We all have heard of terms like infertility or fertility-related problems. But do you know secondary infertility also exists? This condition arises when a couple has one child and is wanting to be pregnant again. This is when the couple is unable to conceive for the second time that the males may suffer from secondary infertility. In many cases, about one-third of all the secondary infertility cases can be traced to be originated in men. Secondary infertility strikes a man as age progresses, but this does not mean that all men who are ageing may have this condition. The only way to stay safe from this condition is to live a healthy lifestyle and stay away from tobacco and alcohol.
Dr Kanchi Khurana, Senior Fertility Consultant, Cloudnine Group of Hospitals, Chandigarh talks about secondary infertility in males:
Male Triggers of Secondary infertility
- Low sperm production
- Compromised sperm function
- Inadequate sperm delivery
Breaking down Secondary Infertility
It is an enlargement of veins in the scrotum or the sac of the skin encasing the testicles. This is one of the most common condition causing decreased sperm production and infertility in men. About 30 %of the infertile men may have varicocele.
2# Reduced or decreased testosterone levels
Testosterone or male sex hormone, commonly referred to, plays a key role in sperm production. Levels of testosterone can be decreased due to aging, injury to genital or urinary organs or certain medical conditions as genitourinary infections, thyroid disease, DM, TB, Mumps, Small Pox, Stress or surgery of the genital tract.
3# Unhealthy Habits
Drugs, tobacco and other such habits may make way for secondary infertility in men. It is only the build-up of toxins that is a major reason of secondary infertility in males.
4# Poor semen quality
As age advances, the quality of semen (that carries sperm) tends to decline. After 40 years, poor quality semen is one of the most common cause of secondary infertility in males.
One of the major concerns in today’s life is stress, which can be a cause of premature age lines, fatigue and infertility. Hence, in such times, one must be extremely careful in tackling stress effectively. One of the concerns of infertility can be chronic stress.
6# Prostate enlargement or Prostate removal
Prostate enlargement causes low sperm count and may hinder ejaculation. Prostate removal due to cancer or other conditions can cause retrograde ejaculation and hence infertility
7# Use of drugs
Some antibiotics and few medications used to treat high blood pressure, for example, can affect sperm count and quality. Also, chemotherapy or radiotherapy used for most of cancers will decrease the sperm count and quality.
8# Use of commercial sexual lubricant
These non-toxic, natural lubricants, including peanut, safflower and vegetable oils and petroleum jellies are toxic to sperms and hence decrease fertility.
Excessive weight gain decreases the levels of testosterone and increases estrogen levels. Other common causes of infertility include obesity, diabetes, etc.
Tips for managing secondary infertility in Men
Most of the times, ruling out the cause and treating the cause of infertility wins the battle and solves the problem. However, the treatment of secondary infertility in males depends upon the count and the cause leading to the same.
- Diagnostic Investigation: The easiest, most convenient and the best diagnostic investigation for a male suffering with secondary infertility is a semen analysis done after 48-72 hrs of abstinence at a good infertility centre. According to WHO (2010) guidelines/criteria, the normal count for sperms in a male is the count of more than 15 million per ml. If the count is more than 15 million per ml – Antioxidants and anti-ageing supplements can increase fertility in men .Drug treatment can also improve semen quality.
- IUI (Intrauterine insemination) as an option for planning a pregnancy: If the count is between 10-15 million per ml – IUI (Intrauterine insemination) which involves surgically placing sperms inside a woman’s uterus to increase the chance of fertilization.
- In-Vitro Fertilization: If the count is less than 10 million per ml – IVF which involves stimulating the ovaries of female to retrieve eggs and taking the husband’s sperm for fertilization with eggs in a lab to make embryos and transferring the embryos back to uterus helps to conceive. However, If the sperm count is nil, that is azoospermia, the cause of azoospermia again needs to be ascertained.
The key to coping with secondary infertility is to open communication channels with those that are close to you. Lean on your partner and open your heart to them about how you feel. Knowing you’re in this together can lend strength to your bond and prepare you both for medical intervention. Turn to close family and friends to help you navigate your headspace. There are myriad online support groups for secondary infertility that you can also draw inspiration from. For professional guidance, it is a good idea to meet a counsellor who can help you on the path to conception.
With inputs from Dr Kanchi Khurana, Senior Fertility Consultant, Cloudnine Group of Hospitals, Chandigarh
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