Male Infertility

In the South Asian context, childless couples are often subject to social scrutiny. While fingers are usually pointed towards females, blaming them for being infertile, a growing number of cases reveal that males too could become infertile due to various causative factors. Medical experts observe that infertility affects about 50% couples worldwide and that this is the case in Sri Lanka as well. Male infertility contributes to 40-50% of cases and is now perceived as a significant public health issue both globally and in nations such as Sri Lanka.

- BY KAMANTHI WICKRAMASINGHE

Rising prevalence

Male infertility is seen as a failure of masculinity, as a stigmatizing, silencing, isolating and traumatic experience. "In the past, males were reluctant to accept it due to the socio-cultural stigma," explained Prof. Sanath Lanerolle, senior consultant in Obstetrics and Gynaecology at the Castle Street Hospital for Women. "But now we see a rising prevalence as males accept it and there more males coming forward for investigations. Earlier there was limited access to advanced healthcare services. Now there are more simple and accessible healthcare facilities for this. There is a lot of media exposure as well," he added.

Causative factors

According to Prof. Lanerolle there are many causes for male infertility. Generally male infertility could happen due to low sperm count (Oligospermia/Oligozoospermia). The WHO approves at least 15 million sperms per milliliter of semen. Sperm mortality is another factor that contributes to male infertility. "Weak sperms cannot reach a fertile egg. In addition, the morphology of a sperm also matters. A sperm has a head and a tail but if there's any change to head or the tail it affects the fertility," Prof. Lanerolle explained.

Genetic factors are another cause of male infertility. "Some people are born with genetic deficiencies such as Klinefelter Syndrome. Males affected by such illnesses would produce genetically abnormal sperm. Hormonal imbalances such as producing testosterone in low levels would affect mortality of sperm," he added.