Medical management of male subfertility

The couple must be explained that according to the recent  WHO criteria 2010 , 15 million sperms / ml  motility and   4%  sperms with normal  morphology  are considered as normal physiological semen criteria . In spite  of this even  today  we read  several  labs quoting 60 million count   as normal    in their reports . Because   of this wrong   information  and ignorance  of laboratory   officials  and clinicians   several  males patients( ?) continue to ingest  medicines  for long periods  to increase  their sperm  count . We have to remember  when sperm  count is 15 million / ml or more no treatment is required .

Up to 86 % abnormal sperms is accepted as normal and physiological  and no treatment is warranted. As a matter fact  even male persons with only 4 % - 14 % normal sperms can make their wife conceive either naturally or by intrauterine insemination . Only when < 4% of sperms are normal , IVF / CSI may be required.

Medical management of a subfertile   male :: What to do When the sperm count is < 15 million / ml ?? Ans:- When the sperm count is < 15 million / ml semen analysis must be done at least  three times – 2 weeks apart  and 2 months  apart to confirm  the diagnosis . These patients should directly not be subject to IVF or ICSI . Instead we must try medical treatment for these males to improve the sperm count so that they become father    naturally or with IUI. The whole moto of medical management of a subfertile   male is not to increase   the sperm count 5-10   times or to achieve excellent semen parameters. The motto is to increases the count by a few million so that ICSI  can be converted to IVF  , IVF  to IUI  and perhaps   IUI  into natural  conception  . Medical management are mainly limited to avoidance of alcohol, smoking, life style modifications antibiotics (in cases of Pyospermia) & antioxidants empirically !!