Male Infertility

Male infertility is the inability to conceive a child despite regular, unprotected sexual intercourse for at least one year.

Causes

• Sperm Disorders: Low sperm count, poor sperm motility, abnormal sperm shape.
• Hormonal Imbalances: Issues with hormones like testosterone and others regulated by the pituitary gland.
• Genetic Conditions: Such as Klinefelter syndrome or Y chromosome microdeletions.
• Varicocele: Enlargement of veins within the scrotum that can affect sperm production.
• Infections: Such as epididymitis, orchitis, or sexually transmitted infections (STIs).
• Ejaculation Issues: Retrograde ejaculation, where semen enters the bladder instead of exiting through the penis.
• Lifestyle Factors: Smoking, excessive alcohol use, drug use, obesity, stress, and exposure to environmental toxins.
• Medical Treatments: Chemotherapy, radiation therapy, and certain medications can affect fertility.

Diagnosis

• Semen Analysis: Evaluates sperm count, motility, and morphology.
• Hormonal Testing: Measures levels of testosterone, FSH, LH, and prolactin.
• Genetic Testing: Identifies chromosomal abnormalities.
• Imaging: Ultrasound to check for blockages or varicoceles.
• Testicular Biopsy: Examines sperm production at the cellular level.

Treatment

• Medications: Hormone treatments, antibiotics for infections, and medications for ejaculatory issues.
• Surgery: To correct varicoceles, blockages, or to retrieve sperm directly from the testicles.
• Assisted Reproductive Technologies (ART): Such as intrauterine insemination (IUI) or in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI).
• Lifestyle Changes: Improving diet, exercise, reducing stress, quitting smoking, and limiting alcohol.

Erectile Dysfunction

Erectile dysfunction is the inability to achieve or maintain an erection sufficient for satisfactory sexual intercourse.

Causes

• Vascular Issues: Atherosclerosis, high blood pressure, high cholesterol, and conditions affecting blood flow to the penis.
• Neurological Disorders: Multiple sclerosis, Parkinson’s disease, spinal cord injuries.
• Hormonal Imbalances: Low testosterone levels.
• Psychological Factors: Stress, anxiety, depression, relationship issues.
• Medications: Certain blood pressure drugs, antidepressants, and medications for prostate conditions.
• Lifestyle Factors: Smoking, excessive alcohol use, illicit drug use, obesity, lack of exercise.
• Chronic Diseases: Diabetes, kidney disease, cardiovascular disease.

Diagnosis

• Physical Examination: Checking for physical causes.
• Blood Tests: To assess overall health, hormone levels, and underlying conditions.
• Urine Tests: To look for signs of diabetes or other underlying health conditions.
• Ultrasound: To evaluate blood flow to the penis.
• Psychological Assessment: To identify emotional or psychological factors.

Treatment

• Medications: PDE5 inhibitors (e.g., sildenafil/Viagra, tadalafil/Cialis), hormone replacement therapy if low testosterone is diagnosed.
• Therapy: Psychological counseling, sex therapy.
• Lifestyle Changes: Weight loss, exercise, quitting smoking, reducing alcohol intake.
• Devices: Vacuum erection devices (penis pumps).
• Surgery: Penile implants or vascular surgery.