Male infertility is on the rise and now accounts for nearly 40% of causes. There are many factors leading to a low sperm count and treatment can be divided into lifestyle changes, pharmaceutical intervention and surgery
- Lifestyle changes:
i. Weight loss: Obesity is associated with low sperm counts as there is hormonal imbalance and low testosterone levels in these men. Hence it is important to loose weight
ii. Smoking: Smoking is known to decrease sperm counts and motility. It is seen that the impact of smoking is dependent on number of cigarettes consumed. T has been observed that men who smoked more than 15 cigarettes a day had a 20% reduction in sperm concentration.
iii. Diet: A deficiency in antioxidants may lead to poor sperm motility and morphology. Hence, fresh fruits and vegetables rich in antioxidants, a high protein diet helps. Also eating omega 3 fatty acids helps. Avoid trans fats which decrease sperm count.
iv. Good sleep: Sleep helps to rest the body and alleviate stress and inturn helps sperm parameters to improve
v. Exercise: It has been seen that aerobic exercises for 45 minutes on alternate days has been helpful in increasing semen volume and sperm counts.
vi. Stress reduction: This can be done through meditation, yoga and exercise. In case anxiety levels are high counseling and anti anxiety drugs may be given
vii. Alcohol and drugs: It is better to limit consumption of alcohol. Marijuana and cocaine have been known to impact semen parameters
viii. Vitamin and antioxidant supplements: Vit D has shown to cause decreased sperm counts. Vit E & C are both helpful in male infertility. Besides this anti oxidants like co enzyme 10, lycopene etc.
ix. Avoiding drugs which are detrimental: Some antibiotics , exogenous testosterone supplements, anabolic steroids, anti psychotics
x. Avoid eating too much soya: This contains phytoestrogen and disturbs the hormonal balance in males
xi. Avoid environmental toxins: Chemicals and certain organic compounds may be harmful.
xii. Avoid hot baths and tight under-wears which decrease the sperm count by increasing local temperatures
- Drug Therapy( Pharmaceutical intervention):
i. Antibiotics and anti inflammatory drugs: This treats any infection in male genital tract like prostatistis which impairs semen parameters by generating ROS
ii. Hormonal therapy: Many drug therapies are there to increase production of testosterone and indirectly improve sperm production – These include Injections of human chorionic gonadotropins, follicle stimulating hormone.These have to be taken regularly over a period of 3-6 months before effect can be seen. They only help if the cause is low hormones. Tablets of clomiphene can also be given.
- Surgical treatment:
i. Variocelectomy: This is an option where the cause of low sperm count is due to varicocele ( Dilated veins in testis) . This causes an increase in local temperature impairing the sperm count. Varicocelectomy involves removing this pathology
ii. Anastomosis of vas deference: This is needed where there is an obstruction of vas which leads to absence of sperms in semen. Reopening of obstruction in vas is required
iii. Surgical Sperm retrieval from testis: Sperms are directly retrieved through testis by needle aspiration or biopsy and used for ICSI. This brings hope for men with obstructive azospermia (absent sperms)