Andrology

Andrology is the medical specialty that focuses on male reproductive health and disorders, particularly male infertility and sexual dysfunction. Male infertility is a common reproductive problem affecting men. When couples are not able to conceive after having unprotected sex for at least one year, it is important for both partners to be checked by their physician. One out of three infertility cases are linked to issues with the male partner.

Causes

Male fertility is based on the production of healthy sperm and delivering them into a female partner’s reproductive tract. This basic function may be impaired by many structural and functional factors such as

• Abnormal sperm size, shape, number and motility
• Enlarged veins in the scrotum
• Backward ejaculation of sperm
• Blockage of sperm-carrying ducts
• Hormonal imbalance
• Attack of sperms by body’s own defence system
• Chromosomal abnormalities
• Certain diseases and infections like kidney disease, testicular cancer and sexually transmitted diseases
• Certain medications
• Problems with sexual intercourse
• Excessive radiation exposure
• Excessive use of illegal drugs, alcohol and tobacco smoking
• Stress and obesity

Diagnosis

To diagnose male infertility, your doctor will first conduct a general physical examination and medical history to understand your sexual habits, sexual development during puberty, chronic health problems, medications and surgeries that could lead to infertility. Additional tests may be ordered including:

• Semen analysis: This is a laboratory test carried out to assess the sperm count and quality from a semen sample ejaculated into a sterile bottle.
• Transrectal ultrasound of the prostate: It is an investigation carried out to evaluate the prostate gland and detect any obstruction in the ducts that transport the sperm.
• Scrotal ultrasound: This is an imaging test to diagnose abnormalities of the scrotum or testicles.
• Testicular biopsy: A small piece of tissue is removed from the testicle using a sterile needle and evaluated under a microscope.

Treatment

Treatment measures for male infertility vary depending upon the cause. Sometimes, a combination of treatment options will be suggested to overcome the underlying problem. These include the following:

• Surgery is indicated in cases of obstruction of the sperm duct to improve the sperm motion and backward ejaculation of sperm.
• Medications such as antibiotics are prescribed to treat infections of the reproductive system.
• Male hormone replacement therapy may be used to treat hormonal imbalances.
• Counselling for sexual intercourse problems and relationships can help boost fertility levels.
• Lifestyle modifications may be suggested, including changing habits such as illegal drugs, smoking and alcohol intake, and using stress reduction techniques.

Assisted reproductive technology (ART) includes revolutionary treatment procedures that help couples with infertility problems to conceive. Some of them include intrauterine insemination (IUI), where sperm is placed into the female partner’s reproductive tract, intracytoplasmic sperm injection (ICSI), where a healthy sperm is directly injected into the egg, and in vitro fertilization (IVF), where fertilization takes place outside the body in a lab.