Male Infertility
Causes
Reasons for Infertility in Men
Numerous factors can lead to male infertility. Men are frequently not examined for infertility until their partner has been screened and found to be healthy and ready to conceive.
Male infertility causes can be classified into the following categories:
Sexual dysfunction/problems
Abnormalities connected to the production of sperm and defective testicles.
Transportation abnormalities (blockage)
PROBLEMS RELATED TO IMMUNITY
Infertility is more common in men with sexually transmitted illnesses, but these conditions can be managed with appropriate diagnosis and treatment. There are certain guys who are born with a congenital abnormality that causes a barrier that prevents sperm from leaving the body through their semen. Retrograde ejaculation, or the state in which the semen does not exit the body during sexual activity, is another possible cause of diabetes. Rather, it gets into a man’s pee.
Men may experience infertility issues as a result of inflamed varicose veins (VARICOCOELE) in the penis. Infertility may also be caused by erectile dysfunction. Ejaculation too soon may potentially be the reason. These issues may be the result of external factors such as stress, excessive worry, or low self-esteem. In this situation, men can overcome infertility problems by reducing stress, improving their mood, or seeing a reputable therapist. Infertility can also result from physical conditions such high blood pressure, diabetes, heart disease, cancer, high cholesterol, and radiation therapy for specific conditions.
One of the causes of infertility may also be obesity, especially in cases where the male is overweight.
Evaluation
An assessment of the male infertility diagnostics various tests, which vary from person to person, should be carried out in order to determine the cause of infertility:
Analysis of Semen: Assessing the Sperm count, leukocytospermia presence, motility, progressive motility, and sperm morphology.
Semen inadequacies are frequently classified as follows:
- Reduced spermatozoa count in semen is known as oligospermia, sometimes known as oligoospermia.
- Aspermia: total absence of semen
- Hypospermia: decreased volume of seminals
- Lack of sperm cells in semen is known as azoospermia.
- An increase in sperm with aberrant morphology is known as teratospermia.
- Atherozoospermia: decreased motility of sperm.
Additionally, there are other combinations of these, such as teratoasthenozoospermia, which is characterized by decreased sperm motility and shape.
Hormone evaluation: this test evaluates the levels of the hormones in the blood that are important in the generation of sperm; abnormal levels of these hormones are suggestive of the hormonal issues linked to infertility.
Semen cultures are performed to look for germs that either cause or suggest a genital infection that could lead to infertility.
Semen is analyzed biochemically to measure different chemicals; an imbalance in these chemicals might affect fertility.
The sperm penetration assay, sometimes known as the “Hamster test,” evaluates a man’s sperm’s capacity to pierce an egg during in vitro fertilization (IVF) by measuring the sperm-egg membrane fusion using hamster eggs.
Physical issues such varicocoeles, Klienfelter’s Syndrome, retrograde ejaculation, erectile dysfunction, and premature ejaculation can be diagnosed with a comprehensive physical examination and medical history.
A lack of sperm in the semen sample suggests retrograde ejaculation, ejaculatory incompetence, or a disease obstructing the spermatic ducts.
Scrotal Ultrasonography: To rule out the existence of hydrocele, infections, varicocoele, underdevelopment of the testis, etc.,
Penile Doppler: To assess the etiology of erectile dysfunction and to ascertain adequate blood flow to the penis.
To determine whether erectile dysfunction is present, use nocturnal penile tumescence monitoring (NPT/Rigi Scan).
Our center doesn’t perform many sophisticated investigations…
High values of the DNA Fragmentation Index (DFI) suggest a lower likelihood of conception.
Reactive Oxygen Species (ROS): Based on the presence of free radicals in our bodies that may harm sperm plasma membranes, this aids in determining the risk of sperm damage.
Varicocele in Infertility
About 15% of men have varicoceles overall, while 40% of infertile men have them. Left sides are most commonly affected by varicoceles.The typical age range for guys to first see varicocele is between 15 and 25 years old. Even though the illness might not cause any symptoms, it might occasionally cause pain. This is due to the fact that affected guys may feel a sensation of swelling or a protuberance in their scrotum, as well as dull worry and heaviness in the scrotum that may worsen. These are all believed to be varicocele symptoms. Expert medical professionals believe that varicocele is also caused by twisted or packed veins, which can occasionally be interpreted as a bag of worms.
MEN'S HEALTH
Uncertainty surrounds the process through which a varicocele on one side might impair the fertility of both testicles. It is true that the scrotum typically has a temperature that is several degrees lower than the body temperature. This temperature difference is crucial for healthy sperm generation and testicular function. The typical scrotal architecture carefully maintains this temperature differential. This built-in cooling system may be less effective in a varicocele due to the dilated veins, which might “overheat” and impair the testis’s functionality.
EVALUATION OF VARICOCELE
When performing a physical examination, the doctor will often perform a clinical study of varicocele while the patient is standing and performing the Valsalva maneuver. If so, a scrotal ultrasound ought to be performed. Physical examination is the “gold standard” method of diagnosing varicoceles. A skilled doctor may palpate a patient’s scrotum while they are standing to find a varicocele. A varicocele may also be seen during physical activity and extended standing. The scrotal wall becomes thick or constricted when there is a varicocele, making palpation difficult.
Additionally, venography, ultrasound, thermography, scintigraphy, CAT scans, and magnetic resonance imaging can be used to diagnose varicocele. Although venography is thought to be the most effective diagnostic procedure, it is invasive and requires the catheterization of major leg veins in order to reach this system. Conveniently, varicoceles can be treated concurrently with venography and embolization utilizing balloons or coils. Doppler ultrasound focuses on the identification of venous flow within the varicocele and is less intrusive than venography, with which it correlates well. Due to high costs and a dearth of well-controlled research, the clinical utility of thermography, scintography, and MRI or CAT scans for varicocele is restricted.
RECOVERY of varicocele
01
Subclinical
The physical examination did not reveal varicocele; radiologic or other imaging studies did.
02
First Grade
Varicocele is only palpable during or following a physical examination Valsalva maneuver.
03
Second Grade
Varicocele is perceptible during a standard physical examination; no Valsalva maneuver is required.
04
Third-grade
Upon physical examination, varicocele is palpable and evident to the eye.
Suggestions for Treating Varicocele in Infertile Men
The purpose of varicocele repair is to increase male fertility. Usually, it can be performed surgically under local or general anesthesia as an outpatient. Near the location where the testicles first passed through the abdominal wall, a tiny incision is made in the abdomen. To stop blood flow to the varicocele, the veins responsible for producing it are located and severed.