Male Infertility Q & A: Dr. Rupin Shah

Dr. Rupin Shah is an internationally recognized expert in the field of male infertility and sexual dysfunction. He is the pioneer of male reproductive microsurgery in India and is the developer of the first Indian Penile Prosthesis. He is a consultant to various IVF centers in India and regularly visits Fakih IVF, Dubai, for consultations and sperm retrieval by micro-dissection TESE surgery. Send your queries for Dr. Shah to info@fakihivf.com.

“My semen reports are constantly fluctuating”

Question: I am 27 years old and have been trying for a child for 3 years. My problem is that my semen quality is constantly fluctuating. One day it is 10 million and then 3 million a few weeks later. Why is this happening? What should I do?

Answer by Dr. Shah:  Semen counts fluctuate naturally in everyone. In men with normal counts, this fluctuation will be at a high level, between 50 and 100 million. In someone with sub-fertility, this fluctuation will begin at lower levels, like in your case. Do not worry about the fluctuation. However, you should try to improve the overall sperm count.

If you have a varicocele, then operation for the varicocele may help. Avoid excess heat, tobacco and smoking. Have regular meals, and consume good quantities of vegetables and salads to ensure adequate anti-oxidants in your diet.

Your doctor will check your hormone levels – if there is any deficiency, then hormone therapy may help. Otherwise your doctor will prescribe supportive therapy with minerals, anti-oxidants and other supplements. If the counts continue to fluctuate at low levels despite therapy then you will need to consider IVF.

For further clarification, contact Dr. Rupin Shah.

“I cannot give a semen sample”

Question: I am able to have regular intercourse with my wife and ejaculate without a problem. However, whenever I am asked to give a sample in the laboratory for testing or therapy I am unable to collect a sample. As a result we cannot proceed with treatment. We are very frustrated by this. Please help us.

Answer by Dr. Shah: Do not get distressed – this is a common problem and results from performance pressure. There are various solutions. You can use coitus interruptus to collect a sample – have intercourse at home and at the moment when you feel you are about to ejaculate, withdraw and collect the semen outside. If this is difficult, ask your infertility specialist for a non-spermicidal condom. Then you can have intercourse wearing the condom and collect the sample in it. If that does not work, then a special penile vibrator can be used. This will provide a strong but painless stimulus to the penis resulting in ejaculation in most cases. Finally, if nothing else works, sperm can still be aspirated from the testes with a tiny needle and these sperm can be used for IVF.

If you need further clarification, contact Dr. Rupin Shah.

If you would like to ask Dr. Shah any questions, you may post them on our forum and he will respond as soon as possible.