Resurgence of Andrology and its importance to male fertility
Andrology has been described as “the branch of physiology and medicine which deals with diseases and conditions specific to men”. Andrology actually came into being as a branch of gynaecology, urology, endocrinology and dermatology. Its focus is on male reproductive issues. Andrologia, the first international journal of andrology, was published in 1969.
Infertility has been on the increase and is affecting millions of people in the world. Research has shown that the cause in almost half the cases is due to the male partner. There has also been an idiopathic decline in sperm count and concentration over the last 40 years. This has resulted in an increase in male infertility. However, it has not been until recently that the subject of male infertility has come into the open. Till then, due to cultural issues, the concept of the male partner being the cause of infertility was neglected and not really looked into.
A relevant fact is that the 6th Edition of the WHO Manual has recognised the importance of andrology and, quoting from an authorised source, “commended the importance of SA (semen analysis) as a tool to:
– assist fertility/infertility diagnosis,
– assess male reproductive health and function to guide management,
– guide the choice of ART procedure,
– monitor response to treatment and
– measure the efficacy of male contraception.”
One of the setbacks in advancement of andrology has been the belief that ART – assisted reproductive techniques – can set right all infertility issues and all that is required to achieve pregnancy is to have a spermatozoon (mature, motile sperm cell) from a donor. However, more than this is needed and research has shown that the importance lies in the quality of the gamete, which is a mature haploid (having a single set of chromosomes) germ cell which is able to bond with another of the opposite sex to form a fertilized embryo.
However, with the recent advancement in the field of andrology, new possibilities have arisen whereby it is easier for the male partner to have his sperm and semen assessed which, in turn, help the couple in dealing with any problem with conception.
Many discoveries over recent years have resulted in various technologies such as omics – which is used to identify and determine pools of biological molecules, investigating their roles in relationships and actions in living cells. Other areas that are being covered are OS (oxidative stress), SDF (sperm DNA fragmentation), AI – artificial intelligence, management and treatment of azoospermia (where there are no sperm in the semen), cryopreservation – the freezing and storage of sperm for future use, genetic engineering or modification, stem cell therapy – repairing dysfunctional tissues using stem cells and, of course, surgery.
Other causes affecting reproductive health are also being looked into – environmental issues such as exposure to excessive heat, air pollution and use of harmful chemicals which can affect semen quality. Also affected could be menstrual cycles, menopause and fertility issues with women.
Although there has been a tremendous amount of advancement in the field of Andrology, much more research needs to be conducted, and is ongoing, to bring the maximum benefit to couples wanting to have a family.
In the meanwhile, we at Andrology Center, have state of the art equipment and technology to carry out authentic semen analysis and DFI (Sperm DNA Fragmentation) tests, providing standardized reports. We are pleased to state that we are the only authorised laboratory in India to perform the genuine SCSA (sperm chromatin structure assay) tests, which guarantees accurate results. With such documentation, it is easier for the fertility specialist to analyse the reports and provide the best treatment options for the couple.
