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Frequently Asked Questions

What is Infertility ?

Inability to conceive after 1 year of Unprotected Intercourse, in a simple way Husband & Wife are trying for pregnancy since one year without using any contraceptives – like Condom, Pills etc & Wife not getting pregnant,this is known as infertility.

How many couples get infertility problems ?

About 10–15% of couples get infertility problems.

What are the causes of infertility ?

One third due to hormonal, One third due to some diseases of husband & wife & in one third causes are unknown (Unexplained infertility )

What is the percentage contribution of husband & wife in infertility.?

Female only – 41%
Male only – 24%
Both – 24%
No Cause – 11%

What are the Causes & their percent Contribution for Male Infertility ?

No/Nil Count – 41.15%
Low Count – 40.86%
Low Count with Varicocele – 40.86%
Dead Sperms 3.45%
Sex Problems 2.08%
Genital Abnormalities – 1.87%
NO Discharge – 0.62%

What are the different factors responsible for male infertility ?

The factors are – Hormonal, illness, defects in sperm production, passage obstruction, disease of prostate & seminal vesicles, dilated scrotal veins, back flow of semen in the urinary bladder, defects in male genital organs, poor sex techniques, sexual dysfunctions & unknown causes. In short the factors may be genetic, diseases, environmental, toxic, occupational and nutritional.

How pregnancy occurs ?

Sperm by natural intercourse deposited by husband in the female genital part of wife. At the same time mature egg in released by ovary, picked up by tubes of uterus, fertilized by sperms in that tube. The Embyro produced transported in the tube towards uterus & must implant in the uterus lining to grow in the uterus.

What are the Standard Normal semen parameters ?

The Normal semen parameters are -
* Volume > 2 ml
* Count > 100 mill / ml
* Motility > 75%
* Grade either IV or III type either IV or III type
* Live Sperms > 75%
* Pus Cells 4-6 / h.p.f.
* Aggregates < 10%

What is the minimum required parameters in semen for Fertility ?

Minimum requirements for Fertility should be -
Volume Upto 2.0 ml.
Count 20.0 mill / cu.ml
Motility 50-75%
Grade Either IV or III
Normal Forms Upto 14.0%
Pus Cells < 4-6 / h.p.f.
Agglutination Nil

How many days required for sperm to appear in the ejeculate from the site of production ?

Usually it takes about 19-23 days to appear in semen from testes.

How long the sperms remain active in female genital tract ?

Normally the sperms remain active in female genital tract from 2-7 days.

What is the duration of sperm capacity to fertilize the ova in the female genital tract ?

Probably it is 1 day

Can we predict the pregnancy rate with normal sperm morphology ?

yes, we can predict.
Sperm Morphology Pregnancy Rate
0-14 % 37 %
15-30 % 81 %
31-45 % 82 %
46-60 % 91 %

What should be the percentage of normal sperms in semen ?

It should be more than 14%.

Can a man father a child with poor quality semen ?

Yes, many man can father a child with poor quality of semen. The shorter the duration of infertility, the better are the chances of pregnancy.

How reliable is the semen examination for diagnosing male infertility ?

The reliability of semen examination for male infertility problem is only 60%

What are the common abnormalities seen in semen Examination ?

The common abnormalities are – NO discharge or NO ejeculation (Aspermia)
NO sperms in semen (Azoospermia)
Low sperm count (Oligozoospermia)
Poor motility of sperms (Asthenozoospermia)
Total non motile/dead sperms (Necrozoospermia)
Pus cells in semen (Pyospermia)
Clumping / aggregates of spermatozoa – Head to head, Tail to tail & Head to tail , in such cases there may be possibility of Antisperm Antibodies

My semen examination report is abnormal, what to do ?

Single semen examination is not sufficient to level it as abnormal. at least three semen examinations at an interval of one & half months is necessary to label it as abnormal.

Is there any treatment for Nil sperm in Semen ?

Yes, but in some cases only, depending upon hormonal & biopsy reports. It is either by hormonal or surgical treatment. If it is because of obstruction, the results are good.

Is there any treatment for low sperm count or poorly motile sperms ?

Yes, but in some cases only, depending upon hormonal, biopsy & other investigations.

What is Polyzoospermia ?

When sperm count is more than 250 millions/ ml

What is Teratozoospermia ?

When there are more than 90 % abnormal spermatozoa

What is Necrozoospermia ?

When all the spermatozoa are dead in such cases we have to see whether the sperms are totally dead or they are live but non motile and appearing dead.

What is the procedure of Semen Examination ?

There should be sexual gaping (no intercourse/masturbation) of atleast for 3–5 days. semen is collected by masturbation (Hand Practice) in a wide, dry plastic container.without spillage. Sample should reach to the Laboratory with in half an hour, if brought from home. The more the abstinance/gaping, the higher the chances of getting abnormal & dead spermatozoa, thus ideally the abstinance i.e. sex avoidance should be of 3 days.

What are the tests indicated for abnormal Seminal Parameters ?

Complete Semen Examination.
Morphology Percentage of Sperms.
Hormonal tests (FSH, LH, Inhibin B ,AMH , free and total Testosterone etc).
Colour doppler test for dilated veins of Scrotum (i.e. varicocele)
Semen & urine culture tests.
Testicular biopsy.
Chromosomal tests (Karyotyping)
Y chromosome Microdeletion tests.
Anti sperm antibodies in semen & blood
Advanced Sperm Function tests (HOS, Acrosome Intactness tests etc).

How the abnormal seminal parameters are treated ?

The treatment may be –
Hormonal, Surgical, Nutritional & Preventional.
Genetic causes are difficult to treat .

Clumping or aggregation of sperms, is it because of antisperm antibodies ?

Yes, but sometimes it may be because of bacterial (like E. Coli, Proteus, Pseudomonas) infection besides Anti sperm antibodies.

How Antisperm Antibodies affect fertility ?

Antisperm Antibodies can reduce fertility potential by affecting –
motility & survival of sperms, fertilization, implantation, tubal movements, embryo survival & by causing abortions.

What is the treatment of Antisperm Antibodies ?

Anti sperm antibodies are found in blood & semen. The anti sperm antibodies are treated by giving corticosteroids, for a longer period of time, with serious side effects. hence it is usually avoided. These antisperm antibodies in semen can be reduced to a maximum extent by washing of spermatozoa with different chemicals,

What is Post Coital Test ?

It is basic test for infertility evaluation. Post coital test (P.C.T.) test is finding live spermatozoa 8 to 10 hours after natural sexual intercourse in the female genital tract around the time of egg rupture / release. Normally there should be 8 –10 actively motile Spermatozoa per microscopic field.

What is semen bank ?

It is the place where the sperms after chemical treatment kept for indefinate period of time without loosing the quality.

What is the Purpose of keeping our own sperms in Semen Bank ?

The sperms after chemical treatment can be kept in sperm Bank for years together in some unfortunate or medical situations like –
Description: http://www.infertilemale.co.in/images/bullot.gif Unfortunate loss/death of Child.
Description: http://www.infertilemale.co.in/images/bullot.gif Before going for Vasectomy (Nusbandi)
Description: http://www.infertilemale.co.in/images/bullot.gif Cancer patients before surgery
Description: http://www.infertilemale.co.in/images/bullot.gif Cancer patients before receiving chemo/radiotherapy.

What is the use of Donar Sperm Bank ?

Some patients donot have sperms in their semen. Such patients can take personality matching sperms from certified & Standard donor sperm Bank.

What is husband personality matching donor semen samples ?

The husband personality matching samples are – blood group, colour of skin, eye, hair & bone structure matching.

From where the donors are selected ?

The donors are selected from all walks of societies. Their I.Q., Genetic & Medical disease testing done for different diseases like AIDS, Hepatitis, Sex & other diseases etc . They are kept under observation up to six months before using their sperms for patients.

How confidential is it ?

It is 100% confidential

Can we take donor sperms from our known Relatives ?

NO, We do not allow such practice. Ideally this should be avoided. Donor & patients should be unknown to each other.

What is the meaning of IUI, IVF – ET & ICSI Words ?

These are related with Assisted Reproductive Techniques (ART) - 
Description: http://www.infertilemale.co.in/images/bullot.gif IUI -Intrauterine  Insemination 
Description: http://www.infertilemale.co.in/images/bullot.gif IVF- Invitrofertilization
Description: http://www.infertilemale.co.in/images/bullot.gif IVF-ET-Invitrofertilization with Embryo Tranfer.
Description: http://www.infertilemale.co.in/images/bullot.gif ICSI-intracytoplasmic Sperm injection.

What is the success rate of all these ART procedures ?

The overall success rate varies from 15-30%.

What are the chances of getting genetic or birth abnormalities using all these procedures?

Nil, rather it is equal to as getting pregnant by natural way.

Words common in Male Infertility :-

A.

Azoospermia, Asthenozoospermia, Aspermia, Agglutination, ART, AID, AIH, Androgen, Ambiguous genitalia, Anti sperm antibodies.

B.

Buccal smear

C.

Clomiphene Citrate, Chromosomal Studies, Cryopreservation & Cryptorchidism.

D.

Donor Sperms

E.

Epididymus, Epididymitis, E.Coli, Ejeculation, Ejeculatory duct obstruction.

F.

FSH, Fertility

G.        

GIFT, Genetic Diseases, GnRH, Gynaecomastia

H.           

Hypergonadism, Hypogonadism, HCG, HMG

I.

Immobile cilia syndrome, Impotance, Infertility, Insemination, IUI, IVF, IVF- ET, ICSI

K.

Klinefelter’s Syndrome, Kallman’s Syndrome

L.

LH, Leydig cell, Libido

M.

Maturation Arrest, MESA, MICSI

N.

Noonan’s Sundrome

O.

Oligozoospermia, Orgasm

P.

Prolactin, Pyospermia, PESA, PICSI, Penis, Phimosis, PCT, Prostatitis.

R.

Reproduction, Retrograde Ejeculation

S.

SCOS, SIFT, Semen, Swim up, Swim down, Spermatogenesis, Spermatogonia, Spermatids, Spermatocyte, Sterlization.

T.

Testosterone, Turner’s Syndrome, TESE, TDI,Tamoxifen citrate, Teratoma, Testicular biopsy.

U.

Unexplained infertility, Uretheritis, UTI

V.

Varicocele, Vasography, Vasotomy, Vasoepididymostomy, vasectomy.

W.

Withdrawl Coitus

X.

X-bering sperms

Y.

Y chromosome, Y bearing sperm, y chromosome microdeletion