Editor’s note: Dr. Jamin Brahmbhatt is a urologist and robotic surgeon at Orlando Health and an assistant professor at the University of Central Florida School of Medicine.
CNN
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When heterosexual couples try and fail to conceive, the attention often focuses on the woman. That’s not always the case.
A few times a month, men come into my office and ask, “Maybe there’s something wrong with me?”
Why do some men deny it? I think the possibility that a man may have fertility issues may be more than just a clinical concern. For men who associate their masculinity with identity and self-worth, it can lead to a serious personal crisis.
For me, it’s easy to provide infertility testing and treatment, but it’s difficult to deal with my patients and the emotional and physical challenges that the journey to parenthood can present. I’ve seen couples break up due to difficulties in conceiving.
Recent Alabama court decisions regarding the definition of a fetus and access to assisted reproductive technology have put the spotlight on fertility issues, often spotlighted primarily as women’s issues. That is not the case, so it is important to broaden our focus and address male infertility. It also contributes to the challenges couples face and impacts those involved.
In the United States, approx. 1 in 8 couples Having difficulty conceiving or maintaining a pregnancy. Within this context, male infertility plays an important role and contributes to the health of those around them. 40% of infertility cases.
Couples are generally advised to undergo infertility testing after a year of unsuccessful attempts to conceive, based on the time period for healthy couples if the woman is under 35. If the woman is over the age of 35, the couple should undergo an infertility test after trying to conceive. 6 months of effort. The latter is caused by a decline in fertility with age, and early intervention is important. Although the stated age varies depending on the woman’s partner, it is essential that both partners are tested during the fertility assessment.
Additionally, there are certain health concerns that may affect fertility, such as known genetic conditions, previous surgeries that affected the reproductive organs, previous cancer that required chemotherapy, and chronic conditions such as diabetes. If so, men should talk to their health care provider before trying. For pregnancy. This proactive approach helps you address potential complications early in the process, leaving you prepared for a more informed and focused attempt to conceive.
The first minutes of meeting a male patient reveal what the facts and myths are about their fertility. It’s about being on the same page about online hype and real medicine. The main points I explain to my patients are:
Male fertility naturally declines with age, affecting sperm quality and genetic integrity. This process is influenced by lifestyle choices such as smoking or vaping, excessive alcohol consumption, and obesity, which can significantly reduce sperm quality and production.health issues such as varicocele, just as environmental factors such as heavy metals and excessive heat can damage sperm function, infections and hormonal imbalances can also impair fertility. Stress also inhibits the secretion of hormones needed for sperm production.
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For men seeking a comprehensive understanding of their reproductive health, it’s important to consult a professional.
It is important to dispel myths. Contrary to popular belief, tight underwear and recreational cycling have little effect on fertility. Although supplements can help with certain deficiencies, they do not universally improve fertility and should be used with caution. Finally, frequent ejaculation does not negatively impact overall fertility. Sperm counts may be temporarily reduced, but washing away old sperm can increase the chances of successful fertilization.
Men of all ages can begin assessing their fertility at any time, and modern technology has made it easier than ever.Various “pregnancy hunting” apps and semen analysis kit It can be used at home, allowing men to assess the quality of their sperm without a doctor’s prescription. While these tools are an important starting point, it’s important for those seeking a comprehensive understanding of reproductive health to consult a professional.
A urologist with expertise in men’s reproductive health has the ability to perform a thorough evaluation that goes far beyond what can be done with home tests, and includes information on genetic conditions, hormonal imbalances, lifestyle Addresses the complex issue of male infertility, which can be influenced by factors and environmental exposures.
Semen analysis is an important diagnostic tool in this process. Evaluate sperm count, motility, and morphology, which are important indicators of sperm health. When the sperm count drops below 15 million per milliliter, it is known as oligospermia and the chances of successful fertilization are reduced. Motility problems (less than 40% of the sperm are effectively migrating) can prevent them from moving to the egg. Abnormal morphology, where less than 4% of sperm have a normal shape, can interfere with the sperm’s ability to effectively fertilize an egg.
A complete fertility assessment includes a physical exam to check for varicoceles and other abnormalities, hormonal tests to uncover potential imbalances that may affect sperm production, Imaging tests may also be included to identify structural defects. By integrating these data points, healthcare providers can determine the best treatment options for each individual’s unique situation, from lifestyle adjustments and medical interventions to surgical solutions.
Treatment for male fertility issues can begin now. If you’re sitting, stand up; if you’re standing, start moving. Improved physical health and activity improves fertility. What else can be done depends on what a detailed assessment reveals.
Your doctor may recommend changes such as:
Start with nutritional supplements. However, please be careful. Not all supplements that promote infertility are the same.a 2019 survey It turns out that many of the claims about over-the-counter fertility supplements are not supported by sufficient evidence and should be used with caution. Backed by research, our office puts men on a cocktail of complex supplements packed with Coenzyme Q10, fish oil, and beneficial antioxidants (vitamin D, vitamin E, zinc, and selenium).
Repair large blood vessels. recent guidelines Research-backed studies have promoted surgical correction of severe varicoceles to improve sperm quality and even testosterone levels. This procedure addresses abnormal dilation of the veins in the scrotum, which can change the temperature around the testicles and impair sperm production. Improvements after surgery increase the chances of conceiving naturally.
Start medication. Depending on the underlying cause of infertility, drug therapy may play an important role. For example, hormonal imbalances may be corrected with medications that increase the body’s natural production of testosterone and other hormones involved in sperm production. These non-testosterone-based drugs include clomiphene citrate and anastrozole.
Direct testosterone supplementation is often not recommended as it can stop complete sperm production. but, recent research They found that the use of intranasal testosterone is a viable option for men who want to continue replacement therapy but do not want their sperm count affected.
Production assistance may be required. Intracytoplasmic sperm injection is a powerful technique often used in conjunction with in vitro fertilization. This involves injecting a single sperm directly into the egg to facilitate fertilization. This is especially helpful for men with low sperm counts or problems with sperm motility or morphology.
Addressing male infertility requires care that goes beyond medical care. In a culture where men don’t talk about fertility and where infertility incorrectly defines someone as less of a man, we need to create a culture where we can talk about men’s reproductive health.
As a urologist specializing in this field, I believe that greater awareness and understanding is critically needed. By providing both emotional support and comprehensive education on the subject, we can transform the conversation around male infertility, making it a topic that can be openly discussed rather than whispered about in bedrooms and doctor’s offices. .
