There are several conditions that contribute to male factor infertility, including:
• Low sperm count (oligospermia) – low sperm count can be caused by a variety of factors, including stress, chemotherapy, high fever, lack of sleep, environmental toxins, over-heating, and other unknown causes.
• Abnormal sperm motility – motility refers to the ability of the sperm to move. If the sperm are slow or if they are unable to move straight forward, they will have difficulty penetrating the egg.
• Abnormal sperm shape – if the shape of the sperm is abnormal (normal shaped sperm should have an oval head and long tail) it will not be able to fertilize the egg.
• Germ-cell aplasia – a condition in which sperm-producing cells develop abnormally.
• Abnormal semen – a decreased amount of semen or semen that does not liquefy properly.
• Tube blockages – blockages of the vas deferens or epididymis can be caused by varicoceles (enlarged veins that restrict the production of sperm in the testicles), gonorrhea, and chlamydia
• Sperm allergy – an immune reaction that produces antibodies that kill the sperm. This can occur in both men and women.
Indicators of male infertility include
• Low sperm count or poor quality sperm
• Hormone disorder
• Injury or disease of the male reproductive system (e.g. damage to the testicles)
• Blockage or swelling such as varicocele
• No obvious cause (‘idiopathic’)
These are just some of the many causes of infertility. There is one other aspect and that is of no obvious cause. In other words, there appears to be no reason for infertility in either the man or woman, or both.
indications for surgery
1. Pain
Varicocele may cause dragging pain in scrotum in 5% to 10% of patients.
2. Stress pattern of semen
a) Low sperm count (oligospermia)
b) Poor motility (asthenospermia)
c) Abnormal forms
d) Tapered forms
3. Testicular Atrophy
Loss of Testicular size, Flabby testes
The mere presence of varicocele doesn’t mean that surgical correction is necessary. However, varicocele is the most common, identifiable and surgically correctable factor contributing to poor testicular function and decreased semen quality. Surgical repair of varicocele not only halts the testicular damage but also reverses it.