scholarly journals Understanding Male Infertility for Promising ART

2021 ◽  
Author(s):  
Mahrukh Hameed Zargar ◽  
Faisel Ahmad ◽  
Mohammad Lateef ◽  
Tahir Mohiuddin Malla

Infertility is a serious problem of not being able to conceive despite regular intercourse for more than a year. Natural conception is seen to be achieved in 80%–85% of couples. About 15% of couples suffer infertility with male factor contributing to almost 50% of cases. Paradoxically, on traditional assessment, the underlying etiology of male contribution towards infertility remains unrecognized in 30% of the patients and thereby grouped as idiopathic. Diagnostics of male infertility cannot therefore be limited to usual semen analysis only. The spectrum of the recent research encourages the experts in the field to approach the Clinical, Molecular and cytogenetic shades associated with the problem besides secondary factors like life style and environment. Clinical assessment sums the medical history and physical examination of the affected individual. Molecular and cytogenetic analysis help gain new insights in understanding the problem and thereby an advantage for a successful assisted reproductive treatment (ART). Given the cost and burden ART puts in and prior to application of any invasive techniques, understanding precisely the etiology associated with male infertility is essential for the fertility specialist to circumvent inefficient or any unproductive steps in the fertilization process besides helping in counseling patients on their chance of success with the use of reproductive technology.

Cells ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. 990 ◽  
Author(s):  
Katerina A. Turner ◽  
Amarnath Rambhatla ◽  
Samantha Schon ◽  
Ashok Agarwal ◽  
Stephen A. Krawetz ◽  
...  

Infertility is a devastating experience for both partners as they try to conceive. Historically, when a couple could not conceive, the woman has carried the stigma of infertility; however, men and women are just as likely to contribute to the couple’s infertility. With the development of assisted reproductive technology (ART), the treatment burden for male and unexplained infertility has fallen mainly on women. Equalizing this burden requires reviving research on male infertility to both improve treatment options and enable natural conception. Despite many scientific efforts, infertility in men due to sperm dysfunction is mainly diagnosed by a semen analysis. The semen analysis is limited as it only examines general sperm properties such as concentration, motility, and morphology. A diagnosis of male infertility rarely includes an assessment of internal sperm components such as DNA, which is well documented to have an impact on infertility, or other components such as RNA and centrioles, which are beginning to be adopted. Assessment of these components is not typically included in current diagnostic testing because available treatments are limited. Recent research has expanded our understanding of sperm biology and suggests that these components may also contribute to the failure to achieve pregnancy. Understanding the sperm’s internal components, and how they contribute to male infertility, would provide avenues for new therapies that are based on treating men directly for male infertility, which may enable less invasive treatments and even natural conception.


Reproduction ◽  
2017 ◽  
Vol 154 (6) ◽  
pp. F93-F110 ◽  
Author(s):  
G D Palermo ◽  
C L O’Neill ◽  
S Chow ◽  
S Cheung ◽  
A Parrella ◽  
...  

Among infertile couples, 25% involve both male and female factors, while male factor alone accounts for another 25% due to oligo-, astheno-, teratozoospermia, a combination of the three, or even a complete absence of sperm cells in the ejaculate and can lead to a poor prognosis even with the help of assisted reproductive technology (ART). Intracytoplasmic sperm injection (ICSI) has been with us now for a quarter of a century and in spite of the controversy generated since its inception, it remains in the forefront of the techniques utilized in ART. The development of ICSI in 1992 has drastically decreased the impact of male factor, resulting in millions of pregnancies worldwide for couples who, without ICSI, would have had little chance of having their own biological child. This review focuses on the state of the art of ICSI regarding utility of bioassays that evaluate male factor infertility beyond the standard semen analysis and describes the current application and advances in regard to ICSI, particularly the genetic and epigenetic characteristics of spermatozoa and their impact on reproductive outcome.


2021 ◽  
Author(s):  
Berhe Tesfai ◽  
Fitsum Kibreab ◽  
Hailemichael Gebremariam ◽  
Liwam Abraham

Abstract Background Semen analysis is the first step to identify male factor infertility. World Health Organization estimates that male factor accounts for 50% of couple sub-fertility. The objective of this study was to determine the prevalence and patterns of male factor infertility based on semen analysis in patients visiting Massawa Hospital with infertility complaints. Methods It was a retrospective, descriptive cross sectional hospital based type of study with a census sampling method. Patient’s medical records and hospital laboratory register were used to retrieve semen analysis results of patients from June 2018 to June 2020. Ethical approval was obtained from the Ministry of Health Research and Ethical Review Committee. Confidentiality of patients records kept was secured and consent was obtained from study participants to use their data. Results were presented in frequency, tables and p value < 0.05 was considered significant. Results A total of 112 patients data was analyzed in the study with 49.1% were aged between 20 to 30 years. The prevalence of male factor infertility in these patients was found to be 42% and 79.5% of them had primary type of infertility. Of the study participants; 63 (56.3%), 72 (64.3%) and 70 (62.5%) had sperm count < 15 million sperms/ml, sperm motility < 40 % and morphology of < 60% respectively. One tenth, 15 (13.4%) of the patients had a semen volume of < 1.5ml/ejaculate, out of which 13(86.7%) had primary type of infertility. Moreover; 72 (64.3%) patients had total sperm count/ejaculate of < 39 million and 59 (82%) of these had primary type of infertility. In addition; 50.8% and 50% of patients aged 20 to 30 years had a sperm count < 15 million/ml and sperm motility of < 40% respectively. Conclusion The prevalence of male factor infertility was slightly higher and was dominated with primary infertility. Most patients had lower sperm count, sperm motility but higher semen volume, and majority of the patients with abnormal sperm results were aged between 20 to 30 years. Further prospective researches to determine the risk factors for male infertility and introducing assisted type of fertility in Eritrea are highly recommended.


2018 ◽  
Vol 6 (1-2) ◽  
pp. 25-32
Author(s):  
Fahmin Rahman ◽  
Mohiur Rahman ◽  
Nusrat Mahmud ◽  
GU Ahsan ◽  
Mitheel Ibna Islam

Background & objective: Infertility is a problem of public health importance because of its high prevalence and serious social implications on affected couples and families. Although once believed that the problem is solely due to female factor, it is now generally accepted that male factor infertility is equally as important as the female factor. However, it is not known how far the problem is attributed to male factor. The present study is intended to find the prevalence of male infertility among the infertile couples and its determinants in the context of Bangladeshi population. Patients & Methods: The present study was a descriptive cross-sectional study conducted on male partners of infertile couples (over a period of three months) visiting the Infertility Clinic of Bangladesh Institute of Research and Development in Endocrine & Metabolism (BIRDEM) General Hospital, Dhaka. Male infertility was defined as the inability of a man to make his partner conceive (because of quantitative and/or quantitative deficiency of his sperm) after 12 months of regular unprotected sexual intercourse. On the basis of semen analysis, male partners were divided into two groups – Infertile Group and Fertile Group and the suspected factors were compared between groups using crosstab analysis to determine the factors responsible for male infertility. Result: The present study demonstrated that respondents were generally middle aged (between 30-50 years) with mean age being 35.5 years. Majority (88.5%) was Muslim and belonged to middle class (74.3%). Nearly half (47%) was service-holder and one-third (35.8%) was businessman. About 62% of the male partners were revealed to be infertile on semen analysis [combined prevalence of azoospermia (19%), asthezoospermia (29.2%) oligospermia (12.8%), and teratzoospermia (7.1%)]. Of them nearly one-third (azoospermic ones) was solely responsible for infertility and the rest played contributing role to the overall infertility. The reproductive tract infection (STDs) was reported to be alarmingly high among infertile males (21.4%) than that among their fertile peers (p = 0.002). Smoking, varicocele, overweight or obesity and diabetes also demonstrated their significant presence among infertile males compared to the fertile male group. History of occupational exposure to high temperature, pesticide, trauma to testes, abdominal and urogenital surgery were not associated with male partner fertility. Conclusion: From the findings of the present study, it can be concluded that a substantial proportion of infertility can be attributed due to male partner infertility and its significant predictors are reproductive tract infections or sexually transmitted diseases. The second leading causes are varicocel, diabetes and obesity. Ibrahim Card Med J 2016; 6 (1&2): 25-32


2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Hideyuki Kobayashi ◽  
Koichi Nagao ◽  
Koichi Nakajima

Male infertility problems can occur when sperms are limited in number or function. In this paper, we describe the clinical evaluation of male infertility. A detailed history, physical examination, and basic semen analysis are required. In addition, ultrasound, karyotyping, and hormonal studies are needed to determine specific causes of infertility. In addition, the World Health Organization (WHO, 2009) has developed a manual to provide guidance in performing a comprehensive semen analysis. Among the possible reasons for male infertility, nonobstructive azoospermia is the least treatable, because few or no mature sperm may be produced. In many cases, men with nonobstructive azoospermia typically have small-volume testes and elevated FSH. Although treatment may not completely restore the quality of semen from men with subnormal fertility, in some cases a successful pregnancy can still be achieved through assisted reproductive technology.


2020 ◽  
Vol 22 (3) ◽  
pp. 364
Author(s):  
Ana Andreea Falticeanu ◽  
Olivier Lebecque ◽  
Michaël Dupont

Ultrasound is a useful, cost-effective and minimally invasive tool that can be used in the workup of male infertility. Patient history, semen analysis and hormonal results often precede ultrasound examination as a part of the workup of male factor infertility.In our article, we advocate the added value of a systematic approach of the scrotal ultrasound. We propose a checklist for the complete analysis of testicular and paratesticular structures, useful in everyday practice for both clinicians and radiologists, highlighting what can be expected of and what should be found in the radiologist's report.


2018 ◽  
Vol 5 (4) ◽  
pp. 18-25
Author(s):  
N. G. Kulchenko

In the structure of infertile marriage male factor of infertility occurs in about 40-50%. About 30% of infertile men who have sought medical care have oligozoospermia or azoospermia of unknown etiology. The question of the chances of spermatogenesis recovery and increased probability of sperm extraction in repeated assisted reproductive technology (ART) programs is important for both the doctor and the patient.Purpose. To evaluate the morphological changes of spermatogenic epithelium in patients with male infertility in terms of prognosis of ART success.Patients and methods. 264 men with infertility were examined. The scope of clinical study of all patients included: history, examination, determination of blood hormones, study of ejaculate, karyotype, ultrasound. We performed a biopsy of the testis according to the patient's symptoms. Testicular tissue was subjected to morphological examination.Results. Primary infertility was observed in 172 men (65.2%), secondary — 92 (34.8%). 112 (42.4%) patients had severe infertility. The results of morphological studies in these men showed a different degree of violation of spermatogenesis. Based on the study, a diagnostic algorithm of patients with male infertility is proposed, which allows to predict the success of ART taking into account morphological changes in the testicle.Conclusion. On the basis of clinical and morphological study of the features of spermatogenesis of a particular patient a plan can be made for further personal diagnostic and therapeutic measures.


2013 ◽  
Vol 26 (5) ◽  
pp. 616
Author(s):  
Rui Amorim ◽  
Vitor Oliveira ◽  
Jorge Dias ◽  
Rui Freitas ◽  
Luis Ferraz

The ejaculatory ducts obstruction is an uncommon finding in the study of infertility male factor. We present two cases referred to our department for conjugal infertility, with proven male factor (low ejaculate volume and azoospermia). On physical examination there was no abnormality in both patients. Imaging studies demonstrated intra-prostatic cystic structure, causing ejaculatory ducts dilation. We performed transurethral resection of the ejaculatory ducts. Semen analysis 3 months postoperatively showed 1 case of normalization and 1 case of improvement in sperm count parameters. The couple 1 couple has 2 children, without medical assisted reproductive techniques. The couple 2 had one pregnancy after Intracytoplasmic Sperm Injection, from the ejaculate. This diagnosis depends on a strong clinical suspicion and is of high importance, since this disease has effective surgical treatment. The authors aim to highlight the relevance of the assessment andrological when studying marital infertility.


Author(s):  
Manju Mohan ◽  
Sawarkar Punam ◽  
Sawarkar Gaurav

Background: Male Infertility is one of the burning issues now a day’s nevertheless disregarded reproductive health problems in India. Incidences of this issue expands day by day because of the disturbing lifestyle pattern. Almost 30-40-% of infertility cases found to be related to male factor. Asthenozoospermia is the most common identifiable anomaly related to male infertility found in semen analysis having reduced motility of sperm. Aim and Objectives: To assess the efficacy of Ayurvedic management (Shodhana and Shamana Chikitsa) in the management of Ksheena Shukra Vikara w.s.r. to Asthenozoospermia. Methods: It is a single case study. A 33-year-old male patient who was already diagnosed with Asthenozoospermia for three years approached to Pancharkarma OPD. Sperm motility was only 12%. The patient was treated with Shodhana Chikitsa (Vamana and Virechana with Mahatiktaka Ghritapana and Dashmooladi Niruha Vasti and Uttarvasti with Vidaryadi Ghrita followed by Shamana Chikitsa (Tab Neo Charak Pharmacy, Tab Addyzoa, Chandraprabha Vati, Paripathadi Kashaya, Ashwagandhadi Yamaka, Avipattikar Churna) approximately 3 months. After 3 months, patient-reported improvement. Results: Assessment of the patient with clinical symptoms and sperm analysis report was done following 3 months. Sperm motility increased up to 40% with increment in sperm count.  Conclusion: This case report provides us a guideline that infertility associated with Asthenozoospermia can be treated successfully by adopting basic Ayurveda Siddhanta's.


1970 ◽  
Vol 31 (3) ◽  
pp. 10-12
Author(s):  
P. Raj Pant

Introduction: Infertility is commonly defined as the failure of conception after at least 12 months of unprotected intercourse. 1 Accurate assessment of the prevalence of infertility has always been difficult because of the large scale population based studies. 2 Male factor is the only cause of infertility in about 20 % of infertile couples, but it may be a contributing factor in as many as 30 % to 40 % of cases.3 Factors like diabetes, bronchiectasis, high grade fever, long term medication, urinary tract infection, sexually transmitted infection, epididymitis, testicular injury, un-descended testis, mumps, orchitis, excessive alcohol, smoking, exposure to heat and certain chemicals effect in the spermatogenesis. Impotence or erectile dysfunction remains one of the important contributors in the male infertility. Methods: This is a prospective descriptive study conducted during the health camps in Sindhupalchowk, Manang, Baitedi, Rauthat and Darchula districts of the Nepal. The objective of the study is to find out the factors contributing to male infertility. Couples who were unable to conceive after regular, unprotected coitus of at least one year were included in the study. Detail history, clinical examination and semen analysis was done. Results: There was limited facility of investigation and treatment of infertility in the health camps. The diagnosis was based only on history, examination and semen analysis. Various factors like mumps, chemical exposure like men working in carpet factory, testicular trauma and smoking were found as contributing factor of male infertility in these districts. Conclusions: Testicular trauma, mumps, smoking is common in all the districts. Exposure to chemicals such as dyes, used in carpet factories seems to be responsible for infertility in some men of Sindhupalchowk and Darchula. Keywords: Azospermia; male infertility; oligospermia. DOI: 10.3126/joim.v31i3.2972 Journal of Institute of Medicine, December, 2009; 31(3) 10-12


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