Male infertility: An ignored possibility (2) by Prof. Oladapo Ashiru
Sperm testing is not without its attending issues. For example, sperm count that is below average can result from testing a sperm sample that was taken too soon after the last ejaculation or after an illness or stressful event.
Also, testing a sample that did not contain all of the ejaculated semen, due to spillage during collection, can yield below average sperm count. Therefore, the results are generally based on the selection of several samples over a period.
Treatment of male infertility is possible through assisted reproductive techniques and, sometimes, surgery for Varicocele and undescended testes.
Assisted reproductive techniques are the advanced methods of achieving conception. The techniques could be invasive or non -invasive. The non-invasive techniques include medical treatment with drugs for patients with hormonal imbalances such as anti-estrogens, e.g., clomiphene citrate, tamoxifen, gonadotropins, such as HCG, dietary supplements, e.g., coenzyme Q10, aromatase inhibitors like Anastrazole and cyclic steroids (for immune-suppression). It is important to note that these drugs can be combined to get better results. The clinician has to identify the underlying causes and appropriate medications to use.
Patients with mild and even moderate oligozoospermia can benefit from Artificial Insemination/Fallopian Tube Sperm Perfusion, which is also a non-invasive treatment for the men.
Patients with severe oligozoospermia can benefit from Intra-cytoplasmic Sperm Injection, which involves the direct injection of sperm into the oocyte (eggs). For this to be done the oocytes have to be retrieved from the female partner while semen is collected from the male partner and processed.
The invasive techniques are advanced sperm retrieval methods involving minor surgical procedures, using local anaesthesia. It can be used to collect sperm in patients with azoospermia. Many patients, whose semen very little or no sperm, still have some sperm in their testes (organ where sperm is produced) and epididymis (stores mature sperm). These techniques include the Testicular Sperm Aspiration, Testicular Sperm Extraction, Micro-Testicular Sperm Extraction and Percutaneous Epididymal Sperm Aspiration. They all involve the direct collection of sperm from the testes and epididymis.
Pregnancy rates, according to the above treatment, vary. In artificial insemination pregnancy rates are about 20 per cent per trial and multiple births are common when combined with superovulation. It could be as high as 35 per cent or 45 per cent. It can also go up to 60 per cent with numerous trials, using intracytoplasmic sperm injection techniques. We have also reported many pregnancies and babies born through the TESA/TESE/PESA techniques.
When all else has failed, we counsel couples on the use of third party reproduction, such as the use of donor sperm. There is a process of matching and evaluation of the third party to enable the suitability of the sperm for the said purpose.
The use of antibiotics has also been proved to be effective in treating sexually transmitted infections, such as syphilis and gonorhoea. Similarly, changes in lifestyle, such as quitting cigarette smoking and psychoactive substances, relief from stress, weight loss, dietary change and avoidance of toxins have also shown a significant improvement in the sperm qualities
Total detoxification of the body in a medical spa helps to remove toxins, such as food preservatives, drugs, cosmetics which have propensity for vital organs in the body, thereby improving fertility and overall patient wellbeing.
In summary, the diagnosis of male infertility is not the end of the road for the couple. We encourage both partners to seek treatment together.