Male Infertility (Childlessness) / संतानहीनता
In our Indian society, the objective of marriage is propagation, having children to carry forward the family name. The name & achievements of a childless person are forgotten with his or her Death. Childless couples do not get due respect in the society. They are considered to be handicapped. They have to bear the taunts from people. Sometimes the taunts become so unbearable that the women commit suicide or have extra marital affairs to have children because it is the woman who is held responsible for having no children. Sometimes, pressurized by the family members, the husbands give divorce to the wives.
Meaning of infertility.
If you are married and you want a child. You are having intercourse regularly, without using any contraceptives (condom, copper T or contraceptive pills). After doing all this, if the wife does not conceive for A YEAR, it is called infertility.
In 30 % cases, the men are at fault for having no children, In 30 % cases, the women are at fault, In 30 % cases, both the men and women are at fault and in remaining 10 % cases, the reason is unknown. For having a healthy baby, the outer and inner sex organs of the man and woman need to be normal. Any disease or abnormality in these organs will make it difficult to conceive.
Most of the couples resort to the means like worshipping gods, pooja-paath, mantra-tantra, black magic etc. This is nothing but waste of time, energy and money. Many years after the marriage, they come to the doctor. I would like to urge them that they should not waste time and money in these things and visit family doctor / good sexologist / Gynaecologist / Infertility Specialist in time so they can find the exact reason of male or female infertility and treat it accordingly. Sometimes wasting time may make the disease Incurable.
Causes of male infertility:
1. Abnormal semen contributes major portion among 1/3rd reasons of infertility from male factor that includes,
• When there is Total absence of sperm in the semen then this condition is called as Azoospermia.
• When there is Less than 20 million sperm/ml in semen then this condition is called as Oligospermia.
• When there is Less than 25% sperm motility of sperms then this condition is called as Asthenospermia.
• When there is Less than 30% of sperm with normal morphology then this condition is called as Teratozoospermia.
• When there is 0% motility of sperms in semen then this condition is called as Necrospermia.
• When there is More than 250 million sperm/ml in the semen then this condition is called as Polyzoospermia.
• When there is Absence of ejaculation i.e.no semen discharge during the intercourse then this condition is called as Aspermia.
• When volume of semen is less than 2ml, then this condition is called as Hypospermia.
• When volume of semen is more than > 2ml then this condition is called as Hyper sperm
2. Varicocele & Hydrocele are also most common reasons for Infertility.
3. Testicles that haven’t descended into the scrotum
4. Having antibodies that attack your sperms and destroy them.
5. Hormonal imbalance, such as low testosterone production, etc…
6. A childhood illness such as viral orchitis.
7. A groin injury.
8. Cancer or its treatments, like radiation, etc…
9. Genetic conditions.
10. Blockage in the tubes that carry sperm from your testicles to your penis.
11. Use of calcium channel blockers, which are used for high blood pressure
12. Use of anabolic steroids, which are used for improved athletic performance or hormonal issues such as delayed puberty
13. Use of recreational drugs such as marijuana and cocaine
14. Erectile dysfunction (ED)
15. Problems with ejaculation, such as delayed ejaculation or retrograde ejaculation and premature ejaculation.
16. Low sex drive
17. Abnormalities of penis such as hypospadias and phimosis.
18. Other factors like Older age, heavy Smoking of cigarettes, Heavy use of alcohol, Being overweight or obese, Emotional stress, Depression, Exposure to toxins, such as pesticides, herbicides, and heavy metals and Exposure to heat like frequent expose to hot baths, wearing non porous nylon underwear, suspensory garments and working on a laptop computer for long stretches of time can also causes Infertility
Some deficiencies of vitamins and minerals impair the testicular function which results in Infertility so correction of diet factors is also important. One can try these 10 sperm producing super foods includes Eggs, Spinach, Bananas, Dark Chocolate, Broccoli, Pomegranates, Walnuts, Garlic, Carrots, pumpkin Seeds and other food items rich in vit C, vit D, vit b12, folate and zinc.
Treatment of male infertility : All male factors are not treatable through the medicines alone, some factors needs surgical procedures also.
According to the condition there are very good Ayurvedic medicines to help in treating male Infertility.
In case of oligospermia i.e. less quantity of sperm in semen and less motility of sperms, — medicines like– Dhatu paushtika churan, Aswagandhadi churan, Shatavaryadi churan, Asvagandhadi lehyam, Kounchapaka, Laghu musalipaka, Amritaprasa ghrita, Tablet Purnachandrodaya, Tablet shukar matrika bati, Tablet Brihat Bangeshwar ras, Tablet Pushp dhanva Ras, Capsule shilajit.etc gives very goog results.
For azoospermia : There is absolutely no oral medicinal treatment available for azoospermia (NIL Sperms), male partner is advised to do serum FSH and bilateral testicular biopsy to know whether the sperm production is there in testes or not and to know if there is any blockage of tubes?
If sperm production is there in testes then variety of techniques are there for the retrieval of spermatozoa such as — ICSI (Intracytoplasmic Sperm Injection)like RETA(rete testis aspiration), SPAS( spermatocele aspiration) MESE (microsurgical epididymal sperm aspiration), PESE (percutaneous epididymal sperm aspiration), TESE (testicular sperm extraction) all these techniques helps to aspirate the sperms.
Then these sperms are used for utilisation of IVF & Other micro Assisted fertilisation Processes.
If Infertility is because of Azoospermia Caused by an obstruction of epididymis or vas then one should go for Operations called vasostomy and transurethral resection of ejaculatory ducts (TURED), This is usually done by experience surgeon using microsurgical technique.
For Necrospermia : there is no medical and surgical treatment. Couples may opt for Donor insemination.
For erectile dysfunction, ejaculation problems and for penetration problems one should consult a family doctor or sexologist or a urologist.
For varicocele and hydrocele : Permanent solution is operation only that involves embolization of the incompetent veins and after that couple may get pregnancy naturally or through IUI(intrauterine insemination) and if not the final option is IVF(In vitro fertilization) or ICSI(Intra cytoplasmic sperm injection).
Causes of female infertility : Mainly ovulatory factors contributes major portion among 1/3rd reasons of infertility from female factor that includes,
• Polycystic ovary syndrome (PCOS) or hormonal imbalances causing disturbed cycles.
• Partial or complete tubal block by Sexually transmitted infections such as chlamydia and gonorrhoea, or any other reason
• Pelvic inflammatory disease (PID)
• Uterine fibroids
• Scarring of uterus from a previous surgery
• Painful intercourse
• Old Age: The quality and quantity of a woman’s eggs begin to decline with increasing age.
• Heavy Smoking & Heavy alcohol consumption
• Weight: Being overweight or significantly underweight may also affect normal ovulation.
Female partner is advised to do tests includes complete hormonal assay, Ultrasonography, tubal patency test like HSG(Hystero salpingography), hysteroscopy & laproscopy, etc….
If you are trying to conceive, one of the things that you should take care of most is female partner’s diet and nutrition. Eating wholesome and balanced foods will provide with plenty of nutrition that is required to keep reproductive system healthy, hormones stable, and improve circulation. Those includes avocados, beans, lentils, sesame seeds, green leafy vegetables, nuts and dry fruits.
Medicinal treatment of female infertility : female partner is advised to take following medicines according to the condition. Shatavari churna, Shatapushpa churna, Pushyanuga churna, Kanchanra guggulu, Rajah pravartini vati, Varunadi kashayam, Ashokarista, Phala ghrita, Brihat satavari ghrita, Sheeta kalyanaka ghrita, Ashoka ghrita, tablet Pushpa dhanva ras.
For tubal blocks : Reconstructive surgeries of tube like reimplantation of tube, end to end anastomosis and salpingectomy etc. is advised.
If treatment is unsuccessful, or if the couple still does not conceive, then assisted reproduction techniques are indicated. Assisted reproductive techniques (ART) include intrauterine insemination (IUI), in vitro fertilization (IVF), and IVF with micromanipulation.
Intrauterine insemination (IUI) : This involves the collection of semen by an emission occurring other than during coitus (usually by masturbation) and its transfer into the uterus.
In vitro fertilization (IVF) : In this technique, your doctor places embryos into your uterus that were fertilized outside the body.
IVF with micromanipulation : ICSI (intracytoplasmic sperm injection) Sometimes the sperm cannot penetrate the outer layer, for a variety of reasons. The egg’s outer layer may be thick or hard to penetrate or the sperm may be unable to swim. In these cases, a procedure called intracytoplasmic sperm injection (ICSI) can be done along with in vitro fertilization (IVF) to help fertilize the egg. During ICSI, a single sperm is injected directly into the cytoplasm the egg.
Several other ART methods have been developed over the years. Some of these include GIFT (gamete intrafallopian transfer), DIPI (direct intraperitoneal insemination), FSP (fallopian sperm perfusion), ZIFT (zygote intrafallopian transfer), and IFI (intrafallopian insemination)
Surrogacy : Surrogacy is a method of assisted reproduction where intended parents work with another female (other than the wife) called surrogate mother who will carry and care for their baby(ies) until birth. It is an option for women with an abnormal uterus or a complete absence of a uterus either congenitally or post-hysterectomy.