Male infertility can develop for various reasons. Symptoms are manifested depending on the factor that caused the problem. There are many ways to treat infertility in men.
Often, drug therapy is performed. The most radical is surgical intervention, which is indicated for varicocele and obstruction of the vas deferens.
Artificial insemination methods may also be used.
Infertility in men is a violation of reproductive function, expressed as a change in the quality or quantity of sperm.
In infertility, there are either very few sperm or they are very weak and cannot penetrate the egg and fertilize it.
There are many reasons for the development of infertility:
- Varicocele. Impaired spermatogenesis can occur with an increase in temperature in the scrotum, caused by varicose veins of the spermatic cord and testicles.
- Obstruction of the vas deferens. With unilateral obstruction, sperm quality decreases, and bilateral obstructs the flow of sprematozoa into the ejaculate. Obstruction (obstruction) may be the result of sexually transmitted diseases, inflammatory processes, injuries and the appearance of neoplasms.
- Diseases and pathological conditions of the testicles. Failure of spermatogenesis, lack of active sperm in sperm is caused by some hereditary pathologies, genetic or chromosomal mutations, and mumps.
- Infections of the genitourinary system. By themselves, diseases that are transmitted through sexual contact do not cause disturbances in sperm activity, but if the infection becomes chronic, it damages the cells of the body, which leads to an autoimmune reaction and immunological infertility.
- Inflammation of the prostate gland of a chronic form (chronic prostatitis). The disease leads to a decrease in sperm quality and can also affect the reproductive function of men.
- Immunological infertility. An autoimmune disease that develops against the background of injuries and / or inflammatory processes that occur in the genitals of a man. As a result, the body begins to produce antibodies against its own sperm, which leads to a sharp decrease in their number, decrease in activity and subsequent death.
- Hormonal disorders. Hormonal malfunctions are one of the common causes of the problem of sperm activity in men. Endocrine diseases, as well as neoplasms in the pituitary-hypothalamic system, can provoke a hormonal imbalance.
- Cryptorchidism. Pathology, which is manifested by undescended testicle in the scrotum. Normally, this happens before birth. With the timely detection of cryptorchidism, a corrective operation is performed. If you do not pay attention to this pathological condition, then overheating will begin to develop, which will lead to inhibition of spermatogenesis and absolute infertility in the future.
- Hypospadias. A pathological condition associated with the incorrect location of the urethral opening, in which sperm is released into the bladder. It can only be corrected by surgical intervention.
- Erectile dysfunction. Infertility can cause insufficient erection, lack of erection, premature ejaculation.
In addition to physiological reasons, the following factors can affect sperm quality:
- improper lifestyle (lack of exercise, the presence of bad habits, nutritional errors);
- excessive physical activity;
- stress and psycho-emotional problems;
- some drugs (steroids, antidepressants);
- sharp fluctuations in weight;
- harmful professional activities (the presence of constant vibration adversely affects spermatogenesis);
- hypothermia or overheating;
- adverse environmental impact.
In rare cases, it is enough to exclude adverse factors and sperm quality will return to normal. But this is an exception, most often the patient needs medical, surgical and / or rehabilitation treatment.
- The main sign of male infertility is the absence of pregnancy in a partner after a year of active sexual life without the use of contraceptives.
- Additionally, a man can observe the symptoms of diseases that lead to infertility.
- If the cause of infertility is a varicocele, then appear:
- pulling pain localized in the scrotum, which intensifies after physical exertion and decreases during rest;
- external testicular atrophy - with an advanced form of the disease;
- expansion of veins in other parts of the body, for example, hemorrhoids or varicose veins on the legs (the symptom is not a sign of varicocele, but indicates a tendency to develop such a pathology).
Infertility provoked by infectious diseases will be accompanied by:
- discharge from the urethra;
- itching and burning in the urethra;
- pain in the lower back and / or scrotum;
- pain during urination;
- weakness, general symptoms of intoxication (nausea, vomiting, sweating);
- clouding of urine and / or the presence of traces of pus in it;
- the presence of residual blood in urine or ejaculate.
With chronic prostatitis, the following symptoms can be observed:
- pains localized in the pelvis, scrotum, lower back;
- frequent urination
- pain that occurs during urination;
- traces of blood in the ekulat;
- urination at night.
Types of inability of the inability of a man to conceive are divided by anatomical and functional signs:
- Secretory infertility. May be temporary or permanent. It occurs due to malfunctions in the production and maturation of spermatozoa. Temporary secretory infertility occurs under the influence of adverse factors: high ambient temperature or toxic substances. After their elimination, spermatogenesis is restored, and sperm quality improves. The permanent form is caused by genetic or congenital malformations of the testicular tubule system. If testicular tubule atrophy develops, then infertility is irreversible.
- Excretory infertility. It is caused by difficulties in passing sperm through the ejaculatory canal. This can occur with the development of adhesions in the tubules of the epididymis. In this case, sperm do not enter the seminal fluid. Adhesions form after sexually transmitted diseases, injuries, and also with the development of neoplasms in the tissues of the testis.
- Autoimmune infertility. It develops as a result of a violation of the body's natural protective functions. As a result, an immune response arises - own spermatozoa are perceived as foreign substances. Sperm activity begins to be inhibited, which is why they die in the future.
- Combined infertility. Caused by impaired sperm maturation and the presence of factors that prevent ejaculation (erectile dysfunction).
- Relative infertility. This term refers to infertility, the apparent causes of which are not found. With this form of infertility, a man’s spermogram has no deviations, there are no obstacles to sexual life, but conception does not occur. Sometimes this phenomenon occurs with violations or non-observance of sexual hygiene.
The first step to recovery will be the correction of lifestyle. It is necessary to eat right, maintain physical activity, just relax and eliminate bad habits and factors:
- too high or low temperatures;
- harmful radiation;
- alcohol abuse;
- taking drugs.
In this case, sexual life should be regular - at least three times a week.
The choice of drugs for the treatment of male infertility depends on the factor that caused it:
- Infectious disease that caused infertility is treated with antibacterial agents that suppress the pathogen. After antibiotic therapy, the use of immunomodulating drugs, as well as vitamin complexes, is necessary to increase the body's defenses.
- Inflammatory processes that provoked infertility are treated with non-steroidal anti-inflammatory drugs, physiotherapy and immunostimulants.
- Improving sperm secretion is achieved by taking multivitamins for two to three months. To improve the quality of fresh sperm, vitamins A and E are prescribed, which have an antioxidant effect. Improving the quality of spermatogenesis is also provided by mineral-vitamin complexes, which include zinc and selenium. It is appropriate to use pumpkin seeds, a natural product with the highest zinc content. A similar effect is possessed by drugs that contain L-carnitine.
- Improving blood supply to the testes and prostate gland is stimulated by drugs aimed at regulating microcirculation (Trental, Curantil, Solcoseryl).
- Autoimmune causes of infertility respond to hormonal therapy. To strengthen the barrier between the seminal ducts and blood vessels, drugs containing hydrocortisone or prednisone are prescribed. Hormonal drugs are used with caution, as they can lead to erectile dysfunction if used improperly.
To solve the problem of male infertility are also used:
- Surgical intervention. Operations are performed with varicocele or impaired patency of the vas deferens.
- Insemination. This procedure consists in introducing the sperm of a man inside the uterus of a partner using a special pipette.
- Sperm donation. If the patient does not have erectile function, then sperm is obtained directly from the testicle. If none of the received sperm is suitable for fertilization, then there is only one way out - the use of donor sperm.
- Installation of the endoprosthesis. Some medical institutions of both foreign and Russian clinics offer an innovative way to solve the problem of erectile dysfunction - the installation of an endoprosthesis for a man. Recent developments represent a complex elastic cylindrical structure. A container of liquid for the cylinders is located behind the pubis, near the bladder. The pump device is placed in the scrotum. Immediately before sexual intercourse, fluid flows into the cylinders, stimulates them, as a result of which a high-quality erection develops. After sexual intercourse, the pressure in the cylinders is weakened and the genitals are brought into a naturally relaxed state.
- IVF (in vitro fertilization):
- ICSI technology. The fertilization procedure takes place in the laboratory. Sperm selection is carried out under a microscope - the most active and morphologically suitable one is selected. Fertilization takes place as follows: the selected sperm is brought to the incision in the egg membrane by means of a micromanipulator. Inside the egg, it penetrates without artificial stimulation.
- Pixie technology. The main difference from the previous method of fertilization is the choice of sperm. In this case, the selection of the biomaterial is carried out not visually, but with the help of hyaluronic acid. This method allows you to get the most healthy and mature sperm. Then, the selected sperm is introduced into the cytoplasm of the egg using a superthin needle.
Male infertility is not always absolute and most often the problem can be solved. If you go to the hospital in a timely manner, specialists will make an accurate diagnosis and prescribe the correct treatment. Compliance with all the recommendations of a doctor and maintaining a healthy lifestyle in most cases leads to the desired result - pregnancy of a partner and the birth of a child.
What diseases can cause infertility in men?
For a long time it was believed that infertility is most often a female problem. But in recent years it has been proven that in childless couples in 40-50% of cases men are infertile. If you know what diseases can cause impaired fertility in men, then you can reduce the risk of developing this pathology through prevention.
Infertility is divided into two forms:
- Primary - these are cases when no pregnancy has come from a man.
- Secondary infertility develops in men, from whom women have already become pregnant.
Diseases leading to infertility can be either congenital or acquired.
Pathologies of the development of male organs
During intrauterine development, exposure to unfavorable factors can lead to disruption in the formation of the genital organs of boys.
The most common congenital pathologies are:
- complete absence of testicles or monorchism - one testicle;
- cryptorchidism - a delay in one or two testicles in the abdominal cavity, inguinal canal (this leads to its overheating and impaired sperm production);
- testicular malformations - dysgenesis.
The intrauterine development of the penis can also pass with the formation of congenital malformations. With the splitting of the urethra - epispadias, the urethra is not fully formed.
Depending on the severity, a cleft can reach the bladder.
- Mild forms do not lead to erectile dysfunction, and the most severe ones are accompanied by hook deformity of the penis and painful erection, sex becomes impossible.
- Hypospadias can lead to infertility in the absence of timely surgical treatment. This is a pathology in which the urethral opening is not located in the center of the glans penis, but is displaced towards the perineum.
Violation of ejaculation occurs with phimosis - narrowing of the foreskin. The cause may be an infection or a congenital anomaly.
Another factor in impaired or complete lack of fertility are diseases of the ejaculatory system. The pathology of the hay cord breaks the secretion of sperm, only the seminal fluid secreted by the prostate can be present in the ejaculate, but there will be no sperm. This condition is called Young's syndrome.
Varicocele - varicose veins of the spermatic cord, can be congenital and acquired. In this case, there is a slowdown in blood flow in the scrotum, a violation of thermoregulation and overheating of the testicle.
This condition is observed in 40% of cases in men with infertility.
An additional factor is the immune response against testicular tissues: normally they do not come in contact with blood, but this happens with varicocele.
Injuries to male organs, inflammation or lack of treatment for varicocele can lead to the development of dropsy of the spermatic cord. This condition is not always accompanied by infertility, but in the absence of treatment will lead to it.
Sexually transmitted diseases and STIs
We must not lose sight of sexually transmitted diseases that cause male infertility. These include:
Such pathologies as chlamydia, ureoplasmosis, trichomoniasis, mycoplasmosis, candidiasis are sexually transmitted infections and are not included in the group of sexually transmitted diseases.
- Gonorrhea can be complicated by the development of epididymitis - inflammation of the testicular tissue. The disease develops sharply, the testicle becomes inflamed, it hurts greatly and prevents movement. The result is a violation of sperm formation.
- Inadequate treatment of acute gonorrhea and the ascending spread of infection leads to damage to the prostate gland. Chronic gonorrhea leads to prostatitis, which is complicated by infertility and impotence.
Chlamydial infection often has a hidden course. Many people diagnose it already at the stage of chronic changes. Chlamydia are intracellular parasites, often combined with another genital infection.
- In the absence of treatment, the pathogen ascends into the prostate gland, testicles. A center of chronic inflammation is formed there.
- Prostatitis caused by chlamydia leads to mechanical compression of the urethra and vas deferens.
- With damage to the testicular tissue, irreversible processes lead to scarring of the tubules. Sperm are not able to exit, sperm quality is deteriorating.
- Trichomoniasis is transmitted sexually. This pathogen initially causes urethritis, but with a long course and spread in an ascending way, Trichomonas is able to affect the seminal vesicles, the prostate gland, which leads to persistent infertility.
Candidiasis in men is not a characteristic pathology, women are more susceptible to it. But with weakened immunity, candidiasis of the penis develops. It can manifest as balanitis and urethritis. In this case, sexual intercourse becomes painful, a man avoids sex. If untreated, phimosis forms - a narrowing of the foreskin.
Endocrine and other diseases
Diseases leading to infertility can relate to the pathological conditions of completely different systems.
Lack of fertility is recorded in 30% of patients. At the same time, several factors act on its formation:
- A decrease in testosterone levels, which is more often observed with type 2 diabetes. This is due to concomitant obesity, as in the adipose tissue, androgen to estrogen is metabolized.
- Violation of blood microcirculation in the pelvic organs and narrowing of the lumen of blood vessels. As a result, blood flow to the penis becomes impossible in an amount sufficient for an erection.
- Polyneuropathy violates the sensitivity of the head of the penis. Sexual intercourse becomes longer, and the moment of arousal itself is delayed in time. Neuropathy also affects the moment of ejaculation: violation of the innervation of the sphincter of the bladder leads to the throwing of sperm along the path of least resistance - in the opposite direction.
This is an endocrine organ that sets the rhythm of secretion of all hormones in the body. Pituitary adenomas are accompanied by increased secretion of certain hormones. For example, an increase in prolactin, a hormone that causes the production of milk after childbirth, leads to a decrease in libido and a deterioration in erection.
Hormonal infertility is observed with dysfunction of the thyroid gland. Hypothyroidism leads to erectile dysfunction.
Multiple sclerosis is twice as likely to affect women, but it also develops in men. At a certain stage of the disease infertility develops.
Its causes may be a decrease in activity, increased fatigue, loss of libido. Physiological problems also join - urinary incontinence, impaired innervation and sensitivity.
To this is added the instability of mood and a decrease in self-esteem, the appearance of self-doubt.
- Affect the ability to conceive to a lesser extent. Diseases of the liver with a violation of its function lead to changes in the hormonal background, a decrease in testosterone, an increase in the proportion of female sex hormones.
- This is an infectious disease from which vaccination is provided in childhood. If an unvaccinated boy becomes ill, then this threatens with rapid inflammation of the testicular tissues and damage to germ cells.
Immune form of infertility
It develops after the inflammatory diseases of the testicles, injuries, varicocele. At the same time, antibodies are produced to their own sperm. When they attach to the tail of the sperm, its mobility decreases, to the head - the ability to fertilize. Often the cervical secret of the wives of such men also contains antibodies to sperm. This makes fertilization unlikely.
The presence of genetic abnormalities cannot be influenced externally. If a breakdown occurs, then only in utero, at the time of conception. Many chromosomal abnormalities are accompanied by sterility of the human host.
- Klinefelter's syndrome is the presence of an additional sex chromosome. Normally, the female genotype is recorded XX, in men XY. With this pathology, a man has a full set of chromosomes equal to 47, XXY or simply XXY. Patients with Klinefelter syndrome are almost always sterile. The testicles are significantly reduced in size, sperm are absent.
- Kalman syndrome is manifested by the absence of secondary sexual characteristics. Pathology is based on insufficient synthesis of gonadotropic hormones. Their reduced concentration leads to a violation of testosterone production. Sperm formation becomes impossible.
There are other chromosomal pathologies accompanied by infertility. This is a natural defense against the spread of defective genes.
Sometimes a man considers himself infertile with the impossibility of an erection or completion of sexual intercourse. The reasons for this condition can be exclusively psychological. For some, failure in bed is very difficult. In this situation, the behavior of the partner matters. If a woman begins to focus on unsuccessful sexual intercourse, in every possible way indicates the failure of the spouse, then he will gain a foothold in the negative emotional coloring of the sexual intercourse.
Subsequently, the man will initially be configured to fail. Even with libido, an erection may not occur or may be insufficient.
In some cases, psychological infertility is caused by various fears and phobias. A man, like a woman, may be afraid, for example, to have children. In such cases, sexual intercourse may be incomplete.
Male Infertility Prevention
To avoid the development of sterility, especially at a young age, it is important to observe the basics of a healthy lifestyle and personal hygiene, to be engaged in prevention, and not treatment:
- Proper nutrition is useful not only for the overall strengthening of the body. A sufficient amount of vitamins, trace elements, as well as nutrient composition affects the quality of sperm. Sperm are found in seminal fluid, which is a breeding ground for germ cells. Limiting animal fats leads to improved blood lipid composition. Complex carbohydrates, which require long digestion, do not lead to weight gain. It is also the prevention of atherosclerosis, diabetes.
- Personal hygiene consists in daily visits to the shower and the use of suitable underwear. It must be ensured that it is made of natural fabrics. For men's health, panties in the form of shorts are more useful. The swimming trunks squeeze the testicles, press them to the body, which leads to overheating and impaired spermatogenesis.
- It is good for your health to have one permanent sexual partner. Laxity in relationships, the frequent change of girls, as well as unprotected sexual intercourse increase the chances of contracting an infection. If you still had unprotected sex, then you need to immediately wash the penis with running water, treat it with a chlorhexidine solution. When the first unpleasant symptoms appear in the form of burning, itching, discharge from the urethra, you need to urgently consult a urologist.
- All existing chronic diseases need to be treated in a timely manner.
- Smoking, alcohol impair the functioning of blood vessels, which means blood supply to the penis and testicles. With alcohol abuse, chronic hepatitis and cirrhosis of the liver can develop. In this case, the metabolism of sex hormones is disrupted, and the man becomes infertile.
- Avoid stress and overwork.
- Limit physical activity to moderate, do not overwork.
- Avoid both hypothermia and overheating. It has long been proven that visiting a bath with the goal of steaming is dangerous for men's health: heating the testicles to 40 degrees completely stops the formation of sperm. Higher temperatures make this process irreversible.
- A sedentary lifestyle also negatively affects men's health. Working in a prolonged sitting position, for example, with drivers, truckers, office workers, leads to stagnation of blood in the pelvis. Genital nutrition is disturbed, which can lead to infertility. Therefore, you need to engage in active sports several times a week, visit the gym, just walk home at a moderate pace.
- Work in harmful conditions adversely affects sperm quality. Chemical industry, work in the hot shop, vibration lead to infertility. Therefore, you must avoid harmful work or regularly undergo a medical examination. When the first deviations in the state of health appear, the doctor may recommend a transition to less harmful work.
Diseases causing infertility in men are preventable. If you follow the elementary recommendations of a doctor, then such a problem will bypass.
The causes of infertility in men - the most comprehensive list
Infertility in men is 40% of the causes of infertility in a couple. But this figure is constantly growing, and according to some sources, male infertility is already on par with female in frequency. Usually, they immediately look for the reasons in the woman, and after they are not found, they begin research on male infertility.
- Infertility can be talked about a year after the couple began to try to have children. They immediately begin to examine a woman, or both partners at the same time.
- The causes of male infertility are no less subtle than those of women. Men say about infertility when his sperm is not enough to reach and fertilize an egg, or there is no sperm at all. A man’s inability to impregnate a woman does not necessarily indicate sterility.
- The causes of male infertility are numerous. Defining them is not always an easy task, and sometimes significant difficulties can occur.
Infertility in men can be associated with neuropsychic factors, diseases of the hypothalamic-pituitary system, diseases such as varicocele, cryptorchidism, and many others.
A fairly common cause of infertility is neuropsychiatric factors. Psychological stress, psychological shock, emotional overstrain can affect, to one degree or another, male fertility (the ability to create offspring).
Under the influence of neuropsychic factors, sexual disorders can be observed, which leads to a decrease in libido, problems with an erection, lack of orgasm, and it can also cause a violation in spermatogenesis.
Primary (hypergonadotropic) hypogonadism is a condition characterized by disorders affecting male gonads (testicles). The causes of this may be congenital or acquired diseases.
- Congenital diseases that can be the cause of infertility in men are chromosomal abnormalities (Klinefelter's syndrome), anorhidia, aplasia.
- Acquired disorders that can lead to infertility include severe inflammatory diseases, severe damage from external factors: chemotherapy, radiation therapy, alcoholism, intoxication, and others.
- Secondary (hypogonadotropic) hypogonadism occurs due to disorders that affect the hypothalamus or pituitary gland, in which less gonadotropins are released - hormones that affect the functioning of the gonads.
The pituitary gland (pituitary gland) is one of the endocrine organs of the human body, which is located on the surface of the brain. Intervention in its functioning can lead to problems with the production and quality of sperm. But this is a relatively rare cause of infertility in men.
With Kallman's syndrome, gonadotropic insufficiency of FSH (follicle-stimulating hormone) and active LH (luteinizing hormone) is observed. This condition can be observed with a tumor, meningitis, severe renal failure, etc.
Varicocele is a disease that is characterized by the presence of varicose veins of the testicle (venous plexus). This expansion occurs mainly on the left. Less commonly observed on the right or bilateral. The disease is characterized by impaired spermatogenesis, in which there is a decrease or absence of reproductive function.
There are two main reasons for varicocele, which lead to a violation of spermatogenesis. This is an increase in local temperature (in the organs of the scrotum) and a decrease in the amount of incoming oxygen, as a result of which tissue hypoxia and inflammation develop in the left renal vein.
Symptoms of the disease are severity and discomfort in the scrotum, pain in the testicles, which increases with physical exertion and sexual arousal.
If untreated, the pain becomes constant and very severe. During the examination of the testicles, there is a significant difference and asymmetry in the expansion of the veins. Depending on the severity of the disease, varicocele can be detected by touch or visually seen.
Learn more about varicocele and other vein diseases that everyone should know.
Twisting of the testicle, or rather blood vessels, nerves and vas deferens in one or both testicles, is also called an inversion of this organ. Therefore, at the same time, the production and movement of sperm is difficult, and the man is not reproductive. But symptoms such as pain, swelling in the testicles, and sometimes in addition to fever and vomiting, will quickly indicate this problem.
Cryptorchidism is one of the most common congenital anomalies, which is characterized by a delay in testicular development at various levels (abdominal cavity, in the inguinal canal or in the region of the external inguinal ring), in which it does not descend into the scrotum.
Initially, the male sex glands are located and develop in the lumbar region, from where they descend through the inguinal canal in the embryonic period and reach the scrotum.
When this does not happen, and the testicle remains in the abdominal cavity, it begins to lag behind in development due to the higher temperature in this place than in the scrotum. A significant violation of spermatogenesis occurs (infertility occurs). In a testicle that has not descended, there is an increased risk of developing a tumor process.
Treatment for cryptorchidism is carried out using hormonal therapy (gonadotropic hormones), and in case of failure, they switch to surgical therapy.
Many infectious diseases can damage the testicular germinal epithelium and impair male fertilization.
The first place among such diseases that lead to infertility belongs to mumps (mumps). The disease is caused by a virus that is transmitted by airborne droplets and rarely through contact or household routes.
- Whitening, as a rule, proceeds benignly with lesions of the parotid salivary glands and general intoxication. However, sometimes the disease can proceed more severely, which affects other glandular organs, including affects the male reproductive glands and pancreas.
- Severe orchitis (testicular inflammation) develops with impaired spermatogenesis.
- Gonorrhea is a sexually transmitted disease. The causative agent of the disease is the bacterium Neisseria Gonorrheae. Research has shown that more than 800,000 people suffer from gonorrhea every year.
Acute gonococcal orchitis is another infectious disease in which a violation of spermatogenesis and infertility can be observed.
There are immune causes that are observed with the so-called immunological infertility. It was found that in some cases, sperm can be recognized by the body as foreign bodies.
This type of infertility is characterized by the production of antibodies of different types (sperm-immobilizing, sperm-agglutinating, spermotoxic), which disrupt the normal function of sperm, which leads to infertility. Such antibodies can attack sperm at different stages of formation.
There can be many reasons for their formation, and they must be established by the attending physician.
This condition is much less common compared with other causes of infertility.
On the female side, there are also cases of the production of sperm antibodies, which prevents pregnancy
Radiation therapy and chemotherapy
The high sensitivity of the germinal epithelium to radiation has been proved, because of which its destruction occurs. Men exposed to radiation and chemotherapy have a higher risk of impaired reproductive function. These types of therapy affect spermatogenesis, leading to its violation. The degree of influence depends mainly on the dose and duration of such therapy.
There are many toxic factors that can lead to infertility. The most relevant can be considered chronic alcohol intoxication. Chronic alcoholism is often combined with liver diseases and is accompanied by sexual weakness and testicular atrophy.
Causes of the epididymis and vas deferens
Infertility can sometimes be caused by problems with the appendages of the testicles and ducts of the vas deferens. These structures can be easily checked with your fingers.
Various diseases are known that can affect the epididymis and vas deferens. They can be congenital or acquired. Of congenital diseases, in the first place is the congenital absence of the vas deferens. Acquired diseases are mainly represented by infections, which can lead to a deterioration in reproductive function to varying degrees.
Causes of the prostate and seminal vesicles
Infertility caused by problems on the part of the prostate and seminal vesicles is not so common. As a rule, inflammatory diseases of the prostate and seminal vesicles cause short-term or long-term infertility. Very often, these diseases are chronic and are not accompanied by clinical symptoms.
Chronic prostatitis, as an independent disease, is rare. Often, in addition to the prostate, seminal vesicles, testicular appendages and the urethra (urethra) also suffer. It is recommended for diseases affecting spermatogenesis to conduct a microbiological study of the secretion of the prostate gland and sperm.
It has been established that high body temperature can have a negative effect on spermatogenesis. The temperature in the scrotum is 2.5 ° C lower than that of the rest of the body.
With the help of the studies, it was found that spermatogenesis is stopped, peeling and degeneration of the embryonic epithelium when exposed to elevated body temperature (fever, or very hot baths).
It is suggested that wearing thick and narrow clothing at high ambient temperatures can lead to impaired spermatogenesis.
Every physical trauma (even not always of the genitals) can lead to problems with conception in humans. If a testicle or penis is injured, a man should consult a doctor in order to dispel suspicion of more serious consequences associated with infertility.
Idiopathic - a medical term for the absence of obvious obvious reasons, or they could not be established.
In some cases, the existing cause of infertility cannot be established.
Idiopathic causes are recognized in a minority of cases. This happens when hormonal, microbiological, serological studies are done on men, and their results are normal. Also, no reasons were found that could cause infertility.
All About Male Infertility - Polysmed
Male infertility is the inability of a man to conceive a child within one year of unprotected sexual activity, provided that the woman is healthy and capable of fertilization. If a couple has a problem with conceiving a child, then the examination should be passed to both the man and the woman, since there may be health problems in both sexual partners. See All About Female Infertility.
The main causes of male infertility are impaired sperm excretion during ejaculation and poor sperm quality.
- Low-quality sperm contains a small amount of sperm, sperm have an irregular shape or poor mobility.
- The following diseases can lead to male infertility: testicular injuries, varicocele, hormonal disorders, testicular inflammation, the presence of antibodies to spermatozoa, etc.
- The main methods for diagnosing male infertility are: sperm analysis (spermogram), detection of antibodies to sperm, blood tests for hormones, tests for infections, etc. Treatment of male infertility depends on the cause and includes drug treatment or surgery. See All about the treatment of infertility in women and men.
How to find out if a man is infertile?
If a couple has difficulties conceiving a child, namely, pregnancy does not occur within one year of regular unprotected sexual intercourse, then a man and a woman should undergo infertility testing. Prior to testing, it is impossible to determine whether a man is infertile.
What is sperm and sperm?
Sperm is a fluid that contains a large number of male germ cells, sperm. Sperm are produced in the testicles and during ejaculation (orgasm) are secreted into the urethra, and then enter the woman’s vagina. Next, the sperm move independently in the direction of the egg.
In order for a man's sperm to be able to fertilize a female egg, it must contain the right amount of healthy, motile sperm.
What causes can lead to infertility in a man?
Male infertility can be caused by many different diseases. Most of these diseases are asymptomatic, so often a man does not even suspect that he is sick. Infertility in men may be due to poor sperm quality or the fact that sperm cells are not secreted during ejaculation.
Infertility after testicular injury
Testicular injuries are one of the most common causes of male infertility. Some studies suggest that 30-40% of men who have testicular trauma have abnormalities in sperm composition.
The main symptoms of testicular injuries are: severe pain, redness, enlargement of the scrotum. Even long-standing testicular injuries can cause male infertility.
Infertility after mumps (mumps)
Mumps (mumps) is a viral disease that is usually transmitted in childhood. The main symptoms of mumps are: swelling of the neck (parotid glands), fever, etc. See Mumps (mumps).
In boys suffering from mumps, inflammation of one or both testicles is possible - orchitis. Bilateral testicular inflammation in mumps leads to infertility in 75% of cases, and inflammation of only one testicle can cause infertility in 25% of men.
Infertility and obesity
Overweight and obesity in men can cause infertility. This is due to the fact that in adipose tissue testosterone (male sex hormone) is converted to estrogen (female sex hormone). With insufficient testosterone, the formation of a large number of healthy sperm cells is impossible.
Infertility and Cryptorchidism
Cryptorchidism is a condition in which one or both testicles of a man is not in the scrotum, but in another place (in the abdominal cavity, under the skin in the pubic region, in the inguinal canal, etc.) This is due to the fact that the testes are located before the boy’s birth in the abdominal cavity, and by the time of birth or a little later, descend from there into the scrotum. Delayed prolapse of the testes leads to the development of cryptorchidism.
- As a rule, the diagnosis and treatment of cryptorchidism is performed with a rhinestone after the birth of a child, therefore, cases of cryptorchidism in adult men are extremely rare. Nevertheless, if there is only one testicle in the scrotum of a man, or if there are no testicles at all, he should consult a urologist.
- If in childhood the boy was operated on for cryptorchidism, then the likelihood that he will be infertile is very small.
Infertility and varicocele
Varicocele is an expansion of the veins in the testicles that often leads to infertility. More often, vein expansion is observed in the left testicle. In most cases, varicocele is asymptomatic and only in later stages can pain appear in the scrotum and an increase in half of the scrotum.
With varicocele in men, deviations in the analysis of sperm (spermogram) are observed: a decrease in the number of spermatozoa or their absence.
Varicocele lends itself well to surgical treatment. After surgery, sperm analysis is significantly improved in 70% of men, and they are able to conceive a child.
Infertility and sexually transmitted diseases
Some sexually transmitted diseases (chlamydia, trichomoniasis, mycoplasmosis, gonorrhea, syphilis, etc.) can cause infertility in men. These infections lead to blockage of the tubules through which sperm are secreted. In this case, the seminal fluid of a man will not contain sperm.
Sexually transmitted infections in men often occur without symptoms. However, for some time after infection, a man may experience pain and burning sensation when urinating and ejaculating. If treatment is not started during this period, then the infection becomes chronic and imperceptibly for men leads to infertility.
Infertility after surgery
Some surgical operations performed in the groin area can lead to infertility in men. This is due to the fact that during such operations, surgeons can touch the thin tubules along which spermatozoa should be secreted.
Operations for dropsy of the testicle (hydrocele) lead to infertility in 5-6% of cases. Infertility can also develop after surgery for an inguinal hernia.
Infertility with other diseases and medication
The following chronic diseases in men can be the cause of infertility: arterial hypertension (high blood pressure), diabetes mellitus, blood diseases (sickle cell anemia, thalassemia), chronic renal failure, tuberculosis, etc.
- Recently performed operations under anesthesia, myocardial infarction, stroke, extensive burns and other serious diseases can lead to temporary infertility due to impaired production of male sex hormones. After 3-6 months, as a rule, the ability to conceive is fully restored.
- The treatment of chronic diseases can also affect the ability to conceive a child. Long-term use of certain medications can interfere with sperm production and lead to infertility in men.
- Such drugs include: amiodarone, spironolactone, cancer chemotherapy (cyclophosphamide, methotrexate, etc.), colchicine, allopurinol, antibiotics (erythromycin, gentamicin, tetracycline), sulfasalazine, steroid hormones, etc.
As a rule, some time after the end of taking these drugs, the ability to conceive in a man is fully restored.
Infertility and impotence
Impotence in itself (inability to achieve or maintain an erection) is not a direct cause of infertility. This means that a man suffering from impotence can have healthy, motile sperm cells that can fertilize an egg.
Nevertheless, if a man finds it difficult to have sexual intercourse, and he does not have an ejaculation, then the onset of pregnancy in his partner becomes impossible.
Infertility and age of a man
The age of a man, as a rule, slightly affects the ability to conceive a child. Some studies have shown that older men contain more “wrong” sperm in their semen, but healthy sperm are enough to conceive a baby.
How to find out the cause of infertility in a man?
In order to clarify the cause of infertility, the doctor may recommend the following examinations:
- Sperm analysis (spermogram) allows the doctor to determine how much sperm is contained in sperm, as well as to determine the shape, sperm motility and many other parameters that affect sperm quality. See Spermogram: interpretation of the results. Norms and deviations.
- A blood or semen test for antibodies to sperm shows the presence of specific proteins that reduce sperm motility. Such proteins (antibodies) can be produced in a man’s body after testicular surgery (especially after vasectomy - the intersection of the vas deferens), testicular injuries, testicular inflammation, etc.
- A sex hormone blood test allows your doctor to determine the amount of sex hormones: testosterone, follicle-stimulating hormone (FSH) and luteinizing hormone (LH), prolactin. Too much or too little of these hormones can lead to infertility.
- Ultrasound is widely used to diagnose the causes of infertility. An ultrasound of the scrotum allows the doctor to determine the condition of the testicles, epididymis, spermatic cord. Ultrasound through the rectum (transrectal ultrasound) may be required if the sperm analysis shows a lack of sperm and your doctor suspects a blockage of the vas deferens.
- Testicular biopsy is a microscopic examination of an area of testicular tissue. A biopsy specimen is usually obtained with a needle or through a small incision in the scrotum (under local anesthesia). Using this analysis, a doctor can detect testicular diseases that lead to infertility.
- Vasography is a method for determining the patency of the vas deferens in a man. A vasography is given if there is a suspicion of obstruction of the ducts through which sperm are secreted during ejaculation.
The treatment of infertility in men is considered in the article All about the treatment of infertility in men and women.
Male infertility as a key factor in conception problems
The inability of the male mature body to fertilize is called infertility. A problem manifests itself, as a rule, with repeated attempts to conceive unsuccessfully in a pair. According to statistics, among Russian families in 45% of cases they consider infertility in men as the main reason for the inability to conceive a child.
Causes of male infertility
Such is the mentality that a woman goes to the doctor first. And when after a comprehensive examination it is discovered that she is healthy, the reproductive system is ready for conception, suspicions arise regarding the partner.
For successful fertilization and development of the embryo, the following conditions are necessary:
- full spermatogenesis of the correct sperm;
- sperm maturation;
- physiologically normal ejaculation;
- sperm activity outside the male genital tract until confluence with the egg and full fertilization.
Infertility in a man can be both congenital and acquired. Congenital inability to fertilize develops due to various pathologies in the development of the testicles (cryptorchidism, hypogonadism, etc.). Irregularities in the development of the urethra are frequent. Hypospadias, stricture are more often diagnosed. With these abnormalities, sperm do not enter the vagina.
Diseases leading to infertility in men
The causes of acquired male infertility are many. Most often, this condition is associated with past illnesses. Chronic inflammatory diseases alter normal spermatogenesis, lead to the formation of abnormal spermatozoa incapable of fertilization. The following pathologies can provoke the inability to conceive:
- mumps (mumps);
- sexually transmitted diseases;
- non-infectious inflammatory processes;
- developmental abnormalities in the reproductive system (cryptorchidism, hypospadias, varicocele, hypogonadism);
- trauma to reproductive organs, surgical interventions;
- hormonal disorders;
- genetic factor.
Infertility in a man, the causes of which, as a rule, are complex, is established most often.
Factors contributing to the development of pathology
In addition to pathologies accompanied by phenomena of inflammation, circulatory disorders, hormonal changes, there are contributing factors. Their presence exacerbates the action of the main causes or is the trigger for the development of disorders in the reproductive system of the body.
Infertility factors in men are very diverse:
- work with harmful production factors (ionizing radiation, vibration, chemicals, electromagnetic waves);
- lack of exercise, sedentary work;
- addictions (alcoholism, smoking);
- professional bicycle training;
- tight underwear;
- overheating and hypothermia of the pelvic organs;
- psycho-emotional overload, stress.
Not so scary at first glance, all of these reasons negatively affect sperm counts. Its qualitative and quantitative characteristics are declining.
Types of male infertility and their features
By nature, infertility is of three types:
- The secretory form of infertility is expressed in the inability of the sex glands to produce enough active sperm. Most often this is due to a violation of the blood supply to the tissues of the testes. At the same time, male germ cells have defects, their content in the seminal fluid is sharply reduced.
What the spermogram will tell about
- Autoimmune infertility. Violation of fertility in a man in this case is a complex form for diagnosis and treatment. Infertility factors by the autoimmune mechanism are more often injuries, surgical interventions. Antisperm antibodies perceive their own germ cells as foreign antibodies. They reduce sperm motility, can negatively affect the spermatogenesis process itself. Sperm cannot penetrate the cervical fluid.
- Excretory infertility. The cause of excretory dysfunction is more often the transferred inflammatory diseases, malformations of the urethra and adnexal glands. This type of infertility can cause obstruction of the vas deferens, as well as aspermatism. With this form, qualitative indicators of sperm change: the concentration of spermatozoa, their activity decreases, pathological germ cells appear.
Signs and symptoms of male infertility
Symptoms of infertility in men are more often blurred, non-specific. Sexual constitution, sexual activity has little effect on the ability to conceive.
- As a rule, infertile men lead a very active sex life, do not experience signs of sexual impotence, impotence. A man more often himself is not aware of his problem.
- No obvious symptoms, physical malaise with impaired fertility are observed.
- In 90% of cases, male infertility is almost asymptomatic. One essential feature is characteristic of it: the absence of fertilization with regular sexual activity for one year without contraceptives against the background of the partner's reproductive ability.
Clear signs of male infertility
- congenital pathologies requiring surgical intervention (cryptorchidism, varicocele);
- hormonal disorders with visible signs: underdevelopment of the testicles, swelling of the mammary glands, excess weight;
- with retrograde ejaculation, turbid urine is observed after intercourse.
Indirect signs of impaired reproductive function
- decrease in the amount of ejaculate;
- soreness during sexual intercourse;
- pain in the scrotum and testicles;
- decreased potency.
Autoimmune and genetic abnormalities have no clinical signs
A variety of causes of infertility in men, signs of the disease that do not have obvious manifestations, lead to the untimely appeal for qualified help of narrow specialists. This is an insidious pathology, detected, as a rule, only after many years of fruitless attempts by a man to acquire offspring.
Diagnosis of male infertility
The diagnosis of infertility is established after a comprehensive examination of the male body. The doctor collects a thorough history, analyzes the factors that can lead to impaired fertility. Some developmental pathologies (hyposadia, cryptorchidism) are diagnosed in the newborn age.
Varicocele is detected during a medical examination in the case of a man's complaint of pain during intercourse. During the examination, hypogonadism is also detected.
The most informative are the following research methods:
- qualitative and quantitative indicators of seminal fluid;
- complex blood and urine tests;
- immunological studies;
- tests for sexually transmitted diseases;
- prostate secretion studies;
- DNA analysis.
In most cases, decoding a spermogram gives a complete picture of a man’s fertility. This informative type of microscopic and morphological analysis allows us to judge the sperm motility, their number. The spermogram reveals defects in the structure of male germ cells, sperm viscosity, its acidity, etc.
Ultrasound examination allows to exclude diseases and pathologies of the prostate and testicles. To diagnose an inflammatory disease, microscopic methods for studying biological fluids are used.
- Hormonal tests are aimed at determining the concentration in the blood of testosterone, estrogen and other hormones. According to their results, the hormonal background of the male body is evaluated, which is important in the diagnosis and treatment of male infertility.
- If there is a suspicion of obstruction of the seminiferous tubules, the doctor will prescribe an X-ray examination with a contrast medium. Men suffering from varicocele may be prescribed dopplerography.
- If necessary, additional research methods will be prescribed, consultation with an endocrinologist, andrologist, sex pathologist.
It is worth noting that it is rather difficult for men to decide on a diagnosis due to the fact that most of the procedures they perceive as humiliating, and another part is rather painful. It is extremely important to support the spouse in order to overcome the difficulties encountered on the way to pregnancy.
Male Infertility Prevention
The etiology of the occurrence of impaired fertility of the male body is diverse. Therefore, the prevention of infertility is complex. It is necessary to take care of men's health from childhood. Regular visits to the surgeon and urologist during puberty are required.
A healthy lifestyle is one of the main preventive measures of infertility. Moderate sports, physical activity - the key to improving the functions of the reproductive system. It is important for a man to completely quit smoking and drinking alcohol. Frequent overheating (baths, saunas) and hypothermia are undesirable.
- A complete diet rich in proteins, nutrients, vitamins and minerals is a good prevention of not only infertility, but also strong immunity. Food should be healthy, natural. Spicy, smoked, fried foods are excluded from the diet.
- The basis of nutrition should be fish, meat, vegetables and fruits. An important role is played by the protection of the male body from stress and negative psycho-emotional factors.
- A regular full-fledged sexual life with a constant partner also beneficially affects a man’s fertility.
- First of all, we recommend reading the article pregnancy planning. From it you will receive general recommendations for the couple about the methods of preparing organisms before conception, as well as learn about the analyzes and specialists that are recommended to be visited by spouses.
Infertility in men is a problem not only of a medical nature, but also a social one.
Violation of fertile abilities of the strong half leads to psycho-emotional problems in the family, reduces the quality of social life.
Therefore, it is necessary to seek medical advice as soon as possible, begin to lead a healthy lifestyle, and eliminate the factors that contribute to the development of reproductive dysfunction in men.