Male Infertility

Male infertility refers to the inability of a male to achieve a pregnancy in a fertile female. In humans it accounts for 40-50% of infertility. Male infertility is commonly due to deficiencies in the semen.

PRE-TESTICULAR FACTORS

Pre-testicular factors refer to conditions that reduce hormonal stimulation of the testes:

The prostate gland is a small gland that is only found in men. It is located between the penis and bladder and it surrounds the urethra (the tube that carries urine from the bladder to the penis).

The prostate gland helps with the production of semen (the fluid that transports sperm). It produces a thick, white fluid that is liquefied by a special protein called prostate-specific antigen (PSA). The fluid is mixed with sperm, produced by the testicles, to create semen.

There are a number of conditions that can affect the prostate gland including:

  • Low male hormone levels due to causes such as obesity
  • Drugs and alcohol
  • Strenuous riding, such as bicycle riding and horseback riding
  • Medications, including those that affect spermatogenesis such as chemotherapy, anabolic steroids, cimetidine, spironolactone; those that decrease FSH levels such as phenytoin and those that decrease sperm motility such as sulfasalazine and nitrofurantoin
  • Genetic abnormalities.

Tobacco smoking

Smoking is still controversial in its effect on sperm production.

DNA damage

Inborn faults in the composition of the genetic footprint (DNA) or environmental damage to the DNA molecule might cause sub-fertility.

Testicular factors

Testicular factors refer to conditions where the testes produce semen of low quantity and/or poor quality despite adequate hormonal support and include:

  • Age
  • Genetic defects on the Y chromosome
  • Abnormal set of chromosomes
  • Neoplasm, e.g. seminoma
  • Idiopathic failure
  • Cryptorchidism
  • Varicocele
  • Trauma
  • Hydrocele
  • Mumps
  • Malaria
  • Testicular cancer
  • Acrosomal defects affecting egg penetration
  • Unexplained sperm deficiencies account for 30% of male infertility.
  • Radiation therapy to a testis decreases its function, but infertility can be avoided by avoiding radiation to both testes.

POST-TESTICULAR FACTORS

Post-testicular factors decrease male fertility due to conditions that affect the male genital system after testicular sperm production and include defects of the genital tract as well as problems in ejaculation:

  • Vas deferens obstruction
  • Lack of vas deferens, often related to a disease (Cystic Fibrosis)
  • Infection, e.g. prostatitis
  • Retrograde ejaculation
  • Ejaculatory duct obstruction
  • Impotence

Appointments

Coming To The Urology Hospital

How We Are Doing Our Part In The Fight Against COVID-19

The Urology Hospital is a surgical hospital specializing in the treatment of urological and related conditions. As we are not a respiratory related facility, we will not be actively treating COVID-19 patients. This allows us to continue providing surgical treatment to all our urology related patients and we will gladly accommodate you in this regard.

The safety of our patients and colleagues is our number one priority. Your healthcare is important to us and we are actively working with and following guidance from the National Department of Health and the NICD (National Institute for Communicable Diseases).

Kindly note the hospital has set up a Covid-19 task team and contingency plan and we are preparing for all eventualities.

Please confirm with your Doctor if you are still able to come for your consultation. However, if you have any of the following signs and symptoms then please cancel your appointment, self-isolate and contact the centralised helpline on 0800 029 999:
• Fever
• Cough
• Sore Throat
• Shortness of Breath
• Headache
• Fatigue/Malaise
• Diarrhoea
• Loss of smell and taste

To support screening for COVID-19, before entering the hospital, all prospective patients will adhere to the following:
• Complete a Travel History form
• Undergo temperature screening

Should any of the following signs or symptoms be found, you will be requested to go home, self-isolate and contact the centralised helpline on 0800 029 999:
• Flu-like symptoms (sore throat, cough or chills)
• Fever of 37.7 or above

NB: Please notify the person doing your Travel History if you’re:
• Over 70
• Have any underlying health conditions
• Are pregnant

To protect our patients and staff from the potential risk of COVID-19, we are currently restricting visiting of patients to exceptional circumstances only.

In an effort to limit the number of patients visiting The Urology Hospital Pharmacy due to the COVID-19 pandemic, we will only assist our regular retail patients.  If you have a valid repeat script at The Urology Hospital Pharmacy, please call us in advance on 012 423 4036 to make arrangements to obtain your repeat prescription. We will then prepare it for you in advance. When collecting your script bring your purple script copy or previous medicine containers with you to gain access to the hospital.

Should you need to re-arrange an appointment at the Urology Hospital please call: 012 423 4000 or your Doctor’s rooms.

We appreciate your understanding and co-operation.

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