—Dr. Vineet Malhotra, clinical Director, Diyos Hospital.
Infertility is one of the most common issues being faced by couples and is still not discussed properly in our country.
According to reports of the Indian Society of Assisted Reproduction, 15% of the Indian population of reproductive age suffers from infertility. One in six couples is facing infertility issues in the urban cities as per WHO. 40% of cases are attributed to men, 40% to women, and 20% to both. Most women typically seek treatment first and when the cause of the problem doesn’t lie with them, they have to show their male partners to Gynaecologists. In most of the cases, females have advised investigations and further taken for ICSI and IVF. Males are usually ignored and not been diagnosed properly.
They are not being referred to male fertility specialists for further evaluation and necessary treatment. Denial is common in men, as they tend to think that they have done something wrong and harmful to themselves by doing some of the other activity. It’s hard for them to accept that the issue is internal and out of their control. At Diyos, we rule out the exact cause and diagnosis of male infertility in men. There are several symptoms for male infertility, lox sexual desire, difficult ejaculation, pain followed by swelling in the testicle area, low sperm count, history of prostate problem, or any testicle-related issue.
The most common causes which are identified for male infertility are disorders of sperm (can be odd shaped, not moving in the right way, not at all moving, also known as Azoospermia, or not fully growing). Varicocele (swollen veins in the scrotum) is one of the most common causes of infertility in men and contributes to around 22% of diagnoses. Varicocele causes low and reduced quality of sperm in men and harms sperm growth by blocking blood flow. In many cases, obstruction is a cause wherein sperms are blocked because of past infections, surgeries like vasectomies, having such blockages prevents sperms from testicles to leave the body during ejaculation.
Patient with retrograde ejaculation, where the semen goes backward in the bladder instead of coming out of the penis is one of the factors for male infertility. Men on anabolic steroids cause shrinkage of testicles and decrease sperm production and add to male infertility issues. Stress and depression do affect sperm production in many cases.
At Diyos, we do a detailed clinical assessment wherein an infertility questionnaire is shared with the patient and further scoring is done to access the infertility problem. To diagnose several investigations are performed viz, semen analysis, hormonal profile, ultrasound scrotum, genetic tests, etc; to rule out the cause of male infertility. We offer specialized treatments available for treating male infertility, viz, microsurgical varicocelectomy to fix the swollen veins, leading to sperm movement, numbers, and structure.
Microsurgical vasovasostomy is performed to treat some blocks. We do perform vibrator tests in OPD for patients who are unable to provide semen samples for examination. Patients who are still unable to perform vibrator tests are finally taken for Electroejaculation under general anesthesia for semen sampling. Further Tesa and Micro-Tese procedures are carried out for sperm retrieval and the sample is then cryopreserved to be used further in treatment.
At Diyos, non-assisted reproduction is less promoted and we primarily focus on natural conception with normal pregnancy. Hence, with the right diagnosis, right treatment, and emotional support, we aim to provide a childless couple a path to conceive and achieve normal pregnancy and rise above all mental restrictions and age-old taboos and stigma that surround infertility.