Male Infertility?
Nearly 1 in 7 couples is infertile, which means they haven't been able to conceive a child even though they've had frequent, unprotected sexual intercourse for a year or longer. In up to half of these couples, male infertility plays at least a partial role.
Male infertility can be caused by low sperm production, abnormal sperm function or blockages that prevent the delivery of sperm. Illnesses, injuries, chronic health problems, lifestyle choices and other factors may contribute to male infertility.
Symptoms:
The main sign of male infertility is the inability to conceive a child. There may be no other obvious signs or symptoms.
In some cases, however, an underlying problem such as an inherited disorder, hormonal imbalance, dilated veins around the testicle or a condition that blocks the passage of sperm causes signs and symptoms.

Signs and symptoms you may notice include:

• Problems with sexual function — for example, difficulty with ejaculation or small volumes of fluid ejaculated, reduced sexual desire, or difficulty maintaining an erection (erectile dysfunction)

• Pain, swelling or a lump in the testicle area

• Recurrent respiratory infections

• Inability to smell

• Abnormal breast growth (gynecomastia)

• Decreased facial or body hair or other signs of a chromosomal or hormonal abnormality

• A lower than normal sperm count (fewer than 15 million sperm per milliliter of semen or a total sperm count of less than 39 million per ejaculate)

To get your partner pregnant, the following must occur:

• You must produce healthy sperm. Initially, this involves the growth and formation of the male reproductive organs during puberty. At least one of your testicles must be functioning correctly, and your body must produce testosterone and other hormones to trigger and maintain sperm production.

• Sperm has to be carried into the semen. Once sperm is produced in the testicles, delicate tubes transport them until they mix with semen and are ejaculated out of the penis.

• There needs to be enough sperm in the semen. If the number of sperm in your semen (sperm count) is low, it decreases the odds that one of your sperm will fertilize your partner's egg. A low sperm count is fewer than 15 million sperm per milliliter of semen or fewer than 39 million per ejaculate.

Sperm must be functional and able to move. If the movement (motility) or function of your sperm is abnormal, the sperm may not be able to reach or penetrate your partner's egg.
Medical Causes:

• Problems with male fertility can be caused by a number of health issues and medical treatments:

• Varicocele. A varicocele is a swelling of the veins that drain the testicle. It's the most common reversible cause of male infertility. Although the exact reason that varicoceles cause infertility is unknown, it may be related to abnormal blood flow. Varicoceles lead to reduced sperm quantity and quality.

• Infection. Some infections can interfere with sperm production or sperm health or can cause scarring that blocks the passage of sperm. These include inflammation of the epididymis (epididymitis) or testicles (orchitis) and some sexually transmitted infections, including gonorrhea or HIV. Although some infections can result in permanent testicular damage, most often sperm can still be retrieved.

• Ejaculation issues. Retrograde ejaculation occurs when semen enters the bladder during orgasm instead of emerging out the tip of the penis. Various health conditions can cause retrograde ejaculation, including diabetes, spinal injuries, medications, and surgery of the bladder, prostate or urethra.

• Antibodies that attack sperm. Anti-sperm antibodies are immune system cells that mistakenly identify sperm as harmful invaders and attempt to eliminate them.

• Tumors. Cancers and nonmalignant tumors can affect the male reproductive organs directly, through the glands that release hormones related to reproduction, such as the pituitary gland, or through unknown causes.  In some cases, surgery, radiation or chemotherapy to treat tumors can affect male fertility.

• Undescended testicles. In some males, during fetal development one or both testicles fail to descend from the abdomen into the sac that normally contains the testicles (scrotum). Decreased fertility is more likely in men who have had this condition.

• Hormone imbalances. Infertility can result from disorders of the testicles themselves or an abnormality affecting other hormonal systems including the hypothalamus, pituitary, thyroid and adrenal glands. Low testosterone (male hypogonadism) and other hormonal problems have a number of possible underlying causes.

• Defects of tubules that transport sperm. Many different tubes carry sperm. They can be blocked due to various causes, including inadvertent injury from surgery, prior infections, trauma or abnormal development, such as with cystic fibrosis or similar inherited conditions.

• Blockage can occur at any level, including within the testicle, in the tubes that drain the testicle, in the epididymis, in the vas deferens, near the ejaculatory ducts or in the urethra.
• Chromosome defects. Inherited disorders such as Klinefelter's syndrome — in which a male is born with two X chromosomes and one Y chromosome (instead of one X and one Y) — cause abnormal development of the male reproductive organs. Other genetic syndromes associated with infertility include cystic fibrosis and Kallmann's syndrome.
• Problems with sexual intercourse. These can include trouble keeping or maintaining an erection sufficient for sex (erectile dysfunction), premature ejaculation, painful intercourse, anatomical abnormalities such as having a urethral opening beneath the penis (hypospadias), or psychological or relationship problems that interfere with sex.
• Celiac disease. Celiac disease is a digestive disorder caused by sensitivity to a protein found in wheat called gluten. The condition may contribute to male infertility. Fertility may improve after adopting a gluten-free diet.
• Certain medications. Testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), some ulcer drugs, some arthritis drugs and certain other medications can impair sperm production and decrease male fertility.

Prior surgeries. Certain surgeries may prevent you from having sperm in your ejaculate, including vasectomy, scrotal or testicular surgeries, prostate surgeries, and large abdominal surgeries performed for testicular and rectal cancers, among others.
Environmental Causes:
Overexposure to certain environmental elements such as heat, toxins and chemicals can reduce sperm production or sperm function. Specific causes include:
1.Industrial chemicals. Extended exposure to certain chemicals, pesticides, herbicides, organic solvents and painting materials may contribute to low sperm counts.
2.Heavy metal exposure. Exposure to lead or other heavy metals also may cause infertility.
3.Radiation or X-rays. Exposure to radiation can reduce sperm production, though it will often eventually return to normal. With high doses of radiation, sperm production can be permanently reduced.
4.Overheating the testicles. Elevated temperatures may impair sperm production and function. Although studies are limited and are inconclusive, frequent use of saunas or hot tubs may temporarily impair your sperm count.
Sitting for long periods, wearing tight clothing or working on a laptop computer for long stretches of time also may increase the temperature in your scrotum and may slightly reduce sperm production. But, the research isn't conclusive.
Health, lifestyle and other causes
Some other causes of male infertility include:
> Drug use. Anabolic steroids taken to stimulate muscle strength and growth can cause the testicles to shrink and sperm production to decrease. Use of cocaine or marijuana may temporarily reduce the number and quality of your sperm as well.
> Alcohol use. Drinking alcohol can lower testosterone levels, cause erectile dysfunction and decrease sperm production. Liver disease caused by excessive drinking also may lead to fertility problems.
> Tobacco smoking. Men who smoke may have a lower sperm count than do those who don't smoke. Secondhand smoke also may affect male fertility.
> Weight. Obesity can impair fertility in several ways, including directly impacting sperm themselves as well as by causing hormone changes that reduce male fertility.
> In Ayurveda, male infertility is called Shandhatva or napunsakta. It is the inability to sire a progeny by a man. In Ayurveda, there are multiple causes that lead to Shandhatva.  These include Bija upa tapa (Congenital problems), shukra dosha (sperm abnormalities) and klaibya (loss of libido).
> In Ayurveda main cause of any abnormal function in the body is agnimandya (vitiation of the digestive fire of body) & tridosha dushti (vitiation of three governing factors of body).
Management of infertility in Ayurveda:
Ayurveda supports health by strengthening the body's own self-healing and balancing mechanisms and doesn't rely on intervention by any outside or foreign substance to replace or correct the hormones in the body. It focuses on the treatment of infertility holistically with an aim of improving the overall health and quality of life of the individual.
Dietary Management:
1.Diet plays a vital role in the prevention and cure of diseases and in maintenance of good health. "Annam Brahmam" - Food has been compared to God, in the ancient Indian scriptures since it is the main factor for sustaining and nourishing life.
2.Dietary management involves strict compliance and adherence to foods that increase Ojus (an intersection factor of physical, mental and spiritual health of the body, responsible for overall health, energy and liveliness) and to avoid the substances which diminish the Ojas.
This is important to regulate ovulation and enhance fertilization. Eating whole foods provides all nutrients for the health of the body in addition to the fibers that influence hormonal levels of the body. Foods such as processed carbohydrates, excess starch, antibiotic and hormone laden meat and milk and canned produce destroy fertility.
3.Ojas building food include as milk, ghee, nuts, sesame seeds, dates, pumpkin seeds, honey, saffron and avocados, fresh organic fruits and vegetables, protein from plant sources like beans, and peas, sweet, whole grains, spices such as ajwain powder, turmeric (improves the interaction between hormones and targeted tissues), cumin (purifies the uterus in women and the genitourinary tract in men) and black cumin boost fertility.
Diet should be free from Trans-fats as they block arteries, threaten fertility and harm the heart and blood vessels and therefore, must be avoided. Foods containing preservatives and other chemicals, like artificial sweeteners, Monosodium Glutamate (MSG), diet high in fat and other artificial flavoring and coloring, excess alcohol and caffeine, tobacco, soda, smoking, red meat, refined carbohydrates, such as pasta, white bread, rice etc can exacerbate the problem of infertility.
Treatment principles of Infertility in Ayurveda:
1.Agni deepana and Ama pachana
 Ama formation (toxins created when undigested food forms in the stomach) by the imbalance in Agni (the power of digestion) lead to many diseases. Therefore, the treatment of Ama must always include the treatment of Agni, including the use of digestive and carminative Ayurvedic formulations, eating meals at proper time following an appropriate schedule. Ayurveda Panchakarma treatments help to eliminate Ama thus corrects Agni. Healthy Agni will also contribute to healthy Ojas.
2.Vata Anulomana
 The main dosha involved in infertility is Vata. So Vata Anulomana (correcting the functions of Vata) is very important in the treatment of infertility. Ayurvedic formulations, following routine exercises and a strict diet schedule will help in Vata Anulomana.
3.Sodhana
 Suitable sneha-swedas are done prior to sodhana. Then treatment modalities like Vamana (emesis), Virechana (purgation), Vasti (medicated enema) and Uttara Vasti special enema administered through urethral or vaginal routes) are done as per the condition of the patient. The patient has to follow peyadi krama (strict dietary regimen to be followed after Sodhana). This detoxification therapy helps in the expulsion of the toxins from the body. These therapies help to correct ovarian, tubular and uterine problems causing infertility.
4.Ayurveda treatments help in releasing tension and removing impurities from the body. They nourish the body, revitalize the mind and strengthen the immune system. They are beneficial in reducing stress, nourishing all dhatus of the body and pacifying Vata.
Ayurvedic Herbs:
Infertility itself does not stand alone. It is the result of some other disease. So the herbs used in the treatment are directed towards eradicating the underlying cause. The most commonly known and used herbs such as Ashwagandha (Withania somnifera), Shuddh Shilajit (Black Bitumen), Amalaki (Emblica officinalis) are include in Fax Capsule which is extremely useful formulations which help create the synergistic hormonal balance between the Follicle Stimulating Hormone (FSH) and the Luteinizing Hormone (LH).
No individual herb alone is considered useful for promoting fertility. Therefore, a combination of herbs is used in the treatment of infertility with the purpose of correcting an organic or functional problem that causes infertility.
Ayurvedic herbs used in the treatment for infertility:

• Ovulation disorder - Ashoka, Dashmoola, Shatavari, Aloe vera, Guggulu etc.
• Premature ovarian failure (POF) - Ashoka, Dashmoola, Shatavari, Guduchi, Jeevanti etc.
• Blocked fallopian tubes, adhesions (scar tissue) and pelvic inflammatory disease - Guduchi, Punarnava etc.
  The right combination of herbs helps in regulating menstrual cycles, enhancing general health and wellness, revitalizing sperm (enhancing a man's sperm count, morphology and motility), reducing stress, enhancing sleep, controlling anxiety and increasing energy level, balancing the endocrine system and improving blood flow in pelvic cavity, thereby promoting fertility.
  

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