60% of infertility cases involve a male factor. 40% are primarily male, while 20% are mixed male and female. If a couple has difficulty conceiving, it is logical to evaluate both the man and the woman. Before scheduling costly and invasive tests for a female partner, it is advisable to schedule a thorough and accurate semen analysis. Varicoceles can be caused by dilated veins within the scrotum. This can have a negative impact on sperm production. Varicoceles can be very common. Varicoceles are a common problem in men who experience infertility. Varicoceles are a common problem in secondary infertility, which is when a man is unable to have another pregnancy. Varicoceles can be easily treated by an outpatient male infertility specialist. This procedure involves local and general sedation. The incision is made at the pubic hairline (so that no muscles are involved) and the use of an operating microscope.
Research
Multiple studies have shown that this technique is more effective, has fewer complications, and causes less pain after the operation. It may be difficult for the seminal fluid to flow into the female’s reproductive tract if it is thick. In cases of seminal fluid abnormalities, sperm can often be placed directly into the uterus via intrauterine injection (IUI). Sometimes, sperm-carrying ducts may be blocked or missing. In certain situations, the ducts can be repaired or unblocked. If this is not possible the sperm can be taken and injected directly into the eggs of a woman. It is possible for men to develop antibodies (immune response) to their own fertilized eggs. This could be due to testicular trauma, testicular infections, large varicoceles or testicular surgical procedures. It is not clear what treatment to use for anti-sperm antibody. Corticosteroids may be used to treat anti-sperm antibodies in men.
This can cause significant morbidity in men. Aseptic necrosis (noninfectious destruction) of the hip is the most serious. This requires hip replacement. In most cases, intrauterine fertilization is the first level of intervention. In-vitro fertilization (IVF) is the first level of intervention. If there are anti-sperm antibodies, it is possible to inject the sperm directly into an egg (ICSI). This can include inability to erect or maintain an erection, premature (or backwards) ejaculation and lack of ejaculation. This refers to the inability to produce sufficient numbers of mature sperm by the sperm-producing portion of the testicles. It could be that the testicle is completely devoid of cells that can divide to make sperm. Or, the sperm may not be produced in sufficient numbers to allow for sperm development.
Causes
Varicoceles, genetic abnormalities and hormonal factors could all be responsible for this situation. Even if the testes only produce a small amount of sperm in a low-production situation, the sperm can still be harvested and used in advanced reproductive techniques. Cryptorchidism is a condition in which a baby boy is born with the testes not fully descending into the scrotum. Current recommendations are that the testes be removed surgically if they have not fallen by themselves after one year. Testicular failure may be caused by cryptorchidism. Half of all men born with both testes undescended will not have sperm in their ejaculate, even if they are surgically removed. A number of common drugs can have a negative impact on sperm function and production.
Pituitary hormones stimulate the testicles to produce sperm. The testes won’t produce maximum sperm if these hormones are missing or greatly reduced. Importantly, men who use androgens (steroids), for bodybuilding, reduce the production of hormones that are necessary for sperm production. All men suffering from male factor infertility should have their hormones checked. This will allow you to rule out any serious medical conditions and provide more information about the sperm-producing abilities of your testes. It may also reveal situations that require hormonal treatment. There are many possible infections in the reproductive tract. These infections can be caused by infections of the prostatic gland (prostatitis), the epididymis or the testes.
Viral Infections
Post-pubertal viral infections may cause significant damage to the testes (atrophy) and can cause irreversible infertility. Blockages in the sperm ducts may be caused by bacterial infections or sexually transmitted disease. Viral infections or active bacterial infections can have a negative impact on sperm production and function. White blood cells, which are the body’s response to infection may also have a negative impact on sperm membranes. This can make them less healthy. If there are excessive white blood cells, bacteria, or other abnormalities in a semen sample, it is important to perform a general genital cultures as well as cultures for sexually transmitted diseases such as mycoplasma, Ureaplasma, and Chlamydia.
Genetic testing must be done for men whose total number (calculated by multiplying volume of ejaculate by concentration of sperm by percent that are moving), is less than 5,000,000. Sometimes, low sperm production can be due to genetic abnormalities that could have serious consequences for children. The quality of semen has been shown to be affected by smoking. Smoking can reduce the chances of a woman having a child and increase the likelihood that a woman will have a miscarriage. Smoking marijuana can lead to a decrease in sperm count, motility, normal morphology, and a decrease in average sperm count. Even occasional cocaine use can cause a decrease in sperm count, motility, or normal morphology. Anabolic androgenic steroids can cause a severely reduced spermatogenesis, or even complete absence of sperm. These steroids can cause persistent depression of the pituitary and hypothalamus, which can be irreversible even if the steroids are stopped. Moderate alcohol consumption does not affect male fertility. Alcohol abuse can cause hormonal imbalances and be a gonadotoxin.
Fluid Tests
Standard Semen Fluid Tests – Color, viscosity, time until specimen liquefies, and other parameters should all be measured. A seminal fluid defect can adversely affect the sperm’s ability to move through a woman’s reproductive tract. Forward Progression: This shows how the moving sperm are progressing. Only when the motility (percent of moving) and the forward progression are combined can an accurate picture be obtained about sperm movement. If the forward progression is not recorded separately, a man’s motility can be normal. However, sperm may be moving slowly or not at all.
Viability: Sperm can be alive but not moving. To determine how much of the sperm remains alive, a special staining technique can be used. This test is used to determine if the motility (percentage of sperm moving) is below thirty percent. Fructose is a test that determines if sperm are not being made in men who have no sperm or very few sperm in their ejaculate. A fructose test is able to help distinguish between these two issues. Post-Ejaculatory Urinalysis: Some men ejaculate all of their sperm backwards into the bladder. This can be detected by having the man ejaculate, then immediately afterwards urinate in a separate cup. To determine if there are sperm present, the post-ejaculatory urine can be centrifuged.
Comfort and Convenience
To maximize your results, you need to be as relaxed as possible. The specimen should be taken to the laboratory in a designated area. A majority of men will have male factor infertility that can be treated. These conditions can be treated with medication or surgery and a man will often notice a significant improvement in their semen analysis. This will increase his chances of having a child with a partner through natural intercourse or less invasive methods. Advanced reproductive techniques may be an option for men with conditions that are not easily treated. Even men who don’t produce sperm may still be able to obtain some living sperm from other sources and have a pregnancy with advanced reproductive techniques. This information will be available to those men who don’t produce any sperm and can then explore other options.