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Male Infertility

Male infertility is any health issue in a man that lowers the chances of his female partner getting pregnant with unprotected sex. It can be due to low sperm production, abnormal sperm function, or blockages that prevent the delivery of sperm. Health issues, injuries, illnesses, and lifestyle choices can contribute to male infertility.

Male Infertility Symptoms

The main sign of male infertility is the inability to conceive. Other symptoms include:

  • Problems with sexual function (difficulty with ejaculation or small volumes of fluid ejaculated, reduced sexual desire, or difficulty maintaining an erection—erectile dysfunction
  • Pain, swelling, or a lump in the testicle area
  • Having a lower-than-normal sperm count
  • Recurrent respiratory infections
  • Inability to smell
  • Abnormal breast growth (gynecomastia)
  • Decreased facial or body hair or other signs of a hormonal abnormality

Causes of Male Infertility

Male infertility can be caused by a number of medical issues and health factors, such as:

  • Sperm disorders
  • Varicoceles
  • Infections (such as epididymitis, orchitis, or STIs)
  • Retrograde ejaculation
  • Undescended testicles
  • Hormone imbalances, such as low testosterone
  • Defects and obstruction of tubules that transport sperm
  • Problems with sexual intercourse, such as erectile dysfunction, premature ejaculation , or psychological problems that interfere with sex
  • Medications used in testosterone replacement therapy, long-term anabolic steroid use, and cancer medications (chemotherapy)
  • Prior surgeries, including vasectomy and surgeries involving the scrotum, testicles, prostate, and abdomen
  • Overexposure to certain environmental elements, such as heat, toxins, industrial chemicals, heavy metal, radiation or x-rays
  • Lifestyle factors, such as drug and alcohol use, smoking, and obesity

Male Infertility Diagnosis

Diagnosing male infertility problems usually involves:

  • General physical examination and medical history, including questions on sexual development during puberty.
  • Semen analysis, where semen is collected by having you masturbate into a sterile cup. Your semen sample is then sent to a laboratory to measure the number of sperm present and look for abnormalities or infections. The results of the semen analysis tests tell about your ability to conceive (start a pregnancy).
  • The doctor may order additional tests including, hormone and genetics evaluation, post-ejaculation urinalysis, testicular biopsy (when the semen test shows low sperm count), and other specialised sperm function tests. A scrotal ultrasound may also be required to see if there are other medical conditions such as varicocele or other problems in the testicles and supporting structures. A transrectal ultrasound may be ordered to see if the ejaculatory duct or seminal vesicles are poorly formed or blocked.

Male Infertility Treatment Options

In cases of infertility, it is recommended that the female partner also be checked. Treatment will depend on the cause of infertility. It includes surgery, medications such as antibiotics for infections, other types of oral medications depending on the cause, and hormone treatments.

Surgeries commonly performed at Colin Teo Urology to treat male infertility include:

  • Laparoscopic / Microscopic Varicocelectomy to correct a varicocele (swollen veins) to help sperm movement, numbers, and structure.
  • Vasectomy Reversal. For some men with previous vasectomy wishing to father children due to a change of circumstances, vasectomy can be reversed using microsurgery to join the two cut parts of the vas deferens in each testicle.
  • If patients with male infertility still fail to achieve a successful pregnancy with their partners despite the above measures, the couple will need to consider forms of assisted reproduction. Assisted reproductive techniques (ARTs) involve harvesting and processing healthy sperm either from a semen sample or directly from the testicles under anaesthesia.
  • Microscopic Testicular Sperm Retrieval (microTESE) is one of the techniques used in cases where no sperm is present in the ejaculate. To get enough tissue for sperm extraction, sperm can be retrieved directly from the testicles using an operating microscope. The sperm taken from the testicle can be used fresh or frozen ("cryopreserved").

Why should you choose Dr Colin Teo to perform Male Infertility treatments?

Dr Colin Teo is the Founding Head of Khoo Teck Puat Hospital’s Urology Department, with years of experience in minimally invasive keyhole surgery, operating with precision surgical techniques. Many fellows have trained under his mentorship. He did a Fellowship in EndoLaparoscopy and Andrology at St James’ Hospital in Leeds, UK and was sponsored for a Senior Healthcare Medical Development Program (HMDP) in Advanced Laparoscopic and Robotic Surgery at University of Southern California (USC) Keck Hospital in Los Angeles, USA. Dr Teo is also the President of the Society for Men’s Health.

Seek recommendations on suitable treatment options for male infertility with Colin Teo Urology. Contact us to book an appointment today.