How to cope with male infertility

Between 35 percent and 50 percent of the reasons for infertility in families are contributed by men, contrary to the social construct, which majorly blames women, different research studies indicate.

However, fertility experts in the country say medical technologies are in place to diagnose, cure or assist men struggling with infertility to ease psychological distress, depression, and hopelessness. 

Dr Joseph Kafuuma, a fertility specialist at Women’s Hospital International and Fertility Centre, says male infertility is caused by problems in sperm production and quality.

“Sperms are underproduced or what is produced is abnormal or they are non-functional. The testicles may not be working well. There are men who are born when the testicles are not in the scrotal sac, or they have undescended testes. Some men also have difficulties in erection or maintaining an erection,” he says.

According to fertility research studies, other men may have only one testicle in the scrotum or the one in the scrotum is small. The testicle is where sperm and other hormones that control sexual desires are made in the body. 

Dr Mukuzi Muhereza, another specialist, says infections can also cause male infertility.

“We have diseases such as chlamydia and mumps that block the tubes in the reproductive system,” he says.

Chlamydia presents with pain when urinating, watery discharge from the male organ and burning sensation or itching inside the male organ (the tube that carries urine). Mumps cause sudden swelling of the testicles.

According to the Ministry of Health, up to 75 percent of infertility in the country is caused by treatable infectious diseases. Between 10 and 15 percent of couples in the country cannot have children because of infertility, according to the ministry.

Dr Kafuuma says infections can lead to the blockage of tubes that transport sperm from the testicles to mix with the semen.

“Semen and sperm come from different areas within the reproductive system. They just mix during ejaculation. Once the tubes that are supposed to transport sperms are blocked, the man may ejaculate but only semen will come [without sperms],” he says.

“The tube can also be blocked if a man undergoes surgery when they are young like that of hernia, such tubes that bring sperms can be damaged,” he adds.

According to fertility experts, environmental factors such as heat and heavy metal exposure can also increase the risk of male infertility.

“Men who work with mercury [such as in mining] or lead factories can have problems with sperm production. Overheating around the upper thigh can also cause a temporary reduction in sperm,” Dr Kafuuma says.

Other categories of people who are at risk include men who sit a lot like those who do long-distance travel such as truck drivers, men undergoing cancer treatment, trauma in the lower part of the body or paralysis, which affects the ability to penetrate and satisfy the female partner.

Taking a break or minimising exposure when working in settings that increase one’s risk is important to avoid developing infertility, according to experts.

“Men and women who are going for cancer treatment should first collect and store their sperms [in specialised health facilities],” Dr Kafuuma says.

Assessing male infertility

Medical invesitgation: According to fertility specialists, assessing male infertility involves medical investigations on both partners in case all of them had not had a child before. The assessment includes physical examination and doing sperm analysis in laboratories.

Costs: Information from Jowa Health Specialised Laboratory in Kampala indicates that sperm analysis costs about Shs90,000, but this may vary depending on the facility one goes to. “In Vitro Fertiliation (IVF) can work for men who have very low sperm count. Even men who don’t have sperm, we can do minor surgery on their scrotum and we extract a little tissue from their testicles then we find the few sperms to fertilise the egg [in the lab] and take it back to the woman’s uterus,” Dr Joseph Kafuuma says.

Stigma: Dr Daniel Zaake, another specialist at Life Sure Fertility and Gynaecology Centre in Kampala, says men tend to be negative about fertility care because of stigma.  He says the cost of treatment and unmet expectations such as failure of the method also affects the interest of men in seeking care.

Treatment: Dr Zaake, however, notes that spouse and friends’ support help with coping, and the IVF experience can strengthen emotional bond between a couple. Dr Mukuzi Muhereza says each IVF session can cost a couple somewhere from Shs14m to Shs18m locally. Fertility specialists say other treatments include giving hormones to men whose testicles are not producing enough sperms, treating infections of reproductive tract, and surgeries to open blocked tubes.

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