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Unlike women, hormone imbalances in men are not a common cause of fertility problems. These problems can stem from organs as far apart as the brain or the testicles, and can show up in blood tests. They can arise because of:
One problem is that of hyperprolactinaemia (a high prolactin level). This is usually caused by a pituitary malfunction or tumour; and can be detected by a blood test. Patients with hyperprolactinemia often also have decreased libido and may be impotent. Treatment with bromocryptine to suppress the high prolactin levels is highly successful in achieving pregnancy.
Another problem is that of hypogonadotropic hypogonadism (poor functioning of the testes because of their inadequate stimulation by the gonadotropic hormones, FSH and LH produced by the pituitary). Most hypogonadotropic patients are hypogonadal - that is, they have low levels of the male hormone, testosterone. This means they have poorly developed secondary sexual characters; an effeminate appearance, scanty hair, decreased libido, and small flabby testes. This can be confirmed by blood tests which show low levels of FSH and LH. This can be treated by replacement therapy most commonly with the gonadotropin hormones ---- HCG and HMG. These are expensive injections and a fairly long course of treatment (6 months to 1 year) is needed for them to work but they are usually effective in enhancing sperm production in these men. An alternative for some of these men is therapy with GnRH analogs, which are administered via a pump.
© Dr. Aniruddha Malpani and Dr. Anjali Malpani www.drmalpani.com
Credits: How to Have a Baby: Overcoming Infertility
