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Signs and Symptoms of Infertility in Men

Signs and Symptoms of Infertility in Men

Infertility in men is most often the result of a medical issue that can only be determined by medical tests and is not readily evident from physical signs or symptoms. However, there are medical conditions, treatments or physical injuries that may result in infertility and should raise concern.

Signs of infertility in men

There are few obvious or tell-tale signs of infertility in men. In fact, erections, ejaculation and the sperm itself may appear normal and reveal no signs of infertility or an underlying medical condition.

However, there might be obvious reason for male infertility, such as a vasectomy or a spinal cord injury. There could also be medical conditions or medication that is affecting sexual performance and fertility, as well as a range of lifestyle factors and the use of steroids or testosterone.

Symptoms of infertility in men

The term “infertility” is used in the medical field to describe a couple’s inability to conceive after a year of unprotected intercourse where the female partner is younger than 35, or after six months where the female partner is older than 35, or the inability to carry a pregnancy to term.

It is important to know that you are not alone in facing infertility. The incidence of infertility worldwide is high. In fact, the World Health Organization (WHO) estimates that approximately 8-10% of couples experience some form of infertility problem. However, the incidence of infertility may vary from region to region.

The truth is that male infertility is far more common than many people realise. In around 30% to 40% of the infertility cases that we work with at Cape Fertility, there is a male infertility factor involved – meaning that the cause of a couple’s infertility is due to, or partly due to, a medical problem experienced by the male partner.

It is also important to realise that “infertility” does not mean that you are unable to have a child, but rather that you will require medical assistance to achieve a pregnancy. Infertility is a medical disorder, which often needs appropriate medical treatment.

Fortunately, it is also true that there are a range of male infertility treatments available for the many possible causes of male infertility.

Causes of infertility in men

There are many factors that can cause male infertility.

Some are obvious, such as male sterilization or vasectomies, or spinal cord injuries, or erection or ejaculatory dysfunction. Other possible causes may be more difficult to pinpoint, such as previous mumps infection, any STDs (sexually transmitted diseases), previous surgery or old injuries especially in the groin area such as a torsion.

A range of lifestyle factors such as being overweight, smoking and drinking, or the use of steroids or testosterone can also affect the quality of the sperm.

Male fertility levels can also decline due to several causes such as age, stress, a compromised immune system, environmental factors like working with chemicals and heat caused by tight briefs, hot tubs and saunas.

There could be medical conditions or medication that is affecting sexual performance and fertility.

Problems with sperm production or the quality of the sperm are the top cause of infertility in men. In fact, male fertility is defined by the “sperm quality”, which refers to semen volume, sperm count, sperm motility (movement) and sperm morphology (shape).

For this reason, after a thorough medical review, the first male infertility test that is done is a sperm test.

How to identify infertility in men

Today’s advanced male infertility tests allow us to pinpoint the medical problem that is causing infertility, and also to recommend the best treatment for it.

The first test that we do at Cape Fertility is a semen analysis.

First, we look at the volume of the sperm. A normal volume is at least 1.5ml. If the volume is much lower than this, it raises the concern of a possible obstruction between where the sperm is produced and ejaculation.

Next, we consider the concentration of the sperm. One measurement of this is to look at how much sperm there is per millilitre of sample. We also look at how much sperm is in the entire sample.

We then move on to motility. General motility refers to what percentage of the sperm are moving, even if they are just twitching or swimming in circles. Progressive motility refers to the percentage of the sperm that are not just moving, but also actually making progress in its movement. We consider 42% for total motility to be within normal range and 32% for rapidly progressive sperm or sperm that is moving from point A to point B.

The next thing we look at is morphology, which refers to how the sperm looks. Men are often appalled to hear they have only got 4% or 5% normal-looking sperm. However, we only expect 4% of the sperm to look normal, because that is what is usually the case.

We also look at the pH of the sperm. This can give us information about what’s happening with the ejaculatory ducts that make the fluid to support the sperm. We can also see how many of the sperm are alive. We check for antibodies, because if you have had a previous vasectomy and a reversal, there can sometimes be antibodies that might hinder the sperm from moving normally.

This is the routine sperm test that we do at Cape Fertility. But thanks to our advanced facilities and technology, we are also able to do more advanced male infertility tests when necessary, such as DNA fragmentation, which looks at the DNA integrity of the sperm; and a whole spectrum of sperm function tests.

Where to get male infertility treatment

Fortunately, whatever challenge there may be related to the production of sperm or the quality thereof, there are advanced treatments available. For example, if there’s a severe limitation on the amount of sperm, there are other alternatives such as IVF or ICSI, during which the sperm is actually injected into the egg in a lab. Even if there is absolutely no sperm in the sample, there are medical and surgical options available to address this, and if those options are not suitable, there is always the option of a sperm donation.

The treatment or combination of treatments are often highly individual and obviously depend on what is revealed by the semen analysis report.

We offer many advanced treatments at our purpose-built premises in the beautiful city of Cape Town, with procedure rooms and a modern sophisticated laboratory adjacent to our Main Reception and Staff Offices. These facilities, along with our experienced team, ensure all the latest fertility treatments are used with great success at Cape Fertility.

If you are concerned about your fertility, we would like to invite you to set up an initial consultation with one of our fertility experts at Cape Fertility. It is as simple as contacting us here

At Cape Fertility, we value each individual patient and we look forward to providing you with individualised and personalised care, affordable quality fertility treatment, and higher success rates at our custom-designed premises in the Claremont Medical Village under the eaves of the picturesque Constantia Mountains and the back of Table Mountain.

 

IVF and Blocked Fallopian Tubes

IVF and Blocked Fallopian Tubes

 

If you are trying to achieve a pregnancy but have blocked fallopian tubes, you will be pleased to know that In Vitro Fertilisation (IVF) treatment has helped millions of women with blocked or damaged fallopian tubes to have a baby. In fact, IVF was created specifically to treat the many women who face the challenge of blocked fallopian tubes.

In this article, we find out what role the fallopian tubes play in conception and why they are so important to achieving a pregnancy, how blocked or damaged fallopian tubes can be treated and how IVF circumvents the challenge of blocked fallopian tubes to help achieve a pregnancy.

What role do the fallopian tubes play in conception?

The fallopian tubes are minute, delicate tubes that stretch from the uterus to the ovaries and are a crucial part of the female reproductive system.

As there is no direct connection between the ovaries and fallopian tubes, the egg is transported to the uterus in a peritoneal fluid produced by the fimbriae on the edge of the tube’s opening. When an ovary releases an egg during ovulation each month, the egg is picked up by the adjacent fallopian tube with the little finger-like projections called fimbriae at the very end of the fallopian tubes.

The egg is then gently moved down along the tube to meet the sperm. For this to happen, healthy tubal cilia are essential – these are tiny little hair-like projections inside the tubes. The cilia gently move the little egg along to where it can meet the sperm and, if fertilised, the cilia gently move the embryo along to the uterus, where it will hopefully implant and become a pregnancy.

How important are fallopian tubes?

It is easy to understand just how important these tiny, delicate structures are, because this is where fertilization usually happens. By transporting the eggs from the ovaries to the uterus, the fallopian tubes allow the egg and the sperm to meet, so fertilisation can take place.

If your fallopian tubes are blocked or damaged, the egg and the sperm are unable able to meet – and natural conception is not possible. In fact, it is so certain that a pregnancy cannot occur with blocked fallopian tubes that procedures to block fallopian tubes are used as a very effective form of permanent contraception, or sterilization.

However, for conception to take place, a fallopian tube not only needs to be open all along its length, it also needs to be free to move around, and the inside of the tube needs to have a normal structure.

Unfortunately, these small and fragile tubes can become dysfunctional in many ways. Fallopian tubes may be blocked for a number of different reasons, they may be damaged or swollen, or there could be damage to the actual structure of the tube preventing it from moving around freely or from moving the egg or embryo successfully along the tube.

It could be that the fallopian tubes are not blocked, but simply swollen or damaged by infection caused by a condition like endometriosis, a previous pelvic or sexually transmitted infection, or previous surgery. It could also be that scar tissue can hold the fallopian tubes down and prevent their free movement. It is also possible for debris of some kind to get inside the tube and cause a blockage. Similarly, there could be some slough or some tissue that is blocking the tube. The cilia – tiny little hair-like projections inside the tubes – can also become damaged or infected, and become unable to move an embryo down to the uterus.

Other possible causes of damage to the fallopian tubes include an internal infection caused by, for example, a burst appendix, bowel problems, or peritonitis – inflammation of the peritoneum, which is a silk-like membrane that lines your inner abdominal wall and organs. Damage to the fallopian tubes can also be the result of surgery to remove fibroids or cysts, which can cause adhesions or scar tissue.

Treatment Options

Unfortunately, there is no medication or natural way to unblock tubes or repair damaged tubes. It is also not possible to “flush out” fallopian tubes.

If tests by a fertility specialist confirms that the fallopian tubes are blocked or damaged, the treatment options are surgery and/or IVF.

Surgery is one of the treatment options for blocked or damaged fallopian tubes. However, often times, the damage may simply be too severe, and cannot be fixed, or surgery may simply not be the optimal treatment given your unique circumstances, such as your age or other additional fertility challenges you face as a couple.

The alternative to surgery is doing IVF.

IVF treatment for blocked fallopian tubes

In essence, the IVF process bypasses the fallopian tubes to achieve a pregnancy. Very simply stated, during IV, the female partner’s eggs are collected and fertilized with sperm in a laboratory. The embryo is then implanted into the uterus.

While this sounds simple, the reality is that IVF treatment involves a number of steps and procedures that typically spans 28 days. It involves taking fertility medications, as well as continuous monitoring through blood tests and ultrasound scans during your IVF treatment cycle. The IVF process also includes the egg collection procedure and the collection of a sperm sample, with which the eggs are fertilized in the laboratory. After three to five days in incubation, the best fertilized eggs – called embryos – are chosen for transfer into the uterus. A pregnancy test is usually done around Day 28 of the IVF process to determine if the treatment resulted in a pregnancy.

The process of having IVF treatment is quite a journey, but when you have your IVF treatment at Cape Fertility, you will enjoy truly individualised and personalised care. We value each individual patient and provide affordable quality fertility treatment as well as higher success rates at our purpose-built premises in the beautiful city of Cape Town.

At Cape Fertility, we use patient-friendly protocols and provide you with a customised cycle sheet, describing exactly what happens on each day, and when and how each step must be completed – from what medications should be taken and when monitoring needs to be done. This is prepared and carefully monitored by a team of fertility experts and you will have your own IVF co-ordinator to guide you through every one of the various steps of the IVF treatment.

IVF Treatment for blocked fallopian tubes

IVF is a safe and trusted medical treatment. It has been used to treat blocked fallopian tubes for more than three decades across the world, and its success rate is impressive. Since the first IVF baby was born in 1978, an estimated eight million babies have been born thanks to IVF treatment, helping millions of couples throughout the world overcome the challenge of infertility.

At Cape Fertility, we achieve some of the best IVF success rates in the world. Yet, we are always striving for higher success rates to ensure even more of our patients can experience the joy of have their own baby.

The first step in receiving IVF treatment for blocked, damaged or swollen fallopian tubes is simply to contact us by clicking here

We look forward to providing you with our signature individualised and personalised care!

 

Treatment for Blocked or Damaged Fallopian Tubes

Treatment for Blocked or Damaged Fallopian Tubes

Blocked or damage fallopian tubes are a very common cause of infertility.

Fortunately, there are a number of highly effective treatments for blocked or damaged fallopian tubes, most notably fallopian tube surgery and In Vitro Fertilisation (IVF), a highly effective fertility treatment that was originally created especially for women with blocked or damaged fallopian tubes.

The fallopian tubes are incredibly thin and delicate structures with tiny little hair-like projections inside the tubes. They can very easily become blocked or damaged.

Healthy, open and functional fallopian tubes are so critical to conception, that tubes can be purposely blocked as a form of permanent contraception. In fact, the reversal of blocked tubes due to sterilization is one of the most common requests we receive from patients. When a sterilization is done, the objective is obviously to damage the tube, so the sperm cannot reach or fertilize an egg. This is often done by placing a little clip or a little silicone ring on part of the tube, that compresses it and causes that piece of tube to die.

The fallopian tubes can also be blocked if debris of some kind gets inside the tube. Similarly, there could be some slough or some tissue that is blocking the tube. Another possible cause of a blocked fallopian tube is an embryo that got stuck in the tube instead of moving down to the uterus, called an ectopic pregnancy.

The fallopian tubes may also be damaged or swollen, or there could be damage to the actual structure of the tube preventing it from moving around freely or from moving the egg or embryo successfully along the tube.

Treatment Options

Unfortunately, there is no medication or natural way to unblock tubes or repair damaged tubes.

If blocked or damaged tubes are confirmed on an HSG test or laparoscopy, the treatment options include surgery and/or IVF.

Flushing The Fallopian Tubes

Some patients ask how they can flush out their fallopian tubes as a possible treatment.

It is true that sometimes when a HSG test is done to check the fallopian tubes, the dye that is injected into the uterus and flows through the fallopian tubes might dislodge tiny bits of debris from inside the tubes. However, this is not an established treatment and if there’s scar tissue damage inside of the tube, it certainly can’t be flushed out.

Surgery As A Treatment Option

Surgery is one of the treatment options for blocked or damaged fallopian tubes.

As an example, the best-case scenario for repairing a sterilization is if all that is required during surgery is cutting out the damaged section of tube and reconnecting the two sides. Unfortunately, this is not always possible, because – for example – a significant piece of the tube was removed (this is common when sterilizations are done at the same time as a Caesarean) and there is just not enough tube left to join up together. At other times, the damage may simply be too severe, and cannot be fixed.

IVF As A Treatment Option

The alternative to surgery is doing IVF.

Basically, the IVF process bypasses the fallopian tubes to achieve a pregnancy. Very simply stated, during IV, the female partner’s eggs are collected and fertilized with sperm in a laboratory. The embryo is then implanted into the uterus.

Practiced for more than three decades across the world, IVF is a safe and trusted medical treatment, and its success rate is impressive. Since the first IVF baby was born in 1978, an estimated eight million babies have been born thanks to IVF treatment, helping millions of couples throughout the world overcome the challenge of infertility.

At Cape Fertility, we achieve some of the best IVF success rates in the world. Yet, we are always striving for higher success rates to ensure even more of our patients can experience the joy of have their own baby.

How Do You Choose The Right Treatment?

Many factors need to be considered when selecting the right treatment option for blocked fallopian tubes.

When it comes to surgery, as with all medical procedures, there are some risks to consider. These include the anaesthetic as well as the risks of damage to other organs, such as the bowel, the pipe between the kidney and the bladder, blood vessels and the risks of infection.

In addition, it must be considered that just because a fallopian tube has been unblocked, it does not mean it will stay open or that a pregnancy is guaranteed. The surgery may also not be successful. There is also a risk surgery will cause scar tissue and result in an ectopic pregnancy (an embryo that implants in the fallopian tube instead of in the uterus). This can be an emergency, and if the tube ruptures, it might have to be removed.

Beyond the risks of surgery, there might be other reasons why your fertility specialist recommends one treatment rather than another.

To do this, your fertility specialist will carefully consider how much damage has been done to the tube. Sometimes, the damage may simply be too severe, and cannot be fixed.

Your age must also be taken into account. Older women face a race against time as a woman’s egg quality declines rapid after the age of 35. If you are just 25 and you have many years of good quality eggs ahead of you because you are younger, surgery might be more beneficial because you can get more pregnancies going forward. However, if you’re 40, you do not have as much time.

The right treatment will also depend on how many children you want to have. If you just want to have one more child, IVF treatment may be the better option because, at Cape Fertility, we have excellent success rates with even a single IVF cycle. But if you want to more children, surgery may be the better option for you.

There might also be a reason unrelated to your fallopian tubes for you to undergo IVF treatment, such as if your partner has a problem with sperm.

Of course, the costs are also a factor to consider. Not all medical aids will pay for the surgery. The costs of the surgery, which must be paid upfront to the hospital, include the surgeon, the anaesthetist and the hospital, and essentially it can end up costing the same as an IVF cycle. Of course, not all medical aids will pay for IVF treatment either.

However, for a more efficient treatment, that is equally cost-effective as surgery is, IVF is a good option.

Which is the right treatment for you?

The only one way to establish for certain which blocked fallopian tube treatment is best for you is to consult a fertility specialist and to have the necessary tests and investigations done. The right treatment always depends on your unique and individual fertility challenges.

The first step in receiving the right treatment for blocked, damaged or swollen fallopian tubes is simply to contact us by clicking here…

At Cape Fertility, we value each individual patient and provide affordable quality fertility treatment as well as higher success rates at our purpose-built premises in the beautiful city of Cape Town.

We look forward to providing you with our signature individualised and personalised care!

 

 

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