Dr Roland Chieng, Director, Specialist Obstetric & Gynaecology & Singapore Registered Acupuncturist, Virtus Fertility Centre provides us with insight on Male Infertility and its causes, prevention and treatment.
Infertility is defined as a failure to conceive in a couple trying to reproduce for a period of two years without conception. In a recent study published in PubMed, it was found that approximately 15 per cent of couples are infertile, and among these couples, male infertility accounts for approximately 50 per cent of causes.
As reported in Straits Times on 28 November 2012, doctors in Singapore have been seeing an increase of male infertility in recent years. Male infertility is a multifactorial syndrome encompassing a wide variety of disorders. In more than half of infertile men, the cause of their infertility could be congenital or acquired.
Common causes of male infertility
1: Poor sperm quality due to:
– High oxidative level as a result of age, excessive low or high activity level, Infection of the genital tract, smoking, alcohol and illicit drug abuse
– Medical conditions and treatment related effect such as inflammatory bowel diseases, Chronic renal condition, liver failure, etc
– Idiopathic
Usually this manifests with a normal sperm density but deficient in sperm motility and poor morphology giving rise to poor fertilising potential.
Treatment is generally difficult and is directed to the underlying causes if any.
Idiopathic cases have been effectively treated with high dose anti-oxidant such as vitamins.
Majority however are not treatable.
2. Sperm under production shown by a reduced sperm density.
Most of the cases are as a result of genetically related poor testicular function, such as chromosomal abnormality and undescended testes. Up to about 5% to 10%are still amenable to treatment using hormone manipulation and surgery. Therefore full investigation and assessment and warranted in order to restore normal fertility using appropriate therapy.
What can be done to decrease one’s risk of infertility?
Male infertility in contrast to female infertility is nearly always not obvious. Poor ovulation is obvious with menstrual abnormality; tubal obstruction cases will have history of past infections and severe dysmenorrhea. Abnormal sperm condition does not show in any way. The sexual function could be completely normal and the semen appearance will remain non conclusive. Therefore the only way left will be an early check with semen assessment whenever in doubt.
Healthy lifestyle remains important thereafter such as smoking cessation, maintain a healthy body weight and adequate physical activities.
Treatment and alternatives
There are currently 2 types of assisted reproduction techniques available for male infertility.
1. Intrauterine insemination which involves preparation of ejaculated semen and this sample will be placed in the uterine cavity at the projected time of ovulation.
2. IVF with ICSI.
This is IVF treatment where the fertilisation of the egg is done with micro injection of selected sperms in the laboratory. Nearly all cases of male infertility can achieve pregnancy by ICSI as long as adequate amount of sperm is available.
Do you have any questions about male infertility? Drop us your questions below.
By Dr Roland Chieng
Certified Specialist In Obstetrics And Gynaecology
Roland Chieng Fertility and Women Care
Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road #10-33 Singapore 329563
Tel: +65 6694 1833 | Fax: +65 6694 1823
Email: enquiry@FertilityCentre.com.sg
