Understanding Male Infertility

Dr. Rita Bakshi talks about Male Infertility and how common it is, what are the causes, etc.

Let’s talk about male infertility. India, especially, and even many other countries, people believe fertility is a woman’s prerogative. In fact, she’s blamed for it in case of a couple does not have a baby, but let me tell you. In 30% of cases, it’s a male, who’s responsible in 30%, it’s female. And in the rest, nothing really is wrong.

And yet they don’t have a pregnancy. So I let’s talk about the male part first. Now, a male, as I said, is born with a testes, which is a factory where the sperms are produced. Do you know why testies are hanging out? In a case of a male unlike ovaries, which are there inside the body, because testes require a temperature, which is lower.

So they require a cooler temperature inside the body. We know it’s 37 degrees centigrade, but outside, they are in a much cooler atmosphere. Yeah. And here is the point, which I would like to point even before I start my dialogue is that people who work in conditions, which are heat related like smelting and welding and people who keep their laptop on their laps all the time, these are increasing the temperature of the testes and therefore are hampering the production of sperms.

So, let me tell you that males otherwise have sperm production from starting from puberty and throughout their life. It is never that they have no sperms, let us say, uh, there is something like called an andropause, but it’s really not like a menopause that zero zero. No. So where can where in the, let me tell you, first of the values, which are a little important, because these are WHO values, which probably all males should know is that there is something called a count in a, in a, in a male, which is, around 15 million.

Yes. There are millions of sperms and it requires just one sperm to fertilize, an egg, but 15 million is the account that they take an average, leave it to the good count. So it is just to tell of people who are worrying and have got some of the tests done and they realize that they have said not 60 million or 120 million, but if they have anything above, 15 million is good enough.

Similarly, it should be a motile sperm should be motile and a nice progressive motility and a nice morphology. These are the three facts in a sperm that we see. Which calls for, uh, looking or not looking into. Now sperms are produced in the testes, as I said, and then they traveled through tracks like an epididymis with stores the sperms, and through a valve which travels the sperm and they’re joined by secretions from the seminal vesicles and the prostrate, and all of them contribute to the, sperm, in some or the other manner. In the end, it’s a nice, a head and a nice actively moving, long-tail sperm, which is a good looking sperm as we call it. Now, the, the male scan, have problem, one, as I said, is in temperature and which could be, you know, only because of extrinsic, all varicose seal and you know, other condition shouldn’t, which increase the temperature of the testes and which can hamper the production.

Then they can have some kind of obstruction. You know, to the long tracks, they can get obstructed whether, because of infections or tuberculosis or any other reasons sometime, you know, in children get, uh, operated for hernia and, uh, you know, they, their valves gets, um, you know, they’ve, they’ve tied the valves somewhere and you’ll realize that, you know, the sperms are not coming out in their jaculate. And it is only for all the males I would just request because males usually do not come out to get checked. That is one only one simple test semen analysis, and that clarifies a picture more or less on how we are going to look at the males.

So if you have a, you know, just get one semen analysis after two to three days of abstinence, uh, give a sample and ejaculation, uh, preferably in the lab where it’s going to get tested because within an hour it should reach the lab and the person should be looking at it.
So if, uh, uh, you give, uh, uh, sample in the lab and you look at coagulation and then liquefaction, the sperm should get liquefied and they should have enough sperm. And as I did say, the count, the motility, and the morphology is to be seen now, in case there is a problem. So we, in case the problem could be less count – that is oligospermia. It could be less, motile – it could be asthenospermia, or it could be a not good looking sperm that is not the normal morphology is called teratospermia.

So it could be oligospermia, asthenospermia, or teratospermia, as the language goes, and then we can correct all. The important is that you just have to find out what is the problem, and then you can correct it. Then, however, there are males who have zero sperms and what is called azoospermia and that is what is, what is worrisome. If you have no sperms yet, If the factory is producing sperms, we can get the sperms out from there. So you can still have an IVF Tesa baby, as we call it testicular sperm extraction, and yet have your own child, even when you have no sperm in the ejaculate.

So azoospermia could be obstructive or it could be non-obstructive. So an obstructive is for me, easy to. Diagnose easy to operate and easy to have your own baby. In a non-obstructive azoospermia where there is no obstruction and the factory is not sure. So we still do a tesa. We make sure if we can get sperm from Tesa or peza or something mesa as you say microsa.

You know, you open the testies, you look at microscopically at each tubule. Find out if we can still get a sperm, take that sperm out and then fertilize with the women’s egg, through an IVF procedure and still you get, uh, your own biological baby. Important is that you should know that you are important males are very, very important. Malse, have an equal responsibility of giving a good pregnancy and that any structure that you may have, or any problem that you have is treatable.

I would just like to say that everything is treatable. You just have to reach the right doctor. Thank you!

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