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What is infertility?
Infertility is a fairly common condition in which a man (or a woman) is unable
to produce offspring. From the medical point of view, infertility is defined as
the failure of a couple to conceive after one year of regular, unprotected
sexual intercourse. It affects 1 in every 6 couples.
Male infertility is diagnosed when, after testing of both
partners, reproductive problems have been identified in the male partner. The
major cause of male infertility is failure to produce enough healthy sperm.
What causes it?
Both men and women can have problems of infertility. Studies
showed that female and male factors each account for 30% of infertility cases
with the rest either both suffering from problems or having non-identifiable
causes.
Sperm problems are the leading causes of male infertility.
Any reduction in the quantity (i.e. sperm count) or quality of sperm reduces the
chances of conception.Known causes of male infertility are:
- Sperm production problems
- Genetic causes such as Klinefelter Syndrome and Down Syndrome, which are associated with low sperm counts
- Infections such as sexually transmitted infections and mumps may result in reduced sperm production
- Medical conditions such as undescended testes, varicocele and torsion of testis
- Drugs such as anabolic steroids, cancer drugs and some anti-hypertensive drugs
- Sexual problems such as erectile dysfunction, premature ejaculation and
failure of ejaculation
- Hormonal causes such as pituitary tumours, though these are uncommon
- Antibodies which make sperm clump together so that they can't move
properly
- Other reasons such as poor quality sperm after vasectomy reversal; spinal
cord injury; and medical conditions like diabetes and hypospadias
What are the main symptoms?
In most cases, there are no obvious symptoms apart from the
fact that your partner cannot become pregnant.
How can I prevent it?
- Practise safer sex such as using condoms to avoid sexually transmitted diseases.
- Don't smoke and drink in moderation.
- Avoid using anabolic steroids as they shut off sperm production.
- If you are taking any medicines, check whether they could affect sperm quality – talk to your doctor.
- Stay away from illicit drugs – one joint of cannabis can affect sperm production for 36 hours.
- Some vaginal lubricants are spermicidal or impair sperm activity.
What to do if you think you may have infertility problem
- Seek medical advice, but don't panic if your partner doesn't become pregnant
straightaway – conception takes time even for the fertile couples. The usual
rule of thumb is to wait a year before seeking help.
- Your partner also needs to be checked out because (obviously) it takes two
to make a baby.
- Undergo tests as advised by your doctor, which may include:
- Semen
analysis
- Sperm
function tests
- Blood and
urine tests to check for infections
- Hormonal
blood tests – the key one measures FSH
(follicle stimulating hormone), as very
high levels indicate that sperm production
has failed
- Genetic
tests looking for major chromosomal
abnormalities
- Testicular
biopsy – a tiny sample of tissue may be
extracted using a needle to find out
what's happening to sperm production
- A special
X-ray to check for blockages in the vas
deferens tubes and ejaculatory ducts
What are the main treatments?
Before considering any specific treatment, make sure you are
adopting healthy lifestyle such as quitting smoking and consuming alcohol
sensibly.
Treatments for infertility depend on the causes for it.
- Steroid
treatment to reduce sperm antibody levels
- Antibiotics for
infections
- Hormonal
treatments
- Medication for
some ejaculation problems
- Vitamins E, B12
and C, and zinc supplements may improve sperm
quality
- Erectile
dysfunction – the cause is physical in the
majority of cases and can usually be
successfully treated
- Surgical
treatment for conditions such as hypospadias
and varicoceles
- Assisted
conception techniques such as in-vitro
fertilization (IVF) and intra-cytoplasmic
sperm injection (ICSI)
How can I help myself?
- Finding out that you may have some sort of fertility problem may hurt your
pride. It's common to feel defective or a failure. Don't bottle up your
feelings and decide that you're a failure – you're not! Try talking to your
partner about how you feel – you may find that this helps both of you.
- Talking to other men in the same boat and discovering that you're not
alone can also be a great help.
- You may seek help from fertility counseling services such as the
Subfertility Service of the Family Planning Association of Hong Kong, or
Assisted Reproductive Units of hospitals under the Hospital Authority or
private hospitals.
- If all the treatments have failed, you could either accept to be childless
or consider adoption. Further information can be obtained from the Adoption
Unit of the Social Welfare Department at 2852-3107.
Statistics
Research shows that
- Infertility
affects 1 in every 6 couples
- Male
factors alone account for 30% of
infertility cases
Do You Know...
Safer sex, not smoking and sensible drinking can help prevent
infertility
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Hotline
Hong Kong Family Planning Association
Service Hotline Phone: 2572 2222
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