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Male infertility - the most common causes

Male infertility - the most common causes


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The topic of infertility in many environments is quite often marginalized for various reasons, although it certainly should not be. Many couples who are looking forward to the anticipated biological offspring who are concerned do not want to talk about him or cannot admit it to themselves or their partner. It's worth it though face the problem of infertility, start the appropriate diagnostics and check the possibilities of overcoming the obstacle to becoming parents. To encourage our readers to do so, we will bend over today the most common cause of reproductive failure, which is male infertility.

Male infertility

Although it is usually very difficult for men to accept this, the male factor is the main cause of infertility, accounting for as much as 40% of its causes, followed by hormonal factors (25-30%), while maternal factors are only 5-8%.

Male infertility is usually caused by two main reasons: inability to have intercourse (inability to have sex) and / or inability to fertilize.
Good information is the fact that a large part of the causes of male infertility can only be transition state, and hence, thanks to appropriate therapy it can be cured.

Causes of male infertility

Male infertility is usually caused by two main reasons: inability to have intercourse (inability to have sex) and / or inability to fertilize. The first reason, associated with the impossibility of having sexual intercourse may have anatomical background (e.g. malformations such as hypospadias, topping, foreskin short frenulum or penile fibrosis), hormonal disorders, diseases affecting the nervous system or mental disorders. The latter may be a consequence of some kind of psychological trauma and manifest themselves in aversion to sexual contact, impaired sex drive, erectile dysfunction or premature ejaculation.

However, the inability to fertilize is largely associated with disorders related to sperm transport and testicular functions related to both sperm production and hormonal activity. Quite a common reason they turn out to be here variations in the form of varicocele, occurring almost always on the left side. Varicose veins are affected by the disruption of sperm transport and cause damage to the cell membrane and nucleus of the sperm in it, resulting in reduced fertility. This also happens in the case of cryptorchidism and a congenital absence of epididymis and vas deferens.

Some diseases, e.g. leukocytospermia, hydrocele, prostatitis and seminal vesicles can also adversely affect the quality of sperm itself and thus generate fertility problems. He is also responsible for some cases of male infertility Prostaglandin deficiency or hormones that are derived from arachidonic acid. They are found in large amounts in the semen, facilitating and accelerating the sperm reaching the ovum released into the fallopian tube. They also play an important role in fertility in the female body, for contractions of the uterus and fallopian tubes during reproduction and childbirth.

There are many more causes of infertility caused by the male factor, among which there are also chronic stress, medications, testicular overheating, or too tight clothes. For this reason, diagnostics in this direction should include thorough examination and honest and thoroughly collected interview.

Diagnosis of male infertility

Diagnosis of the male factor in infertility is based on:

  • andrological examination - it consists of assessing body composition, development and structure of the genitals (penis, testicles, scrotum, epididymis, vas deferens, prostate), sexual condition
  • semen analysis - the test is carried out after 4-5 days of sexual abstinence from any sexual intercourse. Tested in the last 3 months preceding the collection of sperm, he should not undergo any diseases or take medications. The following semen parameters are evaluated: volume, color, pH, fructose concentration, liquefaction time, number of spermatozoa in 1ml ejaculate, percentage of live spermatozoa, percentage of normal sperm, percentage of movable spermatozoa broken down by type of movement, percentage of sperm binding latex particles, number white blood cells in 1 ml ejaculate.

On the basis of the collected interview and performed tests, one can draw conclusions as to the real existence of the male infertility factor and its probable causes. A department called medicine deals with the diagnosis and treatment of male infertility Andrology, being an interdisciplinary specialty, combining such specialties as urology, gynecology, internal medicine, endocrinology and sexology.

Male infertility treatment

Complete infertility, i.e. irreversible inability to have biological offspring, occurs relatively rarely, which is why well-conducted, reliable diagnostics are the key to the success of proper infertility treatment.

The method of treatment of the male infertility factor depends on its cause - if it is in a mental disorder, it is advisable to visit a psychiatrist and psychologist if it is anatomical, then urological consultation will be required, when it concerns hormonal disorders, then the endocrinologist will take care of it.

Sometimes the reasons for infertility are also simply related with bad habits, lifestyle or medication, and then changing habits or stopping medication will be enough to improve a man's fertility. In some cases, however, the only treatment opportunity is assisted reproductive technology, but it should be remembered that to find out the causes and treatment options for infertility you have to face an unknown diagnosis and start diagnostics, so that perhaps the dream of being a parent will finally come true.

If, after applying for a child, after 12 months of regular intercourse 3-4 times a week without using any contraceptive method, you have not conceived, you should report this problem to a specialist. This decision can be extremely difficult for both partners, but it is worth remembering that the appropriate diagnosis will allow you to find out the cause and possible implementation of treatment, and can give hope for a happy ending and waiting for the desired child.

Pathophysiology. A textbook for medical students. VOLUMES 1 and 2 Editorial office: Sławomir Maśliński, Jan RyżewskiUrology. A textbook for medical students. Editors: Andrzej BorkowskiVivas-Acevedo G, Lozano-Hernández R, Camejo MI. Varicocele decreases epididymal neutral α-glucosidase and is associated with alteration of nuclear DNA and plasma membrane in spermatozoa. BJU Int. 2014 Apr; 113 (4): 642-9