Infertility is the inability to achieve pregnancy after 12 months of regular unprotected intercourse. Around 85% of infertile couples can identify a cause, with ovulatory dysfunction, tubal disease, and male infertility being the top three. The remaining 15% of couples face unexplained infertility. Notably, 1 in 8 women aged 15 to 49 seek infertility services, often discovering that male infertility is the root cause. The World Health Organization (WHO) estimates that over 80 million couples worldwide suffer from infertility.
Male Infertility: Key Factors and Causes
Male infertility accounts for approximately 35% of infertility cases. Common issues include low testosterone levels, low sperm counts, and other disorders of male physiology. Men should undergo a semen analysis as part of the infertility evaluation process, focusing on semen volume, sperm production, and quality. When no sperm are present in the ejaculate, and sperm are found in the urine, retrograde ejaculation may be diagnosed. Other conditions, such as obstructive azoospermia, where sperm transport is blocked, and non-obstructive azoospermia, often caused by primary testicular failure, can also lead to infertility.
Factors Affecting Male Fertility
- Immune Infertility: Anti-sperm antibodies are found in 10-30% of infertile couples. Factors like trauma, surgery, infections, and varicocele contribute to their production.
- Genetics: Chromosomal anomalies and mutations account for 10-15% of male infertility.
- Mitochondrial DNA Deficiency: Lack of mitochondrial DNA in sperm negatively impacts fertilization.
- Klinefelter Syndrome: This chromosomal defect causes low sperm counts due to an extra X chromosome.
Non-Testicular Causes
- Varicocele: Swollen testicular veins, affecting 40% of infertile men.
- Obesity: Increases the risk of hypogonadotropic hypogonadism.
- Celiac Disease: Causes reversible infertility due to decreased semen quality.
- Lifestyle Factors: Alcohol, smoking, drug use, medications, and even activities like bike riding can affect fertility.
- Tobacco: Smoking may damage testicles and reduce sperm production.
Diagnostic Exams and Tests
The initial evaluation for male infertility includes a comprehensive physical exam, focusing on prior testicular trauma, infections, and environmental factors like heat or radiation. A detailed medical history, including thyroid, liver, and diabetes evaluations, is essential. Physical exams of the penis, scrotum, and testicles are crucial. Blood tests and semen samples collected on two occasions help further diagnose the issue. Ultrasound examinations of the testicles and surrounding tissues provide additional insights.
Treatment Options for Male Infertility
Hormonal manipulation is a common treatment, though testosterone therapy is generally ineffective and can suppress gonadotropin production. Estrogen plays a critical role in male fertility, and medications like clomiphene citrate and aromatase inhibitors that lower estrogen levels can improve sperm production.
Surgery is reserved for cases where a sperm delivery blockage is correctable, such as varicocele repair. Supplements like Coenzyme Q10, folic acid, zinc, L-carnitine, selenium, and vitamins C and E have shown some benefits in increasing sperm counts.
Platelet-Rich Plasma (PRP) in Male Infertility Treatment
Platelet-Rich Plasma (PRP) therapy has emerged as a promising treatment for male infertility. PRP, rich in growth factors and cytokines, is used across various medical fields to regenerate and repair tissue. A study published in July 2024 in the International Journal of Fertility and Sterility examined the impact of PRP injections on sperm parameters in men with severe oligoasthenoteratozoospermia (OAT). The study involved 88 men, with the PRP-treated group showing significant improvements in sperm concentration, motility, and reduced DNA fragmentation. These findings highlight PRP’s potential to enhance male fertility.
Other studies also underscore the growing concern about male infertility. For instance, the article “The Forgotten Men: Rising Rates of Male Infertility Urgently Require New Approaches for its Prevention, Diagnosis, and Treatment” , published in Biology of Reproduction, discusses the urgent need for innovative treatment strategies. Another article, “Diagnosis and Management of Infertility,” published in JAMA, provides comprehensive insights into the evaluation and treatment of infertility .
Juventix Regenerative Medical is a leading provider in the regenerative medical field, offering FDA-cleared Platelet-Rich Plasma kits designed for safety and effectiveness. Our kits ensure a platelet concentrate free of red blood cells and leukocytes, vital for the regenerative process. Juventix also offers LED Activators for safe platelet activation, promoting the release of growth factors without the need for chemicals. We also provide Bio-Incubators that transform PRP into injectable Platelet-Rich Fibrin (PRF), offering anti-inflammatory properties for treating various conditions.
References:
- “Effects of Testicular Platelet Rich Plasma Injection on Sperm Parameters in Men with Severe Oligoasthenoteratozoospermia (OAT): A Clinical Evaluation” International Journal of Fertility and Sterility (2024). PMID: 39033373
- “The Forgotten Men: Rising Rates of Male Infertility Urgently Require New Approaches for its Prevention, Diagnosis, and Treatment,” Biology of Reproduction (2019). PMID: 31553040
- “Diagnosis and Management of Infertility,” JAMA (2021). PMID: 34228062
