268 286
HEALTH&FITNESS
268
June15
MALE INFERTILITY
As long as the working apparatus is in
order, most men assume themselves
capable of fathering a child – and that’s
a fair assumption, says obstetrician and
gynaecologist DR CHRISTOPHER NG,
whose fertility clinic offers help for the
15 percent of couples who experience
problems in this area. In half of these
couples, male infer tility can be a
contributing factor.
Apart from the well-known culprits
alcohol, tobacco smoking and obesity,
here are some other possible causes – an
unlucky 13 of them:
•
Varicocele
, a swelling of the veins that
drain the testicle that may prevent normal
cooling of the testicle, leading to reduced
sperm count and fewer moving sperm
•
Infections
such as gonorrhoea or
mumps that can interfere with sperm
production or sperm health, or cause
scarring that blocks the passage of
sperm
•
Retrograde ejaculation
, where semen
enters the bladder during orgasm instead
of emerging out of the tip of the penis
•
Anti-sperm antibodies
that mistakenly
identify sperm as harmful invaders and
attack them
•
Cancers and non-malignant tumours
that can affect the male reproductive
organs or the glands that release
hormones related to reproduction
•
Undescended testicles
that make
decreased fertility more likely
•
Hormone imbalances
, such as low
testosterone, resulting from disorders of
the testicles or an abnormality affecting
the hypothalamus, pituitary, thyroid and
adrenal glands
•
Sperm duct defects
•
Chromosome defects
(Klinefelter’s
s y n d r ome ) c a u s i n g a b n o r ma l
development of the male reproductive
organs
•
Sexual intercourse problems
resulting
from erectile dysfunction or premature
ejaculation
•
Medications
like testosterone replacement therapy, long-term
anabolic steroid use and chemotherapy; they can impair sperm
production
•
Previous surgeries
such as vasectomy, inguinal hernia repair,
scrotal or testicular surgery and prostate surgery
•
Environmental factors
, such as overexposure to heat, heavy
metals, toxins, radiation, x-rays and chemicals, which can reduce
sperm production or sperm function.
To determine the cause in a particular case, scrotal ultrasound
scanning, hormonal tests and chromosomal analysis are used.
Semen analysis
measures the number of sperm present and looks
for any abnormalities in their shape and movement, also screening
for sperm infections.
Treatment
Surgery
can correct a varicocele or repair an obstructed vas
deferens, explains Dr Ng, and vasectomy can be reversed. In cases
where no sperm are present in the ejaculate, sperm can be retrieved
directly from the testicles or epididymis using sperm retrieval
techniques as part of the IVF procedure. Sperm infections should be
treated with
antibiotics
.
Medication
and
counselling
can improve
erectile dysfunction or premature ejaculation, as can
hormone
replacement therapy
, while
multivitamins
(A, C and E),
zinc
and
l-carnitine
can improve sperm quality and motility respectively. In
the end, the couple may require
assisted reproductive technology
treatment; various forms of this are available.
GynaeMD Women’s & Rejuvenation Clinic
1 Orchard Boulevard
#04-03A Camden Medical Centre
6733 8810 |
gynaemd.com.sg