Patient case: Male Infertility.
Mr. KM has no significant past medical history. He has never had any major illnesses, surgeries, or hospitalisations. There is no family history of infertility. He works as a civil engineer and has a relatively sedentary lifestyle. He does not smoke, drinks alcohol occasionally, and reports no recreational drug use. Mrs. KM has regular menstrual cycles, and a gynaecological evaluation has ruled out any apparent issues on her side.
Mr. KM and his wife live in a suburban area of Accra. They have access to a balanced diet but report occasional exposure to environmental pollutants from nearby industrial activities. The couple is under some stress due to societal pressure to conceive.
Physical examination of Mr. KM is unremarkable. His vital signs are within normal limits, and there are no signs of hormonal imbalances or physical abnormalities in the reproductive organs.
A semen analysis was conducted, revealing a significantly low sperm count (oligospermia) with poor motility and morphology. Hormonal profile tests show normal levels of testosterone, follicle-stimulating hormone (FSH), and luteinising hormone (LH). No varicocele or other physical abnormalities were detected on scrotal ultrasound.
Male infertility secondary to low sperm count, possibly exacerbated by environmental factors and lifestyle.
- Lifestyle Modifications:
- Encourage regular exercise and a balanced diet rich in antioxidants to improve sperm quality.
- Advise reducing alcohol intake and avoiding exposure to environmental toxins where possible.
- Stress management techniques, including counselling and relaxation exercises.
- Medical Treatment:
- Consider the use of supplements such as folic acid, zinc, and coenzyme Q10, which may help improve sperm count and motility.
- If no improvement is seen in six months, consider assisted reproductive techniques, such as intrauterine insemination (IUI) or in vitro fertilisation (IVF).
- Follow-Up:
- Repeat semen analysis in three to six months to assess the response to lifestyle changes and medical treatment.
- Regular counselling sessions to support the couple emotionally throughout the treatment process.
With appropriate management and potential use of assisted reproductive technologies, there is a fair chance of achieving conception. However, continuous monitoring and adjustment of treatment may be required.
(A). Hormonal imbalance
(B). Low sperm count (oligospermia)
(C). Varicocele
(D). Irregular menstrual cycles of his wife
(A). Increased alcohol consumption
(B). Reduced physical activity
(C). Stress management techniques
(D). Exposure to industrial pollutants
(A). Elevated testosterone levels
(B). Normal hormone levels (testosterone, FSH, LH)
(C). Low follicle-stimulating hormone (FSH)
(D). High luteinising hormone (LH)
(A). Surgical intervention
(B). Use of assisted reproductive techniques like IUI or IVF
(C). Long-term use of testosterone replacement therapy
(D). No further treatment
