Male infertility – delayed conception

Male infertility – delayed conception

Delayed conception and male infertility are problems that affect the male’s ability to reproduce. It can be caused by different factors and it is essential to establish the cause to determine the treatment plan.
What are the causes of delayed conception in males and what are its presenting symptoms?

What are the symptoms of male infertility?

There are clear signs and symptoms that indicate male infertility:

  • Inability to conceive 
  • Hormonal disturbances that are presented by changes of hair growth pattern and decreased facial hair
  • Changes in sexual functions 
  • Testicular pain and swelling 
  • Chromosomal abnormalities 

If any of those symptoms occur, it is essential to seek advice from a specialized physician to make a proper diagnosis and treatment protocol

What are the causes of delayed conception ub males?

The factors that affect conception include:

Sexual disorders:

Premature ejaculation, genetic problems like blockage of the genital tract and sexual organs injuries

Environmental factors:

Premature ejaculation, genetic problems like blockage of the genital tract and sexual organs injury

Tumors:

Some tumors affecting the testes, the prostate or the spermatic cord may cause hormonal disturbances resulting in prevention or disorders of spermatogenesis (synthesis of sperms) resulting in fertility problems.

The Prostate and delayed conception

Some prostate problems may cause delayed conception due to deceased or disorders of spermatogenesis like: benign prostatic hyperplasia, prostatitis or prostate cancer.

Hormonal disorders and delayed conception

Sperms are affected by a hormone called androgen and any disturbance in this hormone leads to delayed conception.

Sperm blockage

Sperm count may be normal but they may not reach the ejaculate due to some problems like: infection, injuries and surgeries

Retrograde ejaculation

This condition causes the ejaculate to move backwards into the bladder instead or forward through the urethra. This may be caused by surgeries, bladder injuries, urethra injuries or as a result of some diseases like multiple sclerosis, spinal injuries and diabetes 

Testicular disorders may lead to delayed conception

Problems of the testes like increased testicular temperature, varicoceles and undescended testes may decrease in sperm count and quality

Immunological infertility

This is caused by the presence of antibodies that cause decreased sperm quality affecting their ability to reach the fallopian tube for conception. As anti-sperm antibodies cause decreased fertility

Diagnosis of infertility and delayed conception

Examination usually starts with:

  • Physical examination and history taking: this allows for discovery of varicoceles or indicate hormonal issues
  • Sperm analysis
  • Ultra sound of the testis to determine the presence of varicoceles .
  • Rectal ultrasound to inspect the prostate.
  • Testicular biopsy: to determine if spermatogenesis is affected. If not, then a blockage is investigated.
  • Genetic screening: to determine genetic or congenital defects causing infertility.
  • Blood tests: to determine testosterone and other male hormones levels.

Treatment of male infertility

To determine an effective treatment protocol, a diagnosis is needed by factoring in the cause and duration of the problem. 

The desired optimum result is to completely cure infertility if possible

Penile implant

They may be indicated in cases of erectile dysfunction unresponsive to treatment
There are two types of prosthetic penile implant:
– Malleable implant: malleable metallic cylinders covered with medical grade Silicone.
– Hydraulic inflatable implants: they are the most used and they have the advantage of full penile relaxation when not in use.
They are simple surgeries that don’t change the structure or tissue of the penis. They only add rigidity and mostly don’t need hospital stay.
The success rate of implant surgeries is 97% due to recent advances in the techniques used

Lifestyle changes

Some life style changes may aid in recovery of fertility like regular workout or sports, smoking and alcohol quitting or stopping medications that may affect fertility under the supervision of a qualified doctor.

Pharmaceutical treatment

Some drugs aid in increasing sperm count and the probability of conception. They can also treat testicular disorders increasing spermatogenesis and its effectiveness.

Surgical interventions

Surgeries are used when other treatment protocols are not effective. Surgeries are used to remove blockage and restore sperm mobility. They can also be used to treat varicoceles and prostate problems..

Treatment of delayed conception in Dar Elzokora

1– Once arrived, the patient goes through four stages:

An assistant physician takes a complete history of the case and the patient including chronic diseases or previous surgeries and procedures. This is essential for making a proper diagnosis.

2– A specialist determines the required investigations needed for highlighting the cause and making a proper diagnosis

3– After reviewing the patient’s history and investigation results, an accurate diagnosis is reached. Then an appropriate comprehensive treatment protocol is initiated under supervision of Dr. Osama Ghattas, Andrology surgeries expert.

4– A pharmacist explains the treatment protocol: its uses, proper doses and interactions with other drugs like those of diabetes and hypertension

Then continuous follow up of the case is maintained till the patient achieves full remission and recovery.

Ejaculation is caused by a combination of psychological and physical factors. The cause may include hormonal or neurologic problems. Thorough investigations and complete history taking are needed to determine the cause .

It could take about three months after starting the treatment but it depends on the condition and the types of treatments.

Some instructions may help in solving delayed conception problems:

– Sports and regular workout increase sperm quality

– Avoiding exposure high temperatures as they may affect spermatogenesis

– Quitting smoking and alcohol

– Avoiding exposure to radiation and insecticides

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