By Dr. Oliver Pack (Medical Doctor – Reg. No. 030308944).
The male factor infertility represents approximately 40% of all causes of infertility. The abnormal quality of the sperm affects practically half of the couples that present fertility issues. Since in these cases the chances of achieving a natural pregnancy are significantly reduced, the male factor must be meticulously evaluated.
A man is sterile when he is unable of producing fertilisation, whilst he is infertile when he has fertility problems that hinder or prevent the woman from conceiving a healthy baby with his sperm.
In this article, we want to get you in contact with the so-called ‘male factor’ in more detail: its causes, diagnosis and treatment.
To diagnose the male factor in patients, it is necessary to perform a medical history (information to create a medical history). This diagnostic includes: personal and familiar background, sexual habits of the couple, the consumption of noxious substances for fertility such as alcohol, drugs and cigarettes, the possible exposure to excessive heat or radiation; and a complete physical examinations to analyse the phenotype and the secondary sexual features, the state of the penis, the prostate, the testes, etc
In this case, the problem is in the production of male hormones that regulate the male sexual organs.
The problem of infertility occurs due to a blockage in the seminal ducts through which sperm should circulate.
In this case, the problem is in the testes, which do not correctly produce sperm cells due to either genetic or acquired issues.
In these cases the concrete cause of sterility is unknown. Within this cause, we may find alterations in the concentration, motility and morphology of the sperm cells.
Counseling plays a key role in addressing habits and situations that may compromise reproductive capacity, helping individuals make informed lifestyle changes to improve fertility. Hormonal treatments are often employed in cases of sterility caused by endocrine dysfunctions, while antibiotics are prescribed to resolve infectious processes that affect reproductive health.
Additionally, surgical interventions are effective for conditions such as varicocele, obstructive azoospermia, and cryptozoospermia, providing targeted solutions to structural or functional barriers to fertility.
Oligospermia is the term defined by a low concentration of sperm cells in the ejaculated sperm of a man of reproductive age. The World Health Organisation (WHO) has established that a concentration of less than 15 million sperm cells per millilitre of sperm should be considered oligospermia.
To diagnose it we must perform a spermiogram, which consists of a sperm analysis using a microscope to study both the amount and quality of the sperm cells (for example, if they have motility issues or a defective morphology).
Asthenospermia or asthenozoospermia happens when the sperm cells’ motility is abnormal. To diagnose it we perform a spermiogram in which the motility of the sperm cells is evaluated based on their progressivity, straight movement ability and speed.
When a man presents morphologic alterations in more than 96% of his sperm cells we are facing teratozoospermia. The morphology of an ideal sperm cell should be as follows: ovoid head, regular contour, single and straight tail, fixed and transparent nucleus. All this can be observed in a spermiogram.
The issue with oligospermia, asthenospermia and teratozoospermia is that they are asymptomatic pathologies, because they present no evident symptoms, such as pain, to detect them. Normally men who suffer from them do not find out until the time when the couple wishes to have a child and they undergo fertility tests.
Male fertility depends on many factors, it is not static. The spermiogram results alone are not enough, they must be interpreted together with other tests and a personalised clinical evaluation.
If a man wishes to have children and the medical treatments do not remedy his fertility issues, it becomes necessary to resort to assisted reproduction techniques.
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