All over the world, the problem lies solely in the men partner in about one in five infertile couples and in about another quarter of cases, both partners are responsible for the problem. Although, there is common belief of blaming only female partner are still prevail. It has been estimated that one in 20 men have some kind of fertility problem and one in every 100 men produces no sperm in their ejaculate. But fortunately, one in eight infertile men are medically treatable.
Medically untreatable sub-fertility
Three quarters of infertile men have sperm present in the semen but with subnormal value. Procedures like, intra-uterine insemination (IUI)-Inserting prepared sperm into the uterus or in-vitro fertilisation (IVF)-insemination of egg with prepared sperm in a dish, can help this group of men to overcome the situation.
Untreatable male sterility
About one in nine infertile men has no sperm in their semen. Azoospermia may be due to absent sperm production or blockage in the duct. At present no treatment is available even with modern IVF settings to treat male infertility with absent sperm production but infertility due to blockage can easily be treated by intracytoplasmic sperm injection (ICSI) in conjunction with epididymal or testicular sperm aspiration or testicular biopsy under local anaesthesia or with frozen sample. Thus this procedure is mainly indicated for male factor infertility in which the count, motility, or strict morphology is low. In a highly reputed IVF clinic has achieved cumulative pregnancy rate with ICSI around 70 percent and found no significant increase in congenital defects in ICSI babies compared to general population.
Indications for ICSI
* Oligozoospermia ( < 20 million per ml)
* Asthenozoospermia ( < 30% progressive motility)
* Teratozoospermia (abnormal shaped sperm)
* Antisperm antibodies
* Fertilisation failure after conventional IVF
* Ejaculatory disorders
* Congenital bilateral absence of vas deferens
* Obstruction of both ejaculatory ducts
* Azoospermia due to obstruction
* Failed vasovasostomy
Even if it is very stressful for an infertile man after an initial diagnosis of infertility but man have to understand that absence of sperm in the semen is not the end of the world. And at the end of the day, with the help of ever advanced technology, a man need only one healthy sperm to fertilise an egg compared to minimum 100 millions in natural conception.
So, every man has to ensure that he has at least one healthy, good swimmer sperm by practicing a healthy lifestyle so that his future desire to have a healthy baby does not turn into ashes.
Dr Fatima Momtaz
Source: The Daily Star, June 27, 2009
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