Introduction
Male Infertility is the medical condition that affects male patients with the inability to conceive. It is usually characterized by low sperm production, abnormal sperm function and blockages that prevent delivery of the sperm.
Male infertility is usually diagnosed using tests that analyze the sperm to check the following:

• Sperm Count.
• Quality of sperm.
• Sperm Movement.

There are a variety of reasons for male infertility, such as,

• Physical problems preventing normal ejaculation of sperms in semen.
• Sexually transmitted diseases.
• Infections.
• Autoimmune disorders.
• Lifestyle choices, like drinking alcohol and using drugs.

Male patients suffering from infertility usually experience any of the following symptoms:

• Issues in sexual functioning that include difficulty in ejaculation, low volume of ejaculated fluids, diminished sexual desire, and erectile dysfunction.
• Testicular Area Issues that include pain, swelling or a lump in the testicle area.
• Recurrent Respiratory issues like infections.
• Not able to smell.
• Gynecomastia or abnormal breast growth.
• Hormonal abnormality like reduced facial or body hair.
• Low Sperm Count, which could be less than 15 million sperm per 1ml of semen or a total count fewer than 39million sperms per ejaculate.

Male Infertility Medications
Some of the medications that might be recommended for treating male infertility issues like:

Endocrinopathies
Some of the medications used to treat male infertility rising from hormonal imbalances are:

Patients suffering from infertility issues caused by hypogonadotropin hypogonadism usually respond to,

• Gonadotropin replacement: usually effective in hypothalamic and pituitary dysfunction.
  Pulsatile Gonadotropin-releasing hormone (GnRH) therapy: usually used for patients with an intact pituitary function.
• Estrogen Modulators: like Aromatase Inhibitors usually block converting testosterone to estrogen, leading to an increase in the testosterone serum concentration.
• Clomiphene Citrate: a weak estrogen-receptor helps in increases the release of FSH and LH hormones, in turn, increasing the production of testosterone. It is also effective in improving the sperm characteristics like sperm count etc.
• Glucocorticoids: are usually prescribed for patients with congenital adrenal hyperplasia.
• Dopamine Antagonists: like bromocriptine or cabergoline are used to treat hyperprolactinemia.

Antisperm Antibodies
This is a steroid treatment option that has proved effective by showing improvement in the quality of sperm, leading to higher conception rates. Low-dose steroids might be recommended for 3-6 month for patients with antisperm antibody levels greater than 1:32. Patients are usually informed of the potential adverse effects of steroids, such as avascular necrosis of the hip, weight gain, and iatrogenic Cushing Syndrome.
Retrograde Ejaculation
Doctors might recommend medications Imipramines, like pseudoephedrine that will help close the bladder neck to help in antegrade or forward moving ejaculation. These medications, however, will not be effective for patients with a fixed abnormality like the bladder neck on that occurs after a surgical procedure.

Authored by Dr. Anitha Mani - Infertility Specialist & Laparoscopy Surgeon