Surgical methods: Surgery has been the oldest form of treatment for male infertility.
- Varicocoele: Varicocoele is the engorgement of testicular veins. Due to the increased temperature of the testes, spermatogenesis if affected leading to infertility. Microsurgery performed to interrupt these veins is known to improve male fertility in about 70% of the cases.
- Cyrptorchidism: The undescended testes can be placed back in the testicular sac through a surgical procedure.
- Blocked ejaculatory ducts: blockage of the ducts can be due to infections like STD or tuberculosis or due to vasectomy. These can be easily fixed using microsurgical techniques.
- Ejaculatory dysfunction: This forms a significant proportion of the cases of male infertility. Inability to ejaculate can be due to trauma, neurological disease or psychological problems. On investigating if a physical problem is identified it can be treated using surgical methods. In patients whom the ejaculatory reflex is intact, a mechanical vibrator can be implanted on the undersurface of the penis which induces ejaculation. If the above technique fails, another surgical method called electroejaculation can be done. In this procedure, an electrode is placed in the rectum near the prostate to stimulate ejaculation by stimulating the nervous plexus.
- Hypospadias: When the urethra opens on the undersurface of the penis, it is called a hypospadia. This can be surgically treated by plastic surgery.
- Tumor: In case of a testicular tumor, it must be removed by surgery and further treatment must be decided.
Medical therapy: Medical therapy is mainly used in patients with hormonal problems like hypogonadism. It involves therapy with hormones like Gonadotropin releasing hormones, Leutinizing hormone, and Follicle Stimulating hormone. Drugs which dilate the blood vessels of the penis e.g seldenafil is used for treating impotence. Antibiotics and immunosuppressant agents like steroids have are used for treating infections of male accessory gland infections and immunological disorders like presence of antisperm antibodies. Diabetes is one condition which is associated with reduced male fertility and can be treated with the use of oral hypoglycemic drugs or insulin.
Alternative therapy: A large number of macromolecules like L- Carnitine, folic acid, Vitamin C, Vitamin E, zinc etc have been used as supplements for the treatment of male infertility. Supplementation with zinc has also shown to reduce male infertility by improving sperm functions.
Lifestyle modifications: Lifestyle modifications play an important role in the treatment of male infertility.
- Quit smoking: Several studies have proved that smoking is harmful for male fertility and must be avoided.
- Psychoactive drugs: The use of psychoactive drugs like marijuana also causes an abnormality in the sperm function.
- Alcohol: Consuming alcohol causes failure of liver functions leading to increased levels of estrogens in blood. This in turns causes reduction in the testosterone levels reducing fertility in males.
- Exercise also plays an important role in improving male fertility. It keeps away excessive fat and obesity which contributes to infertility. Nonetheless exercise must not be overdone especially cycling which can increase the temperature of the testes and decrease the sperm production.