It is the wish of many couples to have children and organize a happy family, but it turns out that about 15% of couples in the world suffer from infertility, that is, one out of every six couples suffers from infertility.
Just like 35-year-old David (pseudonym), who has been married to a wife of the same age for three years. Although he has been working hard to "create a man", he has not succeeded in giving birth to the next generation. After seeking medical treatment, he finally found that the problem originated from the man. He had been infected with mumps at the time, which affected the ability to make sperm and caused infertility.
Ho Si Ho, a specialist in urology, will discuss with you how to seize the opportunity to give birth?
Both parties are responsible for fertility issues
Medically speaking, it is defined as infertility when both men and women fail to conceive after one year of normal sex without contraception.
About 30% of all infertility cases are caused by men, 30% by women, 30% by both sexes, and 10% by unknown causes.
In Hong Kong, the number of births through artificial insemination is on the rise, reaching 7,000 in 2021.
Despite advances in technology, not every couple with fertility problems can successfully conceive a child through treatment.
Taking artificial insemination as an example, if the sperm and eggs are successfully extracted, about 40% of the cases will be able to conceive, and about 35% of the cases will finally be successful.
Many causes of male infertility
In male infertility, a common cause is a problem with the ability to make sperm, resulting in abnormal sperm in the semen.
Testicular trauma, hormonal abnormalities, injury to the vas deferens during certain surgeries (such as hernia surgery), chemotherapy, mumps infection that damages the testes, and congenital recessive testis, etc. Infertility.
In addition, lifestyle habits are also closely related to fertility. For example, smoking has been shown to affect sperm count and quality.
How is male infertility diagnosed?
The doctor will draw blood for the patient to check the levels of male hormones and sperm stimulating hormone (FSH), and at the same time, the patient will need to have two semen analysis.
Once the report is available, the doctor will meet with the patient and their partner to conduct a physical examination and review the medical records.
At this time, the cause of infertility in some patients may be found out, and treatment methods may be recommended for them.
Abnormal semen problems include low sperm count (Oligospermia), low sperm motility (Asthenospermia), and abnormal sperm (Teratospermia).
Most of these patients do not need surgery, or seek help from gynecologists and artificial insemination laboratories to extract suitable sperm and put them into the woman's uterus to shorten the process of sperm swimming to the egg.
Azoospermia
A small number of patients have no sperm in their semen sample, a condition called Azoospermia.
The disease is divided into obstructive and non-obstructive. The former involves inflammation, surgical impact, etc. Most of the patients need to undergo reconstructive surgery to remove the obstruction in the vas deferens or prostate, or extract sperm from the testes for artificial insemination.
Since a woman's fertility and the success rate of artificial insemination decline with age, the choice of surgery depends on the age of the two and the number of people who plan to have children.
The cause of non-obstructive azoospermia may be a genetically-induced sperm development problem. Such patients need to undergo genetic testing. If it is confirmed that azoospermia is caused by a genetic abnormality, because sperm cannot be obtained from the patient, the patient cannot pass any test. The treatment was successful in giving birth.
If it is not a genetic problem, the testicular sperm extraction from the testicles of the patient will be surgically extracted, and the sperms will be extracted. However, these sperms may not be mature, so the success rate is only about 40%.
On the other hand, patients with obstructive azoospermia have normal sperm development, so it is possible to extract mature sperm from the epididymal testis by surgery (epididymal sperm aspiration), with a higher success rate than non-obstructive azoospermia.
The above two operations can be carried out with the assistance of microscope technology, and the advantage is that it can maintain a certain success rate while reducing the structural damage to the testis or accessory testis.
Preparing for Early Childhood
Having children is a lifelong event for a couple.
If the couple intends to have children, it is recommended to go to the family accountant to receive a physical examination, especially for couples who are over 30 years old or have the above risk factors.
If the test report finds abnormal, you don't have to waste a year of trying to have a baby before seeking medical treatment.
Generally speaking, if you go to the HA for medical treatment due to fertility problems, the waiting time is often two to three years. If a woman is over 40 by then, she will not be accepted by the HA for artificial insemination.
At the same time, the partner must also be married and also a Hong Kong resident.
On the other hand, an infertile man who had clinically encountered cancer at a young age suffered from cancer. Although he learned that chemotherapy would affect his sperm-producing function, he did not take it seriously at the time and did not extract and store sperm before chemotherapy.
He later recovered and unsuccessfully attempted to conceive a child with his partner years later.
Therefore, it should be mentioned here that patients with serious diseases should consider storing sperm for future fertility before receiving treatments that affect fertility. This service costs about HK$2-3,000 per year.
Ho Si Ho, a specialist in urology
Website of the Hong Kong Society of Urology: https://www.hkua.org
Hong Kong Society of Urology YouTube channel: https://www.youtube.com/channel/UCUnlbbQ6ugAUSpFY0-g-P7A
(Information provided by the Hong Kong Society of Urology)
*The content of this article is for reference only and does not replace clinical medical advice. If you have any questions, please consult your doctor.