Andrology - Men’s Health and Infertility

Male Infertility is termed as a most common health issue found in males that lowers the chances of natural conception of a baby by his partner with his sperm. The fertility of a man completely depends upon the quantity and quality of his sperm. If the sperm that the man ejaculates is less in the count or is of poor quality, it makes it difficult, or sometimes impossible for him to make his partner pregnant. Infertility is a widespread problem and approximate 10% of males suffer from male infertility. It is estimated that 5% of men have some kind of infertility problem with low numbers of sperm and 1% male have no sperm in their ejaculate. It is worthwhile to note that almost half of all infertile couples have a malefactor, either alone or in combination with a female factor, as the cause of infertility. There is no obvious sign of infertility and many men are able to get an erection, have intercourse and ejaculate. The appearance of the ejaculated semen appears normal to naked eyes and medical tests are needed to check the quality of sperm. There could be many causes for infertility in men and through medical testing, the doctor may be able to fine the exact cause of the problem.

Abnormalities of semen parameters causes:

• low sperm count
• slow-moving sperms
• Improperly shaped sperms.

Other causes for infertility could be due to:

• genetic disorder
• medication effect
• obesity
• smoking
• alcohol intake.
Some men may have an absent sperm in the semen, a condition called Azoospermia. This could be due to problems with the testicles in producing sperms or due to an obstruction in the duct channel system transporting the sperms. Another reason for infertility could be due to damaged testicles due to injury, surgery, viral infections in childhood, or when they are undescended. In some cases, the testicles may be normal but may not receive hormonal signals from the brain to produce sperms. Lifestyle factors like poor or unhealthy diet, lack of physical activity, smoking, alcohol intake, drug abuse, stress may also adversely affect the chances of achieving pregnancy.

Male sexual dysfunction

Sexual Dysfunction is referred to as a situation when there is any kind of physical problem including:
1. Low testosterone levels
2. Blood vessel disorders
3. Stroke or nerve damage from diabetes or surgery
4. Smoking
5. Excessive alcohol consumption
6. Drug abuse
7. psychological problem including:

• Concern about sexual performance
• Marital or relationship problems
• Depression
• Feelings of guilt
• Effects of past sexual trauma
• Work-related stress and anxiety that prevents you or your partner from getting sexual satisfaction.
• Male sexual dysfunction is a common health problem and may affect men from all ages, however, is more common with increasing age.

The main types of male sexual dysfunction are:

1. Erectile dysfunction:

It is the inability to get and keep an erection for sexual intercourse. Erectile dysfunction is a very common problem could be caused by:
• Diseases such as hardening of the arteries, which affect blood flow
• Nerve disorders
• Stress, relationship conflicts, depression, and performance anxiety
• Injury to the penis
• Diabetes and high blood pressure
• Unhealthy habits like smoking, drinking too much alcohol, overeating, and lack of exercise.

2. Ejaculation Disorders:

Various types of ejaculation disorder are mentioned below:
• Premature Ejaculation: It is a situation in which ejaculation occurs before or too soon after penetration. This could be a result of depression, stress, history of sexual repression, low self-confidence, or lack of communication or unresolved conflict with a partner. Studies show that certain drugs and antidepressants may affect ejaculation. Other cause could be the nerve damage to the back or spinal cord.
• Delayed or inhibited ejaculation: It is a condition in which ejaculation doesn’t happen or takes a very long time. It could be caused due to a chronic health problem, side effects of certain medication, alcohol abuse of surgeries. It could also be caused due to psychological factors such as depression, anxiety, stress or relationship problems.
• Retrograde Ejaculation: It is a condition in which the ejaculate during orgasm is forced back into the bladder rather than through the end of the penis. This kind of problem is most common in males suffering from diabetes. In some men, retrograde ejaculation could be due to problems with the bladder nerves which force the ejaculate to flow backward.

3. Prostate problems:

The prostate is a walnut-sized gland found only in men just below the bladder. It surrounds the urethra (the tube that carries urine through the penis). The prostrate is responsible for making fluid for semen. With age, the prostrate grows naturally and usually without any problems.
All men are at risk of a prostate problem that could include:
• Benign Prostatic Hyperplasia (BPH), also known as an enlarged prostate. It is a condition in which the prostate gland grows to an unhealthy size.

Common symptoms of BPH include:
i. Frequent Urination
ii. Feeling that you are unable to get all urine out
iii. Difficulty getting a urine stream going
Benign Prostatic Hyperplasia doesn’t lead to prostate cancer.

• Prostate cancer. The risk of prostate cancer increases with age and could be caused due to family history.
• Prostatitis: It is a condition is caused due to inflammation or an infection of the prostate, often caused by bacteria and is common in young and middle-aged men.

4. Andropause

Andropause, also known as male menopause is an age-related problem that occurs in men due to changes in male hormone levels.

Andropause involves a drop-in testosterone (a hormone produced by the testes to fuel the sex drive) production in men over the age of 50. It is also known as testosterone deficiency, androgen deficiency, and late-onset hypogonadism.

Male menopause can cause physical, sexual and psychological problems such as depression, low energy, lowered self-confidence, insomnia, increased body fat, gynecomastia, erectile dysfunction, reduced libido, and infertility. One may also experience decreased testicle size, hot flashes, and loss of body hair.

5. Genital surgeries Circumcision

Removal of the foreskin, the skin covering the tip of the penis from the human penis is called Male Circumcision. In this procedure, adhesions are removed by opening the foreskin, and the foreskin is separated from the glans. The procedure takes less than 30 minutes.

The procedure is usually done on new-born babies for religious reasons. In older children or adults, the procedure can be performed to treat certain conditions like:
• balanoposthitis (it is the condition of inflammation of the tip and foreskin of the penis)
• phimosis (inability to retract the foreskin)
• paraphimosis (when the foreskin is retracted and can’t be returned to its original position)

6. Penile curvature

Penile Curvature is an abnormal bend that occurs in the penis during an erection. It could occur by birth and be associated with a condition like a hypospadias (abnormal opening of the urethra). It may also be a result of Peyronie disease. In this condition, the fibrous scar tissue develops in the deep tissues of the penis due to some previous injury to the penis or due to fracture of the penis (injury caused during intercourse). In some cases, it could also be a result of a surgery or radiation treatment for prostate cancer.

7. Penile augmentation

Penis augmentation or enlargement surgery is medically known as phalloplasty. It is a procedure to permanently enlarge the penis. Penile enlargement is seeked by men for both physical and psychological reasons. While the length of the penis is the primary concern, the penis enlargement surgery can also widen the penis. About one third of the total penis length is hidden inside the body. The penile lengthening procedure helps this hidden part of the penis to exteriorize by cutting the ligaments at the base of the penis through a small incision made on the lower abdomen allowing the penis to lengthen naturally. After that the tissue placed between the lengthened penis and the pubic bone.

Andrology

Andrology is a most common procedure used to treat issues related with male reproductive systems. It involves:

• Diagnosing the reasons of Male infertility.
• Identifying the requirement of application of therapeutic techniques to improve fertility.
• Embryo banking and related consulting services.

Dr. Manu Gupta specializes in treating problems associated with male reproductive system and other issues related to mail infertility. He is a well-known andrologist in Delhi. He is treating patients suffering from infertility through the most advanced techniques. His advanced procedures of treatment in Delhi promises to transform lives of millions of people.