The commonest surgically treatable cause of male infertility is Varicocele. Varicocele means dilated tortuous veins of spermatic cords. Varicocele causes hyperthermia of the scrotal contents including testes, which causes hypo spermatogenesis. Varicocele accompanied by male infertility and poor semen parameters, should be treated.
Prostate infection can be diagnosed clinically on history taking and finding of tender enlargement of prostate on DRE. Prostate infection can deteriorate sperm count and motility, causing male infertility. It should be treated with appropriate antibiotics for adequate duration.
Hydrocele is collection of fluid in the tunica vaginalis sacs around the testis. It causes the same hyperthermia effects as does varicocele. If found associated with male infertility with poor semen parameters, hydrocele should be surgically treated.
Occasionally male infertility patients may show complete absence of sperms in the semen analysis. In such patients, serum male fertility hormonal profile should be asked for. If this profile is abnormal, kindly discuss the future management with your Urologist/ Andrologist.
Occasionally, the male hormonal profile is normal, inspite of having absence of sperms, in which scenario, obstruction to sperm transport needs to be evaluated and accordingly treated. Occasionally, this may be due to obstruction of ejaculatory ducts. This can be effectively treated by endoscopic surgery by experienced Urologist./Andrologist.
There is fairly large number of patients who exhibit poor semen parameters with no identifiable cause of infertility. This group of patients are clubbed together as Idiopathic Infertility. Various empirical therapies are available. But no definite success can be assured in this group.