes of female infertility are easily identifiable, however, same is not the case with male infertility. An exact cause for infertility is identified in only one out of three men facing the problem.

The reasons responsible for male infertility are:
1) Trouble producing enough normal sperms:
A low sperm count can be a result of a number of causes, and one of them is a rise in the temperature of the testes. The testes are normally a couple of degrees cooler than the rest of the body, but when the temperature rises, due to any reason, it may negatively affect the production of sperms. If testes are damaged by medical procedures like chemotherapy, or radio therapy, fertility is adversely affected. Hormonal deficiency i.e. insufficient production of sex hormone testosterone by the testes may also be a reason for reduction in the number of sperms. Apart from this, pituitary disorders such as a tumour may lead to infertility. Idiopathic oligospermia is the most common cause of low sperm count. In this, reduced count is a result of no identifiable reason.

2) Trouble delivering sperms into the vagina:
Although there are quiet a few reasons responsible for the sperms not reaching the vagina, the most easily identifiable factor is erectile dysfunction – an inability to achieve or maintain erection. Any damage to the tubes that transport sperms (epididymides and vas deferens) may also cause trouble delivering the sperm in the vagina. Such a damage is often a result of sexually transmitted infection like gonorrhoea. Retrograde ejaculation can also be held responsible for infertility in men.

The nature of the treatment and chances of regaining fertility depends on the causes of infertility. Injections of hormones may successfully treat low testosterone levels and help increase the production of sperms. While various treatments are available for erectile dysfunction, damage to the tubes that transport the sperms can be treated with microsurgery. When the patient doesn’t respond to the initial infertility treatments related to erectile dysfunction or retrograde ejaculation, artificial insemination is used to increase the chances of conception. Alternatively, a single sperm may be taken from the semen or directly from the epididymis or the testes, and then, a process known as intracytoplasmic sperm injection (ICSI) is followed to fertilise the egg. The fertilised egg is then put in the woman’s uterus.

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