The burden and frustration that infertility brings to any couple can be daunting. According to worldwide statistics, Infertility is a worldwide problem worrying many couples who consider having kids. It affects about 15% of the world’s couples. That’s about 49.000.000 couples!

Male infertility can be the cause in more than 50 percent of the cases.So, male infertility is not a problem to treat lightly. Here we’ll know all about its causes, symptoms, diagnosis and who is the best male infertility doctor in Dubai.

What is male infertility?

A man is considered infertile when he does not conceive during the first year of his marriage despite practicing a normal marital life and without using contraceptive methods, as it occurs 60% of fertilization and pregnancy normally in the first year.

It happens either due to one of four problems; his sperm production, number, motility, or transportation. Any of these problems or combined affect the male’s chances of having kids.

What normally happens?

The male reproductive system is designed to produce and store sperm, also delivering them to the female reproductive system where it can fertilize the egg and make a fetus. As follows:

  • The testes produce sperms under the effect of some hormones like testosterone this process is called spermatogenesis.
  • The sperms then travel through some tubes.
  • The seminal vesicle and the prostate produce chemicals and fluids to keep the viability of the sperm.
  • Before ejaculation, these chemicals, fluids, and sperms combine forming the semen.
  • The semen is delivered to the female reproductive system by the penis.
  • The sperms start their journey in the female reproductive system towards the egg.

So, any problem affecting any part of this pathway may interfere with males fertility.

Causes of infertility in men:

There are many identified causes of male infertility, such as:

These are the most common causes of male infertility. These disorders make changes to sperm that don’t enable them to achieve fertilization. These changes include:

  • Abnormal shape.
  • Not fully mature.
  • Lack of motility.
  • Decreased sperm count (oligospermia).
  • Absent in semen (azoospermia).

These disorders include:

  • Undescended testes are present inside the abdomen which isn’t a suitable medium for spermatogenesis.
  • Infections especially viral infections such as HBV, HIV, and Mumps.
  • Inflammation

Inflammation in the reproductive or urinary tract whether infectious or noninfectious like orchitis (inflammation of the testes) impairs the testis’ production of sperms and obstructs the sperm tract.

Sperm production is done under the influence of several hormones from the hypothalamus, the pituitary gland, and the testes such as LH, FSH, gonadotropins, testosterone, prolactin, and others.

Any abnormalities in the production of these hormones affect spermatogenesis.

Other hormonal impairments may affect spermatogenesis like increased levels of cortisol and thyroid hormones.

Spermatogenesis, like any other biological process, is programmed by genes. And any defects or mutations in these genes will impair it.

Examples of this are:

  • Y chromosome microdeletions.
  • Klinefelter syndrome.
  • Cystic fibrosis.
  • Chromosomal translocation.

Sperms travel through a specific tract and never get in contact with blood. If this happens, the body identifies the sperms as an invader and attacks them with antibodies.

This may happen in cases of severe inflammation or infections in the reproductive system.

Any obstruction in the outlet of the sperms hinders its delivery to the female reproductive system during ejaculation. This obstruction can be:

  • Birth defects when any of the tubes the sperms travel through weren’t canalized.
  • Inflammation and infections cause
  • blocking inflammatory edema.
  • Tumors or benign enlargement like prostate enlargement.
  • Varicoceles meaning congested veins in the scrotum and testes that can block the sperm outlet.
  • Fibrosis of a healing surgical scar.

This means that instead of the sperms going out through the penis they go back into your bladder. Thus decreasing the sperm count reaching the vagina.

This happens when the nerves supplying the bladder are weak and thus the bladder doesn’t close during ejaculation leaving a backward inlet for the sperms.

Many daily bad habits and environmental factors help to cause infertility. Such as:

  • Smoking.
  • Alcohol.
  • Marijuana.
  • Steroids.

Male infertility and its relationship to the misuse of steroids:

Prof Dr.Al-Samarrai, the best male infertility doctor in Dubai pointed out that for decades,These anabolic androgenic steroids (AAS) were restricted to professional bodybuilders, and now these are gradually becoming more common among strength athletes.

Statistically, clinical and research studies indicate that three million young people in USA using These (AAS) & Looking at this increased prevalence, recent clinical and research studies have shed light On the infertility of these men who taking this anabolic steroid In addition to erectile dysfunction and lack of sexual desire.

Unknown infertility causes:

Prof Dr.Al-Samarrai, the best male infertility doctor in Dubai wrote and published a paper explaining that the fertilization rate in the last ten years is declining and Infertility is on the rise!

as recent statistics and clinical researches have proven that the main cause of infertility is environmental, food, air and water contamination lead to fragmentation of DNA because of high release of environmental toxins in the air, including the toxic gas carbon dioxide (CO2) that comes from Transportation and others.

This contamination causes oxidative stress, which leads to damage of DNA in our cells and genetic mutations causing common diseases that have increased in this century compared to the last century, such as infertility, erectile dysfunction, kidney, bladder and prostate cancers, and This is why diagnosing ROS and sperm DNA fragmentation in seminal fluid has become a particularly important test for unknown infertility causes.

Male infertility symptoms:

The hallmark complaint is not being able to achieve pregnancy especially after a year of uncontrolled intercourses.

There can be other symptoms according to the underlying cause. Such as:

  1. Pain during urination or ejaculation.
  2. Sexual dysfunctions like erectile dysfunction.
  3. Delayed puberty.
  4. Hormonal disturbances like growing breasts and diminished body hair growth.

Male infertility diagnosis:

Diagnosis aims to confirm the condition and identify the underlying cause. It is done in three steps: history taking, physical examination, and laboratory tests.

This is an initial evaluation step that guides the diagnosis. The physician asks about:

  • The duration of infertility.
  • Sexual history.
  • Puberty timing.
  • Problems during development.
  • Any urological problems
  • Testicular torsion incidence.
  • Medical history of diabetes, obesity, or any endocrine diseases.

Physical examination is done to inspect and palpate the testes, the prostate, the penis, and other organs guided by the taken history.

  • The testes to estimate their size, position, number, and volume. Sometimes an ultrasound is performed to detect any swellings or abnormalities.
  • The prostate by a rectal examination to detect size, consistency, obstructions, enlargements, and cysts.
  • The penis to look for penile curvature, location of the urethral meatus, and its patency.
  • Other organs like the thyroid gland.

This is the gold standard of diagnosis. It’s done by:

  • Seminal analysis to estimate their count, morphology, motility, and if the medium is suitable for their viability.
  • Blood tests to estimate different hormones levels, the anti-sperm antibodies, and infections.
  • Biopsy from the testes or the prostate to exclude tumors. It’s done if the sperm count is decreased or zero.

Male infertility treatment:

According to the best male infertility doctor in Dubai , treatment depends on the underlying cause and is either drugs or surgery plus lifestyle modifications.

1- Medications

Medications are mostly used to increase the sperm count, adjust hormonal disturbances, and treat infections as follows:

These drugs stimulate the production of sex hormones like testosterone and androgens. Sex hormones are important in stimulating the reproductive system functions and achieving sperm maturation.

These drugs stimulate the release of LH and FSH hormones from the pituitary gland which stimulate spermatogenesis.

Estrogen is needed in very small amounts to produce vital sperms. But when the estrogen level gets too high, it suppresses spermatogenesis.

So, estrogen receptor blockers are used when the estrogen level gets too high to keep it in normal ranges.

Dopamine and prolactin are two hormones secreted by the pituitary gland. They inhibit one another, so they are produced in a balanced way. 

When the prolactin level gets high, it suppresses spermatogenesis. In such cases, we give drugs known as dopamine agonists that mimic the action of dopamine to inhibit prolactin over secretion.

These drugs are used to treat retrograde ejaculation. They help the bladder neck muscles to contract and close during ejaculation. Thus, the sperms will take their normal tract out of the penis.

The doctor may give other drugs like antibiotics for infections, anti-inflammatory drugs, vitamins, and others.

2- Surgery

The surgical interventions used aim for treating the obstruction or achieving fertilization in a more controlled way.

Obstructions can be in the testes, the tubes through which the sperms travel like the vas deferens, the epididymis, and the urethra. And so the following may be done:

  • Varicocelectomy to remove congested veins of the scrotum.
  • Vasovasostomy to bypass vas deferens obstruction.
  • Vasoepididymostomy to bypass vas deferens and epididymis obstruction.
  • Transurethral resection of the ejaculatory ducts (TURED) to treat ejaculatory duct obstruction.

These are techniques to take a good sperm sample for extrauterine fertilization. They include:

  • Testicular sperm aspiration (TESA) where sperms are taken from the testes by an aspiration needle.
  • Testicular sperm extraction (TESE) where a biopsy is taken from the tests and the sperms are retrieved from it.
  • Percutaneous epididymal sperm aspiration (PESA) where sperms are taken from the epididymis by an aspiration needle.

Male infertility new treatments:

According to Prof Dr.Al-Samarrai, the best male infertility doctor in Dubai , newer male infertility treatment in dubai include:

IVF (In Vitro Fertilization)

Sperms taken from a semen sample are used to fertilize the egg outside the uterus then implanted in the uterus.

ICSI (Intracytoplasmic sperm implantation)

It’s more accurate than IVF. As the sperm is directly injected into the egg thus achieving higher success rates.

How common is male infertility?

Male infertility is a global issue. According to recent studies, around 30.000.000 men around the world are infertile. And that around 70% of unachieved pregnancies are contributed by male infertility.

So, male infertility problems should be addressed with more social awareness and education to detect and treat early.

Best male infertility doctor in Dubai

The most important part in treating infertility is the doctor supervising the treatment. Because treating male infertility isn’t just treating a condition; it’s a step in forming a family and fulfilling the future you want for you and your partner.

Prof Dr. Al-Samarrai is the best male infertility doctor in Dubai you can find. With the experience of more than 30 years in treating thousands of infertile males with achieving high pregnancy rates, he established himself as the best male infertility doctor in Dubai .

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