How effectively is male infertility treated. Infertility in men - causes and treatment

When a heterosexual couple cannot conceive a child for a year without using oral or barrier contraceptives with regular sexual intercourse, she is diagnosed with infertility. Behind this medical term lies the tragedy of loving people. With equal probability, the cause is male infertility. But timely diagnosis and treatment can restore reproductive health.

Male infertility: possible causes

Statistical data show that difficulties with procreation in a third of cases are associated with male ill health. His body may not be able to produce enough sperm or deliver them to the egg. Other problems with conception are associated with female or combined (mutual) infertility.

If the causes that cause malfunctions in the reproductive system can be corrected, such infertility is called relative. If it is difficult to determine the pathological processes that violate the reproductive function, and it is impossible to prescribe treatment, doctors diagnose absolute infertility. The latter, fortunately, is extremely rare, and it is associated with past injuries or serious illnesses.

The causes of male infertility are established by the method of a complete examination of the patient

Table: the most common causes of male infertility

Causes of male infertility	Provoking factors
Sperm production problems	chromosomal or genetic causes; undescended testicles (not descending enough in infancy); infections; twisting of the testicle in the scrotum (pinching of the spermatic cord is sometimes observed in premature babies, while the blood supply to the reproductive organs is difficult); varicose veins of the testicles (varicocele); the use of medicines; the influence of chemicals; radiation damage; unknown reasons.
Blockage of the seminal ducts	infections; problems with the prostate; vasectomy (surgical removal of part of the seminal ducts); absence or damage to the seminal ducts.
sexual problems	retrograde and premature ejaculation or its absence; erectile disfunction; spinal cord injury; transferred operations on the prostate gland; pinched or damaged nerves; the use of medicines.
Hormonal problems	deficiency of luteotropin, which stimulates the synthesis of testosterone; abuse of steroids; pituitary tumors.
The production of antibodies to one's own sperm	infection or injury to the male genitalia; vasectomy. unknown reasons.

Secretory male infertility

The secretory form of infertility is characterized by insufficient production of spermatozoa and the presence of defects in them, which interferes with sperm motility and fertilization of the egg. The reasons may be different:

1. The most common disease that provokes dysfunction of spermatozoa is varicocele. The testicular veins dilate, making it difficult for the blood to drain completely. As a result, the blood circulates incorrectly in the tissues of the testicle, and all functions are inhibited. In most cases, a varicocele affects the left testicle, but after it, the blood supply to the right one is also disturbed. As a result, the production of sperm by both testicles stops, which leads to male infertility.
2. This happens if a hydrocele is determined in a man, when a significantly higher amount of fluid (2 milliliters) is collected in the scrotum, squeezing the testes. The neglected form of dropsy interferes with the normal blood supply to the organs and leads to infertility.
3. Cryptorchidism is a congenital anomaly in which the testes do not descend into the scrotum. Doctors recommend curing the disease up to 7 years. With a close location of the testicles to the scrotum in 85-90% of cases, drug treatment brings a positive result. Other parents of boys are offered surgical intervention. Otherwise, the function of the testes is reduced.
4. Parotitis (mumps) with untimely and improperly carried out treatment provokes infertility. The virus that causes the disease affects the glands of the human body, including the genital (testes). This requires a quick start of treatment, otherwise the reproductive function will be difficult.
   The first symptom of mumps is inflammation of the parotid salivary glands.

Prolonged exposure to radiation causes radiation sickness, severely damaging the sperm-forming epithelium of the testicles. This leads to a decrease in the quantity and quality of sperm. And electromagnetic waves acting for a long time cause a similar effect. This information is especially relevant for those who wear gadgets on their belts. The study of the influence of mobile devices on male sexual and reproductive function has not yet yielded clear results, but it is likely that the findings of scientists will not please.


There is still no reliable data on the effect of a mobile phone on the reproductive functions of a man.

Elevated temperature negatively affects the work of the testicles. This should be borne in mind by firefighters, welders, stokers and other people of similar professions. Fans of baths or hot baths are advised to allow the body to cool and dry before putting on clothes. Cycling in ill-fitting underwear also reduces the ability to conceive due to overheating and perineal friction.


Procedures in the bath can not only improve health, but also harm if you do not follow the rules for being in a steam room

STDs (sexually transmitted diseases), tuberculosis, hormonal disruptions lead to impaired spermatogenesis in the testes. Similarly, antitumor and antiepileptic drugs, some antibiotics and steroids with prolonged use act. Stress, lack of protein and vitamins in the diet, unfavorable environment, chronic lack of sleep, tobacco, alcohol and drug abuse also reduce male fertility.

Spermogram evaluation and testicular biopsy are the main methods for diagnosing the secretory form of male infertility. A testicular biopsy determines the condition of the testicular tissue and helps to find the cause of the disease.

To solve the problem, first of all, the factors that led to infertility are eliminated. Sanitation of infectious foci (and their chronic forms), treatment of inflammation, surgical operations for varicocele and hydrocele are carried out.

Video: what is a varicocele and how is it diagnosed

Obstructive form of male infertility

With obstruction (blockage) of the vas deferens, the movement of spermatozoa along one (their number is insufficient) or both sides at once (there is no seminal fluid) is difficult. Obstruction of the sperm duct is called obliteration and is caused by several reasons. Often this is a consequence of inflammation of the epididymis, when the seminal ducts are blocked. Spermatozoa cannot get through them into the seminal vesicles.

Ignoring or improperly treating injuries to the groin and seminal sacs leads to male infertility. There are unintentional damage to the seminiferous canals during surgery on the bladder, ureters and other organs of the small pelvis. Clamping of the seminal canals by a cyst or tumor formation, congenital absence of ducts or appendages, complications after syphilis or tuberculosis reduce fertility (the ability to procreate).

The method of palpation (palpation) determines the presence and localization of congestion in the seminal ducts. Vesiculography helps to examine in detail the obstacles in the way of spermatozoa. Before it, vasopuncture is performed - the procedure for introducing a radiopaque substance.

The cure for the obstructive form of male infertility directly depends on the length of the obliteration (closure) area. The smaller it is, the greater the chance of success. The method of microsurgical operation - vasoresection (cutting the ducts) is used. In some cases, a vasoanastomosis is done, that is, the reconstruction of the vas deferens by connecting to a duct that functions normally.
Obstruction of the sperm duct is called obliteration and is caused by a number of reasons.

Immunological infertility

The immune system is responsible for fighting harmful microorganisms. To do this, antibodies are produced that recognize and attack foreign cells such as bacteria and viruses.

As a result of too active work of the immune system, autoimmunity develops (aggression of the body directed against its own cells and tissues, including sperm). This abnormal reaction is caused by infections, trauma, and testicular cancer.

Immunological incompatibility has no pronounced symptoms. It can be suspected if the pregnancy of the partner does not occur within a year of unprotected sexual relations.

Turning to the andrologist, the man takes a spermogram, according to which the doctor determines:

• sperm count;
• the shape of the spermatozoa;
• their mobility;
• agglutination (gluing of sperm);
• the presence of live spermatozoa.

Normally, the readings fluctuate, but a downward deviation gives reason to assume. Its treatment is to eliminate the root cause. Sometimes this can be done through surgery to correct existing pathologies. For some patients, doctors prescribe courses of corticosteroids, cytostatics, or proteolytic enzymes.
The method of replanting sperm into the cytoplasm of the egg copes with immunological infertility

Combined infertility

With a temporary violation of the reproduction of one of the partners, the couple is diagnosed with combined infertility. This means that a man and a woman have not lost the opportunity to have children, but the likelihood of conception is reduced. The chances of procreation with other partners remain high. In men, the symptoms of such infertility are manifested by a temporary decrease in the quality of sperm, in women - by the immaturity of the egg during a regular menstrual cycle.

For couples facing a similar problem, the reproductologist prescribes a compatibility test, usually showing a negative result.

The method of treatment is artificial insemination (most often IVF).
With a temporary loss of reproductive ability, a couple is diagnosed with combined infertility

idiopathic infertility

A rare case when both partners do not have prerequisites for infertility, but the conception of a child does not occur for unknown reasons. Such a diagnosis sounds only after a comprehensive examination of the couple. Medicines cannot help. Artificial insemination gives a chance to become parents, but the success rate varies for each couple.

Diagnosis of male infertility

Male infertility usually does not manifest itself in any way. Sexual intercourse, erection and ejaculation are carried out without difficulty, and the color and amount of sperm do not arouse suspicion. Symptoms of the diseases that caused it can indicate infertility. For example, in the case of a varicocele, the patient may feel a feeling of heaviness and pulling pains in the scrotum.
Andrologist - a specialist in men's health

An andrologist helps to establish an accurate diagnosis based on the results of studies, including:

1. Physical examination (without instruments). A thorough examination reveals possible disorders in the hormonal sphere. External signs are fat deposits in the lower abdomen with a general decrease in muscle mass, a decrease in the elasticity of the skin. The endocrinologist assesses the patient's neuropsychic activity by checking the ability to concentrate and memorize the text. Violations in the nervous system are considered indirect signs of hormonal failure. The urologist by palpation diagnoses the presence or absence of diseases of the genitourinary system, for example, dropsy or varicose veins of the testicles.
2. Tests for infections. Sexually transmitted diseases and their pathogens adversely affect human reproductive health. Most often detected: chlamydia, mycoplasmosis, candidiasis, ureaplasmosis, the presence of herpes viruses and papillomas. Studies that detect the presence of infectious agents: PCR (polymerase chain reaction), enzyme immunoassay and microbiological analysis.
   Advanced sexually transmitted diseases can lead to male infertility
3. spermogram. This is the collection and analysis of the patient's sperm. The study allows you to evaluate the quantitative and qualitative composition of the male seed.
4. Analysis of the functional activity of the endocrine glands (by blood). The ability of the body to synthesize testosterone and other hormones that stimulate sperm production is being studied. Hormonal disorders are a rare (up to 3% of cases) cause of male infertility, but still occur in medical practice.
5. testicular biopsy. If the spermogram reveals a low number or complete absence of spermatozoa, an invasive (with piercing of the skin) sampling of the contents of the testicles and vas deferens is carried out with a thin needle. The detection of a sufficient number of viable spermatozoa in the testes indicates a problem with the patency of the tubules, which requires surgical intervention.
6. genetic tests. The study of DNA reveals anomalies in the structure and number of chromosomes of the gene code. Karyotyping with a high degree of probability determines these disorders. In some patients, a chromosomal blood test shows the presence of an extra X chromosome. Instead of 46 XY, a karyotype (set of chromosomes) 47 XXY is found. The condition is called Klinefelter's syndrome and entails the non-onset of puberty or infertility when it is reached. The study lasts up to 15 days.
   The cause of infertility may be hidden in the genetic code of a man

The main test for evaluating male fertility is the spermogram. The study requires adherence to the following rules:

• sexual abstinence for at least 2 and no more than 5 days before the test to accurately determine the number of sperm (each ejaculation can reduce the performance by a third);
• refusal to use tobacco and alcohol products 3-4 days before the test;
• a ban on visiting saunas and baths, hot baths are also prohibited, since high temperatures negatively affect the reliability of the data.

The collection of semen in a beaker takes place in the medical office during masturbation. The patient is left alone in the room. There are also specially designed condoms for collecting a semen sample during intercourse. Unlike conventional barrier contraceptives, they do not contain substances that kill sperm.

The test material is stored at body temperature. If it is not examined within two hours or is kept in warm conditions, most of the spermatozoa will die or lose their motility, making the sperm unsuitable for study.
The main test for evaluating male fertility is the semen analysis.

To describe sperm, doctors use the following terms:

• azoospermia - not a single sperm was found in the ejaculate;
• akinozoospermia - sperm are completely immobile;
• antisperm antibodies (ASAT, or ASA) - antibodies that the body produces against spermatozoa;
• asthenozoospermia - insufficiently mobile sperm (category A<25% или А+В<50%);
• hemospermia - the ejaculate contains red blood cells;
• leukocytospermia - an increased number of leukocytes (more than 1 million / ml);
• necrozoospermia - no live spermatozoa;
• normozoospermia - there are some deviations from the norm, but they do not affect fertilization;
• normospermia - all sperm counts are normal;
• oligozoospermia - a small amount of spermatozoa (concentration less than 20 million / ml);
• oligospermia - insufficient sperm volume (less than 2 ml);
• teratozoospermia - an increased number of abnormal sperm (more than 50%).

If the first study shows a discrepancy with the norm, a second one must be carried out. His results may be more comforting. The spermogram should be repeated at least three times within several months to obtain an objective idea of ​​the properties of the biological material.

Table: spermogram norms

Indicator	Norm
Sperm evaluation
Liquefaction time	10–60 minutes
Volume	2.0–6.0 ml
Hydrogen index (ph)	7,2–8,0
Colour	white-grayish, milky, yellowish sperm
The number of sperm in the ejaculate	40–500 million
Leukocytes	no more than 1 million/ml
red blood cells	No
Slime	is absent
Sperm assessment
Concentration (number of sperm in 1 ml)	20–120 ppm
Actively mobile (category A)	over 25%
Slightly mobile (category B) A+B	over 50%
Weakly mobile (category C)	less than 25%
Fixed (category D)	no more than 6–10%
Correct morphology (structure)	over 50%
Agglutination (sticking together of sperm)	No
MAR test (Immunoglobulin Mixing Response)	less than 50%

Video: how to take a spermogram

Hardware examination for infertility in men

This research method does not require special preparation, only sanitary and hygienic procedures before visiting a doctor.

scrotum ultrasound

The main task of ultrasound examination of the scrotum in infertility is to find out the reason for the change in the number of sperm. The processes of maturation and transport of spermatozoa along the seminal pathways are conditionally separated. Ultrasound reveals possible violations of the structure of the testicles, provoking infertility, allows you to detect defects in the patency of the vas deferens. For example, a spermatocele can be diagnosed when the seminal passages in the head of the epididymis are dilated. Ultrasound determines the presence of a cyst of the appendages of the testicles or spermatic cord, which is able to compress the vas deferens, causing obstruction (obstruction). To predict the success of therapy helps to assess the blood supply to the testicles.
Ultrasound examination is able to determine the presence of obstruction of the seminal canals

A qualified uzist uses a high-frequency sensor to scan a patient lying on his side or back, having previously applied a special gel to the skin of the scrotum. Discomfort and pain are excluded. Usually, the procedure for examining organs without pathological changes takes no more than 15 minutes. If you suspect deviations from the norm, ultrasound lasts up to half an hour. All the results of an ultrasound examination are known immediately, for clarification of the diagnosis and subsequent treatment, the patient is referred to an andrologist.

Video: Ultrasound of the male genital organs

Magnetic resonance imaging of the posterior pituitary gland

This method is good because it allows you to quickly detect hidden pathologies that are invisible with ultrasound, for example, tumor neoplasms. The pituitary gland is studied mainly with the help of MRI. This organ is responsible for the production of hormones, and the slightest malfunction leads to hormonal disorders.

The procedure may be denied if:

• the presence of an allergy to iodine (a study without a contrast agent containing this element is allowed);
• excess (over 100 kg) body weight, although the modern design of the apparatus provides for the study of people with excessive fullness;
• heart, kidney or liver failure;
• the presence of implants (if no metallic materials were used in the manufacture, MRI is possible, but not recommended);
• the presence of tattoos with metal elements.

If no contrast agent is used, preparation for magnetic resonance imaging is not required. It is administered intravenously half an hour before the procedure. The best time for an MRI is the first half of the day. To avoid nausea and vomiting, do not eat at least 2 hours before the procedure. Jewelry and other metal-containing objects must be removed so that the readings of the tomograph are not distorted.
For MRI, the patient is placed inside the magnetic field of the tomograph

The research principle is as follows:

1. A tomograph is a medical device with a powerful magnetic field inside. The patient is placed in it. The proton of the hydrogen nucleus, with which all tissues of the human body are saturated, is oriented in magnetic space due to the spin (momentum).
2. Passing certain frequencies of electromagnetic radiation through the pituitary gland causes the protons to vibrate, changing their own spin to the opposite, and then return to their original position.
3. The amount of energy released in the process, the tomograph registers and displays the results on the monitor.

Based on the data received, the specialist makes a decryption. The whole procedure is harmless and lasts an average of 30 minutes.

Video: MRI of the pituitary gland and the area of ​​the Turkish saddle

Treatment and prevention of male infertility

After establishing the cause of infertility, the reproductologist prescribes therapy to eliminate provoking factors. With hormonal imbalance, he prescribes medications that regulate the functioning of the endocrine system. Severe infectious diseases require antibiotics. Impotence is treated with drugs that stimulate erectile function. Congestion of the seminal ducts, as well as varicocele and hydrocele are removed surgically. An integrated approach corrects most of the dysfunctions of the body that prevent procreation.

Infertility treatment means the use of all possible methods that will lead to its overcoming, that is, the onset of pregnancy and the birth of a child. Infertility treatment methods include, for example, the surgical restoration of the patency of the fallopian tubes in a woman, or the surgical restoration of the vas deferens in a man, or the surgical treatment of a varicocele in a man, as well as IVF and other assisted reproductive technologies.

https://ru.wikipedia.org/wiki/Infertility

Assisted Reproductive Technologies

If conservative and surgical therapy has not brought a positive result or the problem cannot be treated, assisted reproductive technologies will come to the rescue. These include:

1. IVF (in vitro fertilization) is used when the sperm is unable to naturally reach the egg. In this case, the eggs are fertilized in a test tube, then the finished embryos are placed in the uterus.
2. ICSI (Intracytoplasmic Sperm Injection) increases the chance of obtaining embryos in IVF. According to the technology, the doctor injects sperm into the cytoplasm of the egg.
3. Insemination involves the introduction of seminal fluid (obtained as a result of masturbation or otherwise, excluding sexual intercourse) into the cervical canal of the cervix.

The IVF procedure ends with the implantation of the embryos into the uterus

Testicular Aspiration Techniques

Testicular sperm aspiration is a microsurgical method for obtaining spermatozoa when it is impossible to remove them naturally. The procedure is carried out in the laboratory under general or local anesthesia, anesthesia and doses are selected individually. There are different types of aspiration:

1. TESE (Testicular Sperm Extraction) - an invasive tissue sampling technique is used for obstructive infertility. The incision of the skin of the scrotum is made larger than with other methods, while capturing the maximum amount of seed material from several sites. Then, after studying under a microscope, unusable spermatozoa are rejected, and fertilization is carried out with high-quality ones.
2. PESA (Percutaneous Epididymal Sperm Aspiration) - epididymal sperm sampling. It is carried out through a skin incision from the appendage, in which mature sperm accumulates.
3. MESA (Microsurgical Epididymal Sperm Aspiration) - access to the appendages is opened through an incision in the skin of the scrotum. Using a sensor equipped with a microscope, the doctor determines the seminal canal with the largest amount of sperm and extracts the seminal fluid with a thin needle. Sperm can be used immediately or frozen for subsequent IVF, ICSI, intrauterine insemination.
4. TESA (Testicular Sperm Aspiration) is a percutaneous aspiration in which sperm is aspirated from the testicles with a syringe with a thin needle.

Before aspiration, sperm formation is stimulated with medication and alcohol, tobacco and products that adversely affect the test material are excluded. Recommendations for preparation are given by the medical staff in charge of semen collection.

Is there a cure for infertility in men? In order to answer this question, it is necessary to understand the causes of infertility in men. Determining infertility in men is a complex process, as symptoms can vary. If the patient notices that the seminal fluid has taken the form of stretching threads or lumps have appeared, you need to go to the doctor. An appointment with an andrologist should be made if a man notices that his sperm count has decreased.

If at the reception it turns out that there are chronic inflammatory diseases of the reproductive system, which led to inflammation in the testicles or prostate, then the patient may complain about the lack of sperm. The doctor will prescribe tests and conduct tests for infertility.

There may also be mild pain in the lower abdomen during physical exertion. This indicates the presence of a varicocele - excessive expansion of the testicular vein. It may have several stages, and infertility begins to develop already at the initial stage, when there are no symptoms of the disease. With this diagnosis, the changes are associated with overheating of the testicles, which is caused by excess blood flow. Part of the sperm simply dies. Such a disease can be diagnosed by ultrasound.

Also a reason to go to the doctor:

• pain during urination and sex;
• itching in the urethra;
• frequent headaches;
• discomfort in the lower abdomen, which are aggravated by sexual intercourse.

All this can be combined with infertility.

In the presence of false urge to urinate, you should also be wary, as this may indicate the development of prostatitis.

All these diseases are treatable and with timely treatment, infertility can be prevented. But even if it has already developed, then modern medicine can offer a lot of therapeutic methods to eliminate it.

However, no specialist can give an unambiguous answer to this question until the results of a comprehensive examination are received, since all cases are individual. You should pass the necessary tests, consult with your doctor. It all depends on the cause and severity of the disease.

According to statistics, 15% of married couples cannot have children.

Which doctor is treating?

Urologist and andrologist - those specialists who treat pathology in men. Andrology is a branch of modern medicine that combines several areas:

• sexopathology;
• urology and endocrinology;
• vascular and plastic surgery.

You may need to visit a therapist, geneticist, endocrinologist, cardiologist, vascular surgeon and pass certain tests.

Complex therapy

How and how to treat male pathology? The main task of complex therapy is to eliminate pathological and harmful household factors, restore the usual rhythm of life, and provide good nutrition. Treatment depends on medical prescriptions.

How and what to treat is determined by the doctor, based on the diagnosis. Even with the progression of the disease, there are chances for recovery and restoration of reproductive function with the help of special medications.

Before prescribing a specific course, secondary risk factors are taken into account, which lead to:

• passive lifestyle;
• lack of regular sexual activity;
• the presence of concomitant diseases;
• prolonged use of antibiotics.

When treating pathology in men, it is imperative to follow all the instructions of the attending physician, timely undergo scheduled examinations in dynamics, undergo regular examinations and not be out of schedule. This is especially important in hormonal therapy for the correct regulation of hormonal levels.

It is also important to follow the treatment regimen when taking antibacterial drugs and anti-inflammatory drugs, when the patient is receiving therapy for sexually transmitted diseases, sexually transmitted diseases, and other inflammatory diseases of the genital area.

Pathology can be treated conservatively and surgically.. For conservative therapy, men are usually prescribed:

• pills;
• injections;
• rectal suppositories;
• solutions for douching the urethra.

During surgical treatment, various surgical and invasive interventions are used, which are prescribed depending on the cause of infertility.

In 84% of cases of infertility, a positive result can be achieved with an integrated approach.

Preparations

In the treatment of pathology in men with medications, the following types of drugs are usually used:

1. Steroid hormone preparations(prescribed when antibodies are found in the semen that prevent conception).
2. Antibiotics(treat infectious venereal diseases).
3. Dopamine antagonists(taken with elevated levels of prolactin in the blood).
4. Antiestrogenic drugs(prescribed to improve spermatogenesis).

If we talk about specific drugs, then most often experts prescribe:

• Lutain. It is an environmentally friendly and natural product, it contains an extract of the Altai deer. Normalizes reproductive function, increases sperm endurance.
• Spematon. Created on the basis of herbal ingredients, quickly restores male fertility.
• AndroDose. Arginine based product. Improves the fertilizing ability of spermatozoa.
• Tribestan. Contains tribulus extract. When taking the drug, sexual desire increases and the ability of spermatozoa to fertilize is actively stimulated. Assign with severe disorders of the reproductive system.
• Menogon. It activates the production of germ cells, increases testosterone in the blood.
• Proviron. A hormonal drug that is used for various disorders in the intimate sphere.
• Proxy Plus. A food supplement that improves sperm productivity. It is used to increase potency.
• Spermstrong. The composition contains natural ingredients to improve the quality of sperm. Used to restore reproductive function.
• Pentoxifylline. The drug improves blood circulation, including the pelvic organs.

Depending on the factor that caused infertility, the following therapy may be prescribed:

1. Bromocriptine. Apply with secretory form of infertility.
2. Parlodel. It is used for hyperprolactinemia.
3. With immunological infertility, IVF methods, intrauterine insemination are indicated.
4. Obstructive infertility is treated surgically.

More recently, it was believed that if a couple fails to have a child, then only the woman is to blame. It is understandable. After all, a man is always perceived as a breadwinner, a protector, a master. And he simply can not have any problems in this area. However, this is not quite true. It has now been proven that if a couple has not been able to conceive a child during a year of sexual activity without contraception, then most likely both partners have problems. That is, the man too. And the probability of this is by no means small.

Symptoms

Signs of infertility in men are most often absent. This is usually discovered by accident. However, the most basic symptom that there is any disturbance is, of course, that the couple fails to conceive a child.

Kinds

Doctors divide male infertility into two types:

• Secretory. This form is characterized by the fact that the testicles do not produce the required amount of sperm. And this, in turn, leads to the fact that conception becomes impossible.
• Obstructive. Due to blockage of the seminiferous tract, the impossibility of the movement of spermatozoa occurs. The result is infertility.

Causes

All the reasons why male infertility can occur can be divided into several groups:

• inflammation, disease and other medical;
• psychological;
• sperm problems.

It is worth considering each of them in order to understand what effect they have on the male body.

Medical

This group includes many different reasons. Here they are:

• Inflammation. Very often, it is the inflammatory processes of the male reproductive system that lead to the fact that there is a violation of the process of sperm production. Unfortunately, it is very difficult for men to get to go to the doctor to identify and cure many diseases of the genitourinary system. But prostatitis or, for example, urethritis can become the reason that it will be more and more difficult to conceive a child.
• Sexually transmitted infections. Many of these diseases are quite hidden, and a man can find out about them when the disease is already sufficiently advanced. And the microorganisms that are the causative agents of such diseases have a negative effect on sperm. As a result, it leads to unsuccessful attempts to have a child. Therefore, it is impossible to postpone the treatment of such diseases in any case, it is better to immediately contact a specialist.
• Hormonal disruptions. Just like women, men also experience hormonal imbalances. This process can begin in adolescence and continue beyond. Very often there may be a lack of testosterone, which is very important for the male body and is responsible for its sexual development. As a result of its small amount, sexual impotence and the inability to conceive a child may occur.
• Diseases and injuries. In a man, part of the genital organs are outside, so it is imperative to ensure that they are not subjected to any injuries. If this happens, then you should definitely consult a doctor. In addition, there are various diseases that can affect the reproductive function of a man. These include, for example, the well-known mumps, as a result of which a man can remain infertile. Or, for example, diseases of the back and spine. It would seem that they are not at all connected with the reproductive system, but they can also have a negative effect on it.
• Bad habits. They have a negative effect on the entire body. Therefore, you should not think that the reproductive system will function normally if a man likes to drink. Smoking will also not bring benefits, and drugs - even more so.
• congenital defects. The cause of infertility can also be causes that are congenital, for example, underdevelopment of the genital organs, a deviation in the structure of the system itself. Or phimosis, a condition in which the foreskin has such a narrow opening that the glans penis cannot be exposed. However, such a violation can be detected with accuracy only starting from the age of five. This condition may not cause concern in young guys, but it is still better to carry out certain treatment in order to avoid problems with conception in the future.
• High temperatures. Doctors believe that temperatures above 35 degrees have a negative effect on the male reproductive system. That is why you should not abuse hot baths, gatherings in the bath and sauna. In addition, very dense and unnatural underwear can also have a "greenhouse effect".
• Harmful working conditions. Working with chemicals can also cause problems in the male reproductive system.
• Medicines. Men who love to use steroids to increase their muscle mass, unfortunately, cause irreparable harm to their body. By the way, antibiotics can also cause male infertility.
• Nervous shocks and depressions. When a person is not able to relax, it is unlikely that he will succeed. You should try to avoid stressful situations.
• Women's "allergy". This phrase refers to the immunological incompatibility of a man and a woman. It's just that the female body does not perceive sperm and rejects it. Most often, such a diagnosis is made when the spouses have already done all the tests. The treatment is quite long, but can bring results.
• Hypospadias. This is a developmental pathology of the penis, in which the opening of the urethra is located incorrectly. As a result, sperm may simply not enter the cervix, which leads to problems with conception.
• Erectile disfunction. In this case, the penis simply does not reach the required size and volume, which is needed for a full-fledged sexual intercourse.
• Not enough knowledge. It also happens that people are simply illiterate in this matter.

Psychological reasons

It often happens that the causes of male infertility are some psychological problems and foundations. For example:

• If a boy has been humiliated and infringed upon since childhood, then it is quite possible that in adulthood the thought will arise in his head that he is not worthy to become a father. As a result, all attempts will fail.
• The absence of a father most often leads to the fact that the boy becomes infantile. He likes that the whole world revolves around him, but he himself does not want to be responsible for anything. As a wife, he chooses a woman who will take care of the same as her mother, and does not want him to have a “rival” in the form of a child.
• But there is also the opposite situation, when the boy is the eldest in the family, and he has to replace his dad. As a result, by a more mature age, he already understands what duties his father has and even gets tired of them. As a result, the desire to have a child disappears.
• The child comes last. It also happens that a man first wants to climb the career ladder, then achieve some material wealth, but the child takes almost the last place on this long list of desires. Hence the problem with conception.

Such causes of problems with conception are by no means uncommon. After their elimination, as a rule, married couples can become happy parents. It is best to contact a psychologist who will help you understand yourself.

Sperm problems

These are reasons that are peculiar only to men. Problems with conception can occur as a result of abnormalities in the quality or quantity of sperm. These include:

• Low active sperm count. The fact is that for conception it is necessary that the spermatozoa be sufficiently active and mobile. Otherwise, the result will be negative. By the way, this is one of the most common reasons.
• It also happens that there are no sperm at all in the semen. This can happen for two reasons - either they do not form at all, or there is an obstruction of the genital ducts.
• A small number of live spermatozoa in semen is the most common cause of infertility in men. This condition is called oligospermia.
• A small amount of sperm is also considered a pathology. In this case, the acidic environment of the vagina cannot be neutralized, as a result, the spermatozoa die.
• A large number of leukocytes in the semen, which may appear as a result of any disease, also leads to a violation of the sexual function of a man.
• A large amount of sperm itself is also not a good sign. The fact is that in this case, the spermatozoa may be underdeveloped, respectively, are not able to fertilize the egg.
• It often happens that spermatozoa already develop with certain defects, this also has a negative impact on the possibility of conceiving a child.
• The absence of sperm at all can occur as a result of any disease.

As you can see, there are a lot of reasons and they are all quite diverse.

Secondary infertility

Secondary male infertility is when a woman is unable to conceive from a man with whom she already has children. Often it occurs as a result of untreated diseases, injuries. The cause can also be a varicocele - an expansion of the veins of the spermatic cord. Secondary infertility is eliminated if treatment is started on time.

Treatment

Of course, both men and women are interested in the question of whether male infertility can be treated. It is treated if you do not delay it. Treatment may vary. For example:

• Medications. The doctor will select the necessary medication, depending on what exactly caused the infertility. If you need to treat inflammation, then it can be antibacterial agents. In case of hormonal disorders, medications containing hormones are prescribed. For problems with sperm, vitamin complexes can be used in treatment.
• Surgical way. It is used if there are any problems with the vas deferens. Of course, scars remain after the operation, which can also become the reason for the impossibility of conception, but there is no other method of treatment yet.
• Folk remedies. They can also be used to treat infertility. And sometimes they do a great job with this problem. The main thing is not to overdo it and consult your doctor before treatment.

If no treatment helps, then the attending physician may suggest artificial insemination.

Prevention

To avoid such a problem in the future, you must try to lead a healthy lifestyle, give up bad habits. Of course, all diseases must be treated on time, and not hope that they will go away on their own. It is worth playing sports, spending more time outdoors. Do not forget about proper nutrition, try not to eat a lot of unhealthy foods. In addition, you need to try to avoid stressful situations, be less nervous, but, on the contrary, enjoy life. And if you suddenly have any suspicious symptoms, then immediately consult a doctor.

Male infertility is an unpleasant thing, but it is quite possible to deal with it. The most important thing is not to despair and not give up.

Not so long ago, women were most often blamed for family infertility. Today, the existing statistics allow us to assert that in about half of the cases the inability to have children in a couple is due precisely to male infertility. And no matter how the representatives of the strong half of humanity oppose it, the fact remains.

What it is?

Forms of male infertility are quite diverse. All of them can lead to the breakup of a family, to a great personal tragedy for a man. In almost 99% of cases, the reason for the inability to have offspring in the stronger sex lies in the violation of the composition of the sperm. Seminal fluid with spermatozoa is a rather sensitive and vulnerable environment; a variety of factors can affect it. A man can suffer inflammation, infection, even slightly injure the scrotum, and his ejaculate will no longer be considered healthy and capable of fertilization.

Men do not like to admit that the cause of their wife's infertility may not lie in her. For such "stubborn" the Ministry of Health has statistics: only in 40% of cases, the lack of children in marriage is due to female infertility. In 45%, the cause lies in the male factor, and the remaining 15% include cases of genetic incompatibility of partners and rare forms of infertility.

The probability of conception, it should be noted, is not so great in perfectly healthy men. If both mom and dad are in perfect reproductive health, the probability of conceiving a child on the first attempt is only 11-13%. Depending on the form of infertility in men with deviations in reproductive function, this probability decreases.

Infertility is when a couple is unable to conceive a child through regular, unprotected sex for a year. For couples in which the age of the spouses is above 35 years, the “critical” period is considered to be a period of six months. If during this time all attempts were unsuccessful, conception is called into question and an examination is prescribed.

Both women and men need to go through it. Only then it is possible to establish the cause and find a way to eliminate it.

Norm

The main reproductive cell of a man is a spermatozoon. The sperm carries the genetic information of the father. It is located in the head of the spermatozoon. The tail helps the cell move so it can reach the egg.

Young spermatozoa originate in the testicles. This process begins during puberty in boys and continues throughout the life of the stronger sex. From the testicles, young spermatozoa enter the seminiferous ducts - tubules, and at the time of ejaculation, mature cells mix with seminal fluid, with the secretion of the prostate gland and enter the woman's genital tract.

The seminiferous tubules are very long. Practically immobile sex cells have to pass through them for a long time: about 2-3 months. During this time, they have time to ripen. The final stage of maturation of germ cells takes place in the epididymis.

In the ejaculate of a healthy man, there are always both living and dead spermatozoa, both mobile and inactive cells. It is important that the ratio of healthy and strong sperm is sufficient for fertilization, because only the most hardy specimens will reach the egg.

It is not enough for cells to develop - they still need to mature, passing through the tubules, and also gain access to the secretory products of the male body. Male infertility is usually divided into three broad types:

• secretory - associated with impaired secretion at any stage of spermatogenesis;
• obstructive - associated with obstruction of one of the sections of the vas deferens;
• other forms associated with immune, autoimmune processes.

There are also rarer forms of infertility, usually genetic, in which healthy and viable germ cells are not produced at all or are produced, but critically few. But such cases in the practice of a reproductive specialist are rare.

Causes of infertility

Secretory infertility

The reasons why men become incapable of fertilization are numerous and multifaceted. In all cases, except for congenital genetic infertility, they, one way or another, are associated with a harmful effect on the processes of spermatogenesis or mechanical ejaculate ejection.

The secretory form of male infertility is most often associated with impaired sperm production. The testicles do not produce enough healthy cells. In addition, it is customary to refer to the secretory form all morphological changes in the germ cells of a man, as well as violations of their mobility, viability. If the sperm is not fast enough, and it has malformations and anomalies (two heads, two tails, lack of a tail and other variations of a distorted shape), then spontaneous conception is unlikely.

The most common cause of secretory infertility is varicocele. With varicose veins, the outflow of blood from the scrotum becomes difficult - “stagnation” occurs, which gradually leads to inhibition of testicular function. Unilateral varicocele often becomes bilateral.

If a man is not provided with surgical assistance to eliminate varicose veins, then secretory infertility can become total and neglected.

The tissue that produces young spermatozoa is very susceptible to fluid pressure. Therefore, infertility often develops against the background of dropsy of the testicle, as well as an existing inguinal hernia. Infertility can be caused by cryptorchidism, or undescended testicles into the scrotum.. The risk of negative consequences is high if a boy under the age of seven has not been given proper treatment.

When at least half of the detected spermatozoa are mobile and can not just move, but move straight and with sufficient speed, then this is considered normal. If the number of such mobile and rectilinearly moving sperm is low, then they will diagnose "asthenozoospermia". In the event that no motile sperm are found at all, the diagnosis of necrospermia will be made.

Normally, about half of the sperm should be morphologically healthy. During the MAP test, as part of the spermogram, the patient's cells are compared with the existing standard - all defective cells are rejected. If the head, tail or neck of a spermatozoon does not meet the strict reference requirements in appearance, the cell is also rejected. For conception, it is necessary that in the seminal fluid of a man there should be at least 40% of healthy and full-fledged cells.

If clots are visually determined in the ejaculate, the sperm is heterogeneous, then it is possible that the spermogram will show the presence of agglutination. It reduces the mobility of germ cells, making conception difficult or impossible. If the spermogram shows an increase in the number of leukocytes, the doctor may suspect an inflammatory process and refer the man for an additional examination - ultrasound, as well as to be tested for venereal and genital infections. In the same way, the doctor will act if pus is found in the semen (pyospermia).

These spermograms are considered to be inconsistent, and even the time of day can affect certain characteristics of the study. Therefore, a man should prepare for the fact that he may have to take the test again to check fertility over time.

Depending on the identified type of infertility, the true cause of fertility disorders is established. For a complete treatment, additional diagnostics may be required - immunological blood tests, a blood test for a hormonal profile, X-ray of the seminiferous tubules with contrast.

Treatment

It is quite possible to cure male infertility. The exception is cases of genetic, congenital infertility. For example, the absence of glandular tissue that produces sperm, or malformations of the seminiferous tract that cannot be eliminated. In all other cases, doctors can offer an individual treatment regimen. According to statistics, it is possible to cure infertility in a man in 85-90% of cases.

Treatment directly depends on the true cause of the pathology. If it lies in a varicocele or inguinal hernia, then a man needs to undergo a surgical operation, after which he will be able to become a dad, because the cause of infertility will be eliminated. With inflammation, the exact localization and degree are established - with grades 1 and 2, treatment can take place at home, more advanced forms require hospitalization in a hospital. In case of blockage of the seminal ducts, an operation is often prescribed, which completely eliminates the obstacle in the way of the germ cells.

D For the treatment of inflammatory processes, antibiotics, anti-inflammatory drugs are used. After the end of the course of treatment, fertility is checked again and a course of therapy supporting spermatogenesis is prescribed.

Regardless of the reason that led to the infertility factor, all men are prescribed vitamins, drugs to improve spermatogenesis (usually dietary supplements), sedatives, designed to bring the psychological state of a man in order. Vitamin complexes for men must contain zinc, selenium, iron, B vitamins, vitamins A and E, as well as folic acid. Biologically active additives ("Spermaktiv", "Viardot" and others) contain zinc and selenium, as well as some plant substances that have a positive effect on the production and maturation of spermatozoa.

All men who are being treated for infertility are recommended to correct their lifestyle, and very often this already has a decisive effect, and pregnancy occurs. Correction involves reducing excessive physical activity to moderate, giving up nicotine and alcohol, proper nutrition, which should be rich in animal proteins and fats.

A man must put his weight in order: he must lose weight or gain the missing kilograms in order to achieve a physiological norm. It is useful to refuse to work on the night shift, because during the night's sleep the body produces the necessary hormones that are involved in the reproductive system. Working in a hazardous industry is a reason to find another income with no contact with salts of heavy metals, paints and varnishes, nitrates.

Those who like to take a steam bath or sit in the sauna are advised to reduce such activities to a minimum, but it is better to abandon them altogether. All factors of overheating and compression of the scrotum should be excluded. You need to wear loose shorts like "family", loose-fitting trousers. Sexual intercourse is recommended regular: at least twice a week, so that the sperm has time to effectively renew itself.

Couples who intend to treat male infertility need to be patient, as the course of treatment can take quite a long time: from three months to a year. Most men manage to cope with the problem and improve sperm counts in six months. If treatment and compliance with all recommendations during the year does not bring the desired result, then hormonal treatment is prescribed.

In some pathological conditions, for example, with large dropsy of the testicle or oligozoospermia of 1-2 degrees, a woman is artificially inseminated with her husband's sperm, in which it is injected into the cervix. If the violations of spermatogenesis in a man are significant, and treatment, including hormonal, does not work, then the couple is recommended to inseminate with donor sperm.

The decision to donate insemination is voluntary. Many couples do not agree to this, because the man does not believe that the child born will be his child.

Insemination with donor sperm

Modern reproductive technologies make it possible to fertilize a woman even with a dead sperm of her husband, however, provided that the structure of the head is not disturbed in the germ cell and there are no violations in the DNA information. In this case, fertilization is carried out microscopically, after taking the egg from the woman. If conception has taken place, the embryo is planted in the uterine cavity and preserved with the help of hormonal therapy.

Hormone treatment

As already mentioned, doctors try to resort to hormonal therapy only when sperm motility is severely impaired, and also in the absence of the effect of other methods of infertility treatment. As the main treatment, hormones are prescribed in the case when the very cause of infertility lies in the imbalance of hormones.

Treatment can be carried out by a blocking method. Its essence is quite simple: for several months the patient takes pills that completely block the production of new germ cells at the hormonal level. After a man stops taking medication, the body starts spermatogenesis with double strength and spermogram parameters usually improve significantly.

Despite the rather impressive results from such a blocking treatment, this method is used relatively rarely. Doctors always try to leave space for the intervention of inexplicable "higher" forces, because sometimes a man who simply takes vitamins, after several years of infertility, suddenly becomes a dad.

Most often, hormonal treatment is carried out according to the stimulating method. It is based on the introduction of small doses of hormones, which, on the contrary, stimulate the process of sperm production, but do not affect the pituitary and hypothalamus. The course of treatment is long: from the moment it starts, it takes from 9 months to one and a half years. All this time, a man will have to conduct a spermogram every three months (this is how long one cycle of spermatogenesis lasts) to determine the effectiveness of the treatment provided.

In some cases, doctors do not go for hormone therapy. If they believe that such treatment has no prospects, then they immediately recommend assisted reproductive technologies or other options.

Psychology

It is not for nothing that a man who is being treated for infertility is recommended sedative sedatives. The psychological consequences that can follow the news of the impossibility of conceiving a baby can be devastating. Stress itself aggravates the situation. To this is added depression, loss of interest in sexual relations with his wife, loss of tenderness in relations with a partner.

However, tablets and decoctions of herbs that act as sedatives are far from all. A man needs help to come to an understanding of a simple truth that is obvious to every woman: a biological father is not a father yet, but the one who raised and raised is a real father.

That is why in the process of treatment it is desirable that a man and his wife visit a psychologist or psychotherapist who will help get rid of prejudices and oppressive internal tension, help to look at the situation from different angles.

Very often, a man who has accepted the situation, put up with it, stopped being nervous and worried, unexpectedly for everyone becomes a biological dad. The fact is that stress hormones block the production of sex hormones, adversely affect testosterone levels. When the stress factor disappears, the man becomes calmer, and after a while, the spermogram indicators also improve.

The most common example is adoption. When there is no longer any hope for treatment and other methods, everything has been tried, the couple decides to adopt the baby. They calm down, focus on raising a child, experience positive emotions more often and suddenly become pregnant.

Treatment with folk remedies

Alternative medicine has accumulated a great variety of recipes and methods that, according to healers, increase a man's fertility. It should be noted that all recommendations are based on the observance of a healthy lifestyle, and in this, folk healers are in full solidarity with colleagues from the field of official medicine. If a man continues to abuse alcohol, drugs, nicotine, lies on the couch and does not want to lose any of his 200 kg, then no folk and traditional remedies will help.

Traditional medicine should be regarded as an auxiliary therapy in the treatment of infertility in men. In no case does it cancel the traditional treatment, which is selected on an individual basis, but it can enhance the effect and help a man become a dad.

Also, you should not practice treatment with folk remedies without the consent of your doctor, since herbs are not at all as harmless as they might seem.

Different types of male infertility need a different approach, and there are no universal recipes. For example, freshly squeezed pumpkin juice is used to increase sperm motility. His man is recommended to take on an empty stomach a glass every morning. And to improve the morphology of spermatozoa, honey and bee products are useful, of course, provided that the man is not allergic to them.

Since ancient times, healers have revered St. John's wort because it enhances male power. The dried branches of this herb are burned and fumigated with them in the room in which the man is located, once a day. Inhalation of this smoke has a positive effect on sperm production. Men living in mountainous regions and in the south have long used fresh quince juice, drinking it in a tablespoon in the evening before going to bed.

Traditional medicine highly appreciates the properties of psyllium seeds for the treatment of infertility in men. A tablespoon of seeds is brewed in a glass of water, let it brew and take a tablespoon twice a day. The same decoction is added to the bath for water procedures. It is important that the water temperature in the bath does not exceed 37 degrees.

A real storehouse of phytohormones is sage. A tablespoon of herbal raw materials is brewed in a glass of boiling water, simmered for five minutes in a water bath, after which the resulting broth is divided into three equal parts. Take one third of a glass once a day. For especially romantic young ladies, alternative medicine offers an exquisite recipe from rose petals. Red and rose petals are rich in vitamin E, so you can make homemade syrup from them and treat your loved one during daily tea parties in the amount of 2-3 tablespoons.

Instead of tea, a man can be offered a decoction of adonis or wild rose. Traditional medicine highly appreciates for men's health and Adam's root. It can be purchased at pharmacies. Two tablespoons of the root are insisted on a thermos of boiling water for at least a day, after which they offer the man two tablespoons three times a day.

For a long time, male infertility has been treated with leeches. Hirudotherapy allows you to achieve a point effect. For example, a leech installed at a biologically active point improves blood circulation in the pelvic organs, which has a positive effect on any stage of spermatogenesis. Special substances that leeches secrete into the human body reduce the level of fibrinogen, make the blood more fluid. A man will definitely notice a general improvement in well-being, strengthening of immunity, and after a while it is possible that he will be able to become a dad.

Hirudotherapy sessions should be conducted by qualified professionals. Leeches should only be used once. A clinic that provides such services must have all permits and certificates in order. With male infertility, leeches are placed on the area around the anus, in the perineum, they capture the coccyx and sacrum.

Sulfur baths, mud clinics are also useful. At resorts that have such natural resources, the number of sessions and their duration for various types of infertility in men is determined by the doctor.

The content of the article:

Male infertility is the inability to fertilize a woman.

Considering that, according to world statistics, every fifth couple experiences difficulties in conceiving a child, and 50% of the “blame” for what happened lies with the man, the treatment of male infertility is a topic that does not lose its relevance.

Unfortunately, the environment is not getting better; being under stress, bad habits, malnutrition, promiscuity lead to the fact that infertile couples are becoming more and more every year.

What factors lead to male infertility

Chronic intoxication negatively affects the epithelium that produces spermatozoa.

The most toxic poisons are:

Lead,
organic peroxides,
granosan,
manganese,
mercury,
aniline,
phosphorus,
carbon disulfide,
benzene etc.

Please note that some drugs have a toxic effect on spermatogenesis. These include:

antibacterial drugs,
nitrofurans,
antidepressants,
sulfonamides.

The quality of sperm is affected by radiation, as the spermatogenic epithelium is damaged.
Listing the altering factors, one cannot fail to mention the dangers of chronic alcohol and nicotine intoxication on the quantity and quality of sperm: morphologically altered spermatozoa with incomprehensible movements or motionless are found in abusing men 5 times more often.

Varicocele or varicose veins of the spermatic cord

With a bilateral lesion, when exposure to elevated temperature occurs on both testicles at the same time, spermatogenesis is impaired.

Depending on the duration of the existence of the pathology and additional provoking factors, changes in the spermogram will appear: from minor asthenia to severe morphological pathology.

Classification

Code according to the international classification of diseases ICD-10: N46

Male infertility can be primary and secondary. With primary infertility in the anamnesis, there are no data on the onset of pregnancy in the partner (partner).

With secondary infertility, there were pregnancies, there are children, but as a result of any aspects, the onset of a second pregnancy in a partner is problematic.

There are the following forms of male infertility:

secretory,
excretory,
autoimmune,
combined.

Secretory infertility is caused by a lack of production of sex hormones, which leads to impaired sperm production. Pathology is called "hypogonadism", it can be primary and secondary.

In the first case, the production of hormones is disturbed in the testicle due to some reason (orchitis, trauma, cryptorchidism, etc.).

In the second case, the cause is CNS lesions: trauma, tumor processes, primarily in the hypothalamic-pituitary region, resulting in a decrease in the synthesis of gonadotropins.

Excretory infertility has a second name "obstructive" and develops against the background of the formation of an obstacle (stenosis, blockage) of the vas deferens, urethra.

It is important that with this pathology, the process of spermatogenesis does not suffer. If the lesion is 2-sided, the sperm does not enter the urethra.

Causes:

Inflammatory process,
surgery,
Anomalies of development with an incorrect location of the external opening of the urethra (epi- and hypospadias).

Aspermatism is another form of pathology. Distinguish between true and false aspermatism.

False - there is nothing more than the reflux of sperm into the bladder during ejaculation (retrograde ejaculation). More often it is a complication of transurethral resection.

The autoimmune form of infertility is a consequence of alteration of the spermatoproducing epithelium by autoimmune complexes, against the background of increased permeability of the hematotesticular barrier.

The combined form is always a combination of a secretory component with an insufficient hormonal component with the consequences of inflammation in the form of obstruction.

Relative (idiopathic) infertility, as a diagnosis, sounds when, despite a complete examination of the couple, no causes were found.

Diagnostics

Sometimes men say to each other: "What is the best test for infertility?"
Of course, a spermogram can give a lot of information - an analysis in which the qualitative and quantitative composition of sperm is assessed.

Spermogram is a simple, non-invasive and quite informative method that allows you to confirm or refute male infertility. The study of ejaculate with pathozoospermia is performed several times, with an interval of 1-3 weeks. Before donating sperm, you must refrain from ejaculation for at least 3, but not more than 7 days.

Fertility criteria is the number of male germ cells in 1 ml, % of actively mobile cells of normal morphology.

In general, a full-fledged diagnosis cannot be established by only one analysis, and then we will talk in more detail about the necessary examination for impaired fertility.
So, a barren marriage involves an examination of a married couple by an andrologist (sometimes a urologist) and a gynecologist.

They begin diagnostic measures with a man, and, in any case, whether the spermogram revealed violations or not, they proceed to the examination of a woman. This is important in order to outline the management tactics for the possible use of assisted reproductive technologies.

Note that the questions will be asked very intimate. The doctor will be interested in everything: whether previous partners had pregnancies, how many times a week there is sex, what contraceptives are preferred, etc.

Tests for male infertility include:

spermogram
In the absence of ejaculate after orgasm, a urine test is performed for the presence of spermatozoa,
Examination of the hormonal background (testicles, hypothalamic-pituitary system, adrenal glands, thyroid gland), most often they examine blood for prolactin, testosterone, follicle-stimulating and luteinizing hormones.
Testicular biopsy to determine patency and identify mature spermatids. If they are present, perform puncture angiography. Indications for biopsy are azoospermia with established normal testicular volume by ultrasound and normal blood FSH levels.
Analysis of prostate juice.
Complete examination for STDs.
Sowing sperm for flora and sensitivity to antibiotics.
MAP - test (determination of antisperm antibodies).
Consultation of a geneticist (determination of the karyotype, with oligo-, terato-, azoospermia).
Ultrasound of the prostate, scrotum with dopplerography, TRUS (indicated for azoospermia, oligospermia to exclude obstruction of the vas deferens and to assess vesicles - seminal vesicles).
Radiography and MRI of the skull, Turkish saddle are prescribed to exclude the tumor process.
Spiral CT with 3D image design.

Treatment of male infertility

Treatment options for male infertility depend on the cause. Treatment is divided into conservative and surgical.

Carrying out conservative therapy implies a simultaneous rejection of bad habits, drugs that have a spermatotoxic effect, a change in "harmful" work, and the elimination of infectious and inflammatory pathologies.

Drugs for the treatment of male infertility

With gonadotropic hypogonadism, the use of hCG preparations (human chorionic gonadotropin) is justified.

For this purpose, Pregnyl is used, which stimulates the production of follicle-stimulating and luteinizing hormones. Estrogen antagonists block the production of female sex hormones, thereby creating conditions for the synthesis of gonadotropins (drugs: Tamoxifen, Clomiphene).

Congenital adrenal hyperplasia is treated with glucocorticosteroids.

With confirmed testosterone deficiency, the use of drugs based on testosterone is justified.

Note that against the background of the artificial introduction of male sex hormones, the progression of atrophy of one's own glands is possible.

With an increase in the level of prolactin in the blood, dopamine antagonists - Bromkriptin and Cabergoline are prescribed, it is possible to perform an operation to remove the pituitary adenoma.

The immunological form of infertility is corrected by the appointment of glucocorticosteroid courses in combination with antihistamines.

If the cause of male infertility is retrograde ejaculation, endoscopic correction can be performed - the introduction of special substances into the area of ​​the seminal tubercle.

Surgical treatment involves eliminating the cause of infertility with the help of surgical treatment: Ivanisevich's operation and others for varicocele, restoration of the vas deferens by applying anastomoses, etc.

Assisted Reproductive Technologies

Artificial insemination

With the simplest methods, the ejaculate is introduced directly into the uterine cavity by artificial means. Pre-spermatozoa are washed in an isotonic sodium chloride solution or special solutions are added to thin the sperm. If several manipulations performed were unsuccessful, then in vitro fertilization is indicated.

After the stimulation, several mature eggs are taken from the woman and placed in a special nutrient medium. After 3-5 hours, spermatozoa are added. After 2 days, several embryos, if fertilization was successful, are transplanted, the rest are subjected to cryofreezing. Embryo implantation is possible laparoscopically.

If the measures are unsuccessful, or when the number of spermatozoa is too small to fertilize the egg (less than 100 thousand per female germ cell or in the absence of spermatozoa with normal morphology (less than 4%)), there is a method of intracytoplasmic injection (ICSI). In this case, with the help of micro-equipment, only one male reproductive cell is introduced into a specially prepared egg. After 48 hours, the embryos are implanted, as in the case of IVF.

The pregnancy rate with intracytoplasmic injection, depending on the clinic in which the procedure was performed, is about 10%, with IVF from 33% to 50%.

If the desired pregnancy has not occurred, you can consider artificial insemination with donor sperm.

Treatment of infertility with folk remedies

Herbal treatment can be tried for idiopathic infertility, ie. when there are no visible reasons, but there are changes in the spermogram.

Surepka

The colza (cruciferous family) is considered a plant that will help increase sperm motility. In addition, Surepka has a prostatotropic effect and enhances erectile function.

The plant contains:

vitamins,
essential oils,
flavonoids,
saponins,
trace elements,
quercetin.

Decoction of infertility

A decoction of Surepka improves blood circulation, reduces the manifestations of asthenia, and increases blood flow to the genitals.

Recipe:

Pour 2 tablespoons of crushed vegetable raw materials into 400 ml of water, simmer over low heat for 7 minutes, leave for 3 hours, strain and drink 100 ml 3 times a day, course 10-12 days.

Perhaps, in vain, colza is considered a weed, it has a spicy taste, during heat treatment the bitterness disappears, and a pleasant nutty aftertaste remains.

Fresh colza salad

For a man who plans fatherhood, you can periodically prepare a vitamin salad with Surepka.

Ingredients:

Young leaves of bittercress 100 grams,
1 medium sized cucumber
Green onion 50 grams,
Chicken eggs 2 pieces,
Salt and pepper to taste.

Grind all components, squeeze a slice of lemon, season with olive oil

Juice from Surepka

They take any aerial parts of the plant, grind it in a blender, squeeze the juice.

It is better to cook fresh every day in spring and summer. Take 1/3 cup 3 times after meals, course 1 month.

Herbal infusion for infertility

In a dark glass bottle, put 50 grams of boron uterus, 30 grams of basil, 1 tablespoon of carrot seeds, 50 mg of cinquefoil, pour 500 ml of vodka, insist in a dark place for 10 days, shake occasionally.

Strain, take 20 drops 3 times a day for 1 month. Store the tincture in the refrigerator.

Aloe

Against the background of inflammation with reduced immunity, there is always the possibility of developing an adhesive process.

Chronic prostatitis, vesiculitis, orchiepidymitis lead to obstruction of the vas deferens.

If the adhesive process has not gone too far, then Aloe juice may well help.

Let's prepare a biological supplement at home.

Ingredients:

We cut the leaves of Aloe, it is desirable that it be an “adult” plant, the older the better.
Wrap the cut leaves in foil and refrigerate for 4 days, then chop them and add ghee and honey.

For 1 part of the leaves you need 3 parts of oil and 3 parts of honey.

The resulting product should be stored in a cold place.

It is better to take before meals, 1 tablespoon 3 times a day, 30 days.

The recipe is not suitable for men with gallbladder and pancreas problems (cholecystitis, pancreatitis), as well as diabetes and obesity.

To increase the effectiveness of taking the supplement, include as many fortified foods as possible in the diet: greens, vegetables, fruits, cereals, legumes, seafood.
Additionally, take 25 drops of ginseng tincture or golden root (available at a pharmacy).

Treatment of male infertility in a sanatorium

Rest in a sanatorium is a good relaxation for the body and an opportunity to improve health. In some forms of infertility, recovery can be achieved after the adoption of procedures.

Mud baths, thermal waters from healing springs, and physiotherapy sessions will help improve men's health.

Sometimes the reason for the deterioration of the ejaculate is prolonged stress. After the man rests and calms down, the spermogram returns to normal without taking any pills.

If infertility was diagnosed against the background of prostatitis, sessions of magnetotherapy, laser treatment, prostate massage, mud tampons, phytobar, paraffin therapy are at your service.

Which sanatorium is better to go to for male infertility?

It depends on your desire and financial capabilities. Good reviews are available from the course of therapy in the resorts of the Krasnodar Territory, the North Caucasus. Sochi, Saki, Adler, Khosta, Kislovodsk, Pyatigorsk, Zheleznovodsk - in these cities there are many sanatoriums specializing in "men's health".

However, if there is a desire, men can be treated for infertility in the Moscow region or Kaliningrad.

Infertility treatment in Israel

Probably, there is no such person who has not heard about the healing properties of the Dead Sea mud. It is possible that domestic health resorts, where mud therapy is used, are no worse in terms of therapeutic effect, but if you evaluate the quality of service, it is better to go to Israel to treat infertility.

Dead Sea health resorts offer a full range of services to resolve a delicate problem.

You can go for treatment with a pre-prepared detailed extract from the clinic, which indicates the diagnosis, the results of laboratory and clinical examinations.

If for some reason you have not been diagnosed, then there are enough clinics in Israel where all this can be done. If desired, it is possible to receive conservative or surgical treatment, followed by a spa rehabilitation.

Note that the required period of therapy in the sanatorium is at least 21 days. This time is necessary for the body to begin to expend energy on fighting the disease, but not on acclimatization.

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