Male infertility

Male Infertility

Male infertility is a serious medical issue affecting millions of couples around the world. With the advancement of medical technologies and increased public awareness, more men are seeking help from specialized medical centers to address this sensitive issue. In Russia, the diagnosis and treatment of male infertility are becoming increasingly accessible, offering patients a greater chance of achieving successful conception.

Types of Male Infertility

Male infertility may present in different forms, depending on the underlying causes. The main types include:

• Secretory Infertility: Caused by impaired testicular function leading to insufficient or absent sperm production. This can result from varicocele, infections, trauma, or genetic disorders.
• Hormonal Infertility: Due to disruptions in the hormonal system, affecting spermatogenesis. Causes may include hypogonadism, pituitary, hypothalamic, or thyroid dysfunction.
• Genetic Infertility: Related to DNA abnormalities that lead to low or absent sperm production, such as Klinefelter syndrome.
• Immunological Infertility: The body produces antibodies against its own sperm, impairing their motility and fertilizing ability. This may result from infections, trauma, or inflammation.
• Obstructive Infertility: Occurs when blockages in the reproductive tract (e.g., due to scarring after infections or surgeries) prevent sperm from being ejaculated.
• Secondary Infertility: Affects men who were previously fertile but lost the ability to conceive due to illness, injury, age, or declining sperm quality.

Symptoms of Male Infertility

Male infertility is often asymptomatic and only discovered when pregnancy attempts fail. However, some signs may indicate reproductive problems:

• Changes in semen volume, consistency, or color
• Pain, swelling, or discomfort in the testicular area
• Decreased libido and erectile dysfunction
• Hormonal imbalance symptoms (e.g., obesity, reduced body hair, enlarged breasts)
• Frequent urogenital infections

It is important to understand that even in the absence of symptoms, fertility problems may exist. If pregnancy does not occur after a year of regular, unprotected sex, medical evaluation is recommended.

Causes of Male Infertility

Disorders in Sperm Production and Maturation:

• Hormonal imbalances (low testosterone, pituitary or thyroid dysfunction)
• Congenital anomalies (cryptorchidism, hypogonadism)
• Inflammatory diseases (orchitis, prostatitis, epididymitis)
• Exposure to toxins or radiation
• Chronic stress and fatigue

Factors Hindering Sperm Transport:

• Varicocele (enlarged veins in the scrotum)
• Obstruction of the reproductive ducts (due to infection, trauma, or surgery)
• Congenital structural abnormalities of the reproductive organs
• Sexually transmitted infections (e.g., chlamydia, gonorrhea)

Other Causes:

• Autoimmune reactions producing antibodies against sperm
• Unhealthy lifestyle (smoking, alcohol, drugs)
• Deficiency in essential vitamins and trace elements
• Age-related decline in reproductive function

Diagnosis of Male Infertility

Diagnosis includes a range of tests aimed at identifying the cause of reproductive dysfunction:

Laboratory Tests:

• Semen analysis: Evaluates sperm count, motility, morphology, and viability
• MAR test: Detects antisperm antibodies
• Hormonal profile: Measures testosterone, FSH, LH, prolactin, estradiol
• Genetic testing: Identifies mutations linked to infertility (e.g., AZF deletions, Klinefelter syndrome)
• Biochemical analysis of semen: Measures levels of fructose, citric acid, zinc, and other indicators of sperm function
• Bacteriological examination: Detects infections affecting fertility

Instrumental Diagnostics:

• Scrotal ultrasound
• Transrectal ultrasound of the prostate (TRUS)
• Doppler ultrasound of testicular vessels

Male Infertility Treatment

Conservative Treatment:

Indicated for infections, hormonal disorders, and mild infertility. It includes:

• Medications: Antibiotics, hormone therapy, antioxidants, vitamins, and trace elements to improve spermatogenesis
• Physiotherapy: Electrophoresis, laser, and magnetic therapy to improve blood flow in reproductive organs
• Lifestyle modification: Eliminating harmful habits, improving diet, reducing stress, and increasing physical activity

Surgical Treatment:

Used for anatomical obstructions or varicocele. Includes:

• Varicocelectomy: Surgical removal of varicocele
• Reconstruction of blocked reproductive ducts
• Sperm retrieval techniques: TESE, Micro-TESE, MESA, PESA — extraction of sperm from testicles or epididymis if absent in ejaculate

Assisted Reproductive Technologies (ART):

Applied when conservative or surgical treatments fail, or in severe infertility cases:

• In vitro fertilization (IVF) — fertilization in the lab followed by embryo transfer to the uterus
• Intracytoplasmic sperm injection (ICSI) — injection of a single sperm directly into the egg
• Intrauterine insemination (IUI) — using partner or donor sperm
• Sperm cryopreservation — freezing sperm for future use

Prevention of Male Infertility

Preventive measures include:

• Timely treatment of urogenital infections
• Avoiding excessive heat or cold exposure in the groin area
• Hormonal monitoring
• Healthy diet, regular exercise, avoiding harmful habits
• Minimizing exposure to toxins, radiation, and unsafe work environments
• Regular check-ups with an andrologist to detect early signs of infertility

Rehabilitation

Post-treatment rehabilitation focuses on restoring fertility and overall health. Key recommendations include:

• Following the doctor's instructions
• Balanced diet, no alcohol or smoking
• Moderate physical activity
• Physiotherapy, vitamin therapy, and hormonal correction if needed
• Psychological support to reduce anxiety and stress
• Regular follow-up exams to monitor progress and adjust treatment

Prognosis and Complications

Prognosis depends on the cause, timing of intervention, and chosen treatment. In many cases, especially those involving reversible factors, fertility can be restored. In severe or irreversible cases, natural conception may not be possible.

Potential complications include reduced semen quality, hormonal imbalance, and psychological stress from prolonged treatment. However, modern ART offers a realistic path to fatherhood even in complex cases.

Medical Care in Russia

Russia has a well-developed network of clinics specializing in male infertility treatment. Patients receive high-quality care using modern technologies. The MARUS medical tourism platform helps patients choose the right clinic for diagnosis and treatment, offering convenient access to professional healthcare services.