Low Sperm count treatment| NO Sperm | Male infertility Causes #sexualhealthformen -Dr.Chaithra Rani

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Dr. Chaithra Rani | Phone ????: +91 6364460268/69 (Online & in-person appointment can be booked online or by call) | Registration No. 109520 Karnataka Medical Council, 2015 |Consultant Fertility Specialist | Shishu IVF Fertility Centre, Rajajinagar, Bengaluru, India
When we come to male factor infertility, it will constitute around 30% of the general infertile couple. So what do we see initially when the couple confirm for investigation from the male partner ? The foremost important thing is semen analysis. In semen analysis we see three important things when concentration that is the concentration of sperms per ml more than 16 million per ml is the normal count and next thing is motility means the sperm has head body and tail it has the ability to move. So it moves and to go and reach the egg. So what is the motility? That we see rapid Progressive slow Progressive non Progressive so there are categories like this it should be at least more than 30% and coming to morphology. So what is morphology? As I mentioned the sperm has head body and midpiece and tail . So is there any defects in the head is there any defect in the body or in the tail. What is the normal criteria is more than 4% that is out of 100 sperms we see in the field? Atleast four out of it or more than that should be normal so whenever it is less. Sometimes even if it is 1% 2% is also okay so the problem happens that when we see almost all the fields we are not able to find even one or two good sperms without any defects that is when the problem is. So that is teratazoospermia. So even though the million it may be of 5 million or 6 million. Even though count is less the morphology is also very important. So unless and until we have the good looking sperms without any defects that is going to affect the fertility even for usually when these kind of patients are there we are suggesting them IVF . So even to do ICSI that is when we take the sperm and instill it into the egg. For that process also we are going to see whichever has less defects or non defect ones. When the morphology is affected it is going to affect the IVF success rate also that is the most important. So and what is the most important question patient will ask so what is the reason some patients may have habits like smoking alcohol or certain other things but most of the patients will be young without any or occasional use of alcohol not much any other substance abuse or habits. Even then their quality will be affected. So it may be one is genetic causes. Another one is lifestyle the overall fertility has reduced compared to even when we see at least 10 years 15 years back the fertility rate has come down drastically maybe a lifestyle environment the food what we eat and the habits what we have so all these things may affect sometimes we don't know what is the reason idiopathic even if we find the reason there may not be very means for all the patients to increase the count. Also there are certain group of patients where the hormone secretion itself is less from the pituitary then for such patients we can give certain injections and repeat the analysis after 3 months and see if there is any improvement. Otherwise generally if it is a primary testicular failure. Then we can't do much about it, obstructive and nonobstructive when it is an obstructive cause that means your test is producing sperms but the outway tract has a problem. In such cases we can do something called PESA or TESA. That means we're going to take out the tissue from the testis or epidermis and examine that tissue under the microscope. If we are able to get the sperms out of it. If the quality is good we can cryopreserve and use it during ICSI or we can take the fresh sample from the TESA and do the ICSI that is IVF process. When it is nonobstructive as I told if it is a primary the hormone secretion is the problem we can give a text from the outside and see if there is any improvement or if it shows that already hormones are elevated that indirectly says that it's a primary testicular failure there is nothing that we can do much about it.

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