Forms and treatment of male infertility. Male infertility as a key factor in the problem of conception Obstructive form of male infertility treatment

”Grows inexorably every year. There are many reasons for this, but one of the most common of them is deviations in the function of the endocrine glands. These glands include the testes, where the maturation and growth of sperm occurs - spermatogenesis. As a result of a violation at least at one of the stages of the spermatogenesis process, the formation of inactive and defective sex cells occurs - spermatozoa, which are simply not able to fertilize an egg. In addition, pathologies in the work of the testicles often cause either long, but unsuccessful attempts to conceive a child, or absolute secretory infertility. This diagnosis often becomes a sentence for a man.

What is secretory infertility?

Secretory infertility is a generalized name for all anomalies associated with testicular function. Before starting therapy for such pathologies, a preliminary long-term diagnosis of the causes that provoked the development of the pathology is necessary. The diagnostic process can be quite lengthy, since high accuracy is required in this case. To compile a complete picture of the disease, the doctor may need information not only about the person's well-being, but also about the lifestyle he leads, injuries and illnesses that were suffered in adolescence or childhood. After identifying the cause that caused the deviation, a course of treatment will follow, aimed at the comprehensive restoration of all internal secretion processes, as well as the general state of male health.

Secretory infertility: causes

Since infertility of secretory genesis is a violation of the proper functioning of the testicles, the reasons for its appearance are somehow connected with some kind of negative effect on these organs - permanent or one-time, injuries, hereditary pathologies, past diseases. The list of the latter is quite extensive:

• varicocele;
• cryptorchidism;
• dropsy of the testicle is a deviation due to which excess fluid accumulates in the tissues of the scrotum, which compresses the testicles, interfering with their normal functioning;
• the testicles are compressed by an inguinal hernia, which interferes with their productive work;
• tuberculosis, syphilis, typhus, sexually transmitted diseases;
• mumps (mumps).

In addition to the above diseases, secretory infertility is also caused by:

• taking certain specific drugs;
• violation of the normal hormonal background;
• some peculiarities of the lifestyle - lack of vitamins, constant stress, chronic lack of sleep, smoking, poor environment, taking drugs, alcoholism;
• harmful working conditions or engaging in specific sports;
• frequent visits to saunas and baths;
• radioactive exposure.

Secretory infertility: diagnosis and treatment

The first stage in diagnosing infertility of secretory genesis is to obtain spermogram results, taking smears for sexually transmitted diseases, and the doctor can also send a man for hormonal tests.

Depending on the test results obtained, which were submitted at the first stage of diagnosis, the doctor prescribes additional tests and studies. For example, it can be a biopsy of testicular tissue or a detailed study of the patient's lifestyle, as well as his working conditions, collecting information on diseases and injuries that were received in the past by a man, including at an early age. This is necessary to establish the cause that caused the appearance of the disorders, as well as to select the most effective therapy.

There are several methods for treating the secretory factor of infertility. For the greatest efficiency, several methods can be used simultaneously.

1. Drug treatment (antiviral and anti-inflammatory therapy).
2. Surgical treatment.
3. Hormone therapy.
4. Isolation of a man from all negative influences.
5. Cancellation of taking medications that have a negative effect on spermatogenesis, as well as replacing them with alternative ones with a minimum of side effects.
6. Comprehensive treatment aimed at restoring and further stimulating the correct functioning of the testicles. It may include not only the intake of certain vitamins and drugs that stimulate spermatogenesis (for example, Spermaton), but also replacement of lifestyle, diet and diet, rest and sleep.

In case of successful diagnosis of the causes of the disease and effective treatment, the couple can return to trying to conceive a child. However, in men, secretory infertility, in contrast to the obstructive factor of infertility, in some especially advanced situations can develop into a very serious pathology, the absolute or even partial restoration of the normal functioning of the testicles with which it is impossible. If, with such a disease, a biopsy of testicular tissue can help to obtain at least a small number of specimens of healthy morphologically and motile sperm, spouses can count on the use of assisted reproductive technologies - in vitro fertilization or ICSI. However, when restoration of spermatogenesis is not possible, the couple will have no choice but to find a suitable sperm donor. Today in our country this service is becoming more and more popular every year, thanks to which the donor base is very extensive, and the search for the most suitable one will not take much time.

To date, the problem of conceiving a child has not spared a lot of families. According to medical statistics, 10% of marital unions do not have the opportunity to give birth to a child without resorting to the help of specialists. Female infertility is observed in 40% of cases of absence of children in the family, and male - in 45% of all couples. Only in 15% of the factors causing the absence of pregnancy in women are biological incompatibility of partners and other rare cases.

Reproductive system in men

To understand the reasons for a man's lack of fertility, it is necessary to have general information about the male body in terms of fertilization. A little more detail on the reproductive system. At the head of the process of conceiving a child, of course, is the sperm - the sex cell (gamete) of the man's body, which is responsible for the fertilization of the egg. The constituent parts of the sperm are the head, neck and tail. Genetic information that will be passed on to the fetus in the future is stored in the head part, and the tail part is necessary to ensure the mobility of the reproductive cell.

The production of germ cells occurs in the convoluted tubules of the testicles, enveloped in a special spermatogenic epithelium. The continuation of the convoluted seminiferous tubules are straight lines. This is the path, about five hundred meters long, which male gametes overcome, ripening and acquiring the ability to fully fertilize the egg. The final ones are the epididymis, it is from them that the spermatozoa come out through the vas deferens. The seminal duct runs through the inguinal canal, then, bypassing the abdominal cavity, ends with seminal vesicles located behind the bladder.

In the vesicles, sperm accumulate and mix with the secretion secreted by the walls of the cavities. The beneficial substances contained in the fluid of the bubbles allow the male gametes to cover the distance to the egg. Through the ejaculatory ducts, they reach the prostate gland, passing through which they are enriched with its secretion. Thus, a biological fluid called sperm is obtained, which contains sperm, nutrients and chemical compounds that give an alkaline environment. During ejaculation, the ejaculatory ducts become open, and sperm enters the urethra, from which it is pushed out at the time of ejaculation.

There are the following types of male infertility. The secretory form is characterized by a violation of the production of male germ cells in the convoluted tubules of the testicles. And with obstructive - there is an obstacle on the way of gametes to the urethra. A little more detail about each species.

Secretory form of infertility in men

The secretory form of infertility is characterized by the fact that the testicles are not able to produce the required amount of sperm, which will be enough for the gametes to pass the entire path and to complete the process of fertilization of the egg. Also, with a secretory form of infertility, a violation of the mobility of gametes is possible, or most of the germ cells have defects in the structure.

Varicocele

The source of the secretory form of infertility is inherently any negative effect on the testicles. The most common disease that results in impaired sperm production is called varicocele - testicular varicose veins. In this disease, the blood vessels of the testicle do not allow the necessary outflow of blood from the organ to occur, and its stagnation occurs, that is, the blood supply to the testicular tissue is disrupted and its functioning is suppressed. As a rule, varicocele begins on the left side, however, after some time, the blood supply to the healthy testicle is also damaged, then other abnormal mechanisms are connected. Thus, the result of varicose veins can be a significant decrease in sperm production by both testicles and secretory infertility occurs.

Dropsy of the testicle

Similar symptoms are likely with another disease - dropsy of the testicle. It is characterized by an abundant accumulation of fluid in the scrotum, which compresses the testicle. This phenomenon must be treated immediately, since the pressure process can cause a failure in the blood supply to the testicular tissue, and as a result - infertility. The danger lies with an inguinal hernia. Such a violation of male health, as cryptorchidism, that is, non-prolapse of the testicles into the scrotum, is quite rare. It is discovered and started to be treated in early childhood, and by the age of seven the boy has completely completed the course of treatment, and the process of prolapse of the testicles should be successfully completed. If this does not happen, the testicles may malfunction.

Complications after mumps

Another disease that gives a disastrous result in the form of loss of male fertility is mumps, that is, mumps. Under the influence of the virus, which is the cause of this disease, the various glands of the body malfunction. It is not uncommon for the onset of parotitis - inflammation of the salivary glands, outwardly expressed as follows, the victim's face swells, becomes rounded. Visible symptoms were the reason for the emergence of a simple name for the disease - mumps. In the process of this disease, the gonads also suffer, most often the testicles. If in childhood a man suffered from orchitis (inflammation of the testicles), which proceeded in a rather severe form, and the treatment was carried out late, in adulthood there may be consequences in the form of impaired testicular activity.

Radiation as a cause of infertility

Damage to the lethal epithelium under the influence of various external circumstances is no exception. The long-term effect of penetrating radiation, which causes radiation sickness and other forms of health disorders, has a strong negative effect on the spermatogenic epithelium of the testicles, damaging it. Naturally, this results in a significant drop in the number of healthy sperm produced. Long and intense exposure to electromagnetic waves can cause similar disturbances. Speaking about this, it should be mentioned that the constant wearing of a mobile device in the belt zone is an electromagnetic effect, although the fact of harm has not yet been proven by mass research.

Overheating of the testicles

One of the most common negative influencing factors is high temperature. As a result of being in a hot environment (for example, the work of a stoker or a welder), the function of the testicles is partially suppressed. Men who care about their future fatherhood should also be wary of visiting a sauna or bath, frequent and prolonged hot baths. It is recommended to end the thermal procedures with a cool shower, or simply allow the body temperature to drop to normal before starting to dress. You need to be careful about constant cycling.

Compression and regular thrusting into the perineum can cause the testicles to malfunction. That is why it makes sense for men to completely abandon cycling when undergoing therapy for the secretory form of infertility, this especially applies to professionals. Another external factor in testicular malfunction is called tight, tight-fitting underwear.

Extragenital pathologies

Serious illnesses such as syphilis, tuberculosis or typhus, hormonal imbalances, or long-term use of medications against tumors and antieleptic drugs, antibiotics, steroid hormones, antiandrogens can lead to a deterioration in the spermatogenic activity of the testicles. The production of healthy sperm is greatly reduced under the influence of such processes as constant stress and insufficient sleep, lack of proteins and vitamins, poor environment, excessive smoking and alcohol addiction, drug use.

As a rule, to identify the secretory type of infertility, in addition to the spermogram, a testicular biopsy analysis is prescribed. This study makes it possible to understand what the condition of the testicular tissue is, and also to find the cause of the disorders. Before the course of the main therapy for secretory infertility, it is necessary to remove the root cause of its occurrence - varicocele, dropsy, mumps, identify and eliminate negative external circumstances or stop taking medications. Only after this, a general treatment is prescribed, with the aim of improving spermatogenic activity. Course treatment is based on the presence of a full-fledged diet of a man, maintaining a healthy lifestyle, taking vitamins and medicines that increase the blood supply to the organs of the scrotum.

Sometimes it is supplemented with stimulating hormone treatment. At the end of the topic about the treatment of the secretory form of male infertility, I would like to say that the healing process is long, gradual, but leading to positive results. Therefore, the recommendations and appointments of a specialist should be taken with full responsibility.

Obstructive male infertility

The obstructive form of male infertility is characterized by the fact that the movement of gametes along the vas deferens from one side (sometimes from two) is not possible. In the case of a one-sided lack of permeability in the sperm, the content of gametes is greatly reduced, and with a two-sided one, the germ cells are absent altogether. Obstruction of the vas deferens (obliteration) occurs and progresses due to various circumstances.

Complications after epididymitis

The most common source of obliteration, experts call the transferred disease epididymitis, that is, inflammation of the epididymis. The disease passes, and the ducts of the epididymis stick together or become clogged, respectively, the penetration of spermatozoa further is impossible and the seed bladder is inaccessible to them. The injuries suffered in the groin area can give not a good result, especially in cases of negligence towards them - a doctor's examination is mandatory, perhaps even treatment.

Infertility after surgery

Another reason may be an unintentional deformation of the vas deferens during surgery on the pelvic organs. The vas deferens can be damaged by pressure from a tumor or cyst in the epididymis. Anomalies from birth - the absence of the ovarian epididymis or the vas deferens occur in the obstructive form of infertility. Obliteration can also be a consequence of the transferred syphilis or tuberculosis.

To detect this type of infertility, there are special methods by which the presence, location and size of the area of ​​obstruction is diagnosed. The basic treatment for the obstructive form of male dysfunction is the surgical revitalization of the patency of the semen output lines. The effectiveness of the surgical intervention is mainly due to the size of the obstruction field. The essence of the operation consists either in excision of the diseased area, or in the creation of another method of advancement for gametes. As a treatment option for this form of infertility, specialists occasionally use an anastomosis (connection between two cavities) with the opposite vas deferens.

Other causes of infertility

There are also reasons for which both partners are "to blame". For example, one of them may have one disease, while the other may have a slightly different nature, but it also makes it difficult to conceive.

Biological incompatibility of partners

Medical practice identifies cases that make up approximately 10% of all problem married couples, when neither the man nor the woman has clear reasons that prevent the spouse from becoming pregnant. And sometimes each partner has children from previous marriages. In such situations, experts talk about the incompatibility of partners of an immunological nature. That is, there is a woman's allergy to the male gametes of her husband or any components of the sperm. This type of infertility is diagnosed by the appointment of a complex of various studies, including an allergy test with the partner's ejaculate. All over the world, the treatment of this form of fertilization problem is difficult. Unfortunately, andrologists and gynecologists cannot yet prescribe a therapy that is effective in all cases, so a positive result is not guaranteed.

Anomalies in the structure of male organs

In addition to the cases described above, experts identify other forms of infertility that are much less common. There is such a disease called hypospadias, in which from birth a man has an anomaly in the structure of the penis - the urethra is located not at the top of the penis, but on its lower surface. In the case of this defect, the chance of conception is very low, because at the time of ejaculation a large number of gametes most likely do not end up on the cervix, which means they do not reach the egg. Another source of male failure is a disorder of sexual function - erectile dysfunction, that is, the inability to achieve and maintain an erection. Unfortunately, such consequences are associated with various inflammatory diseases that remain untreated. These include chronic prostatitis and specific urethritis, the most common male health problems. The presence of dysfunction in a spouse may allow a couple to fully have sexual intercourse no more than once a month, and with such a regularity, the possibility of fertilization of an egg is unlikely.

Ignorance of the biology of men and women

Unfortunately, there is another reason that prevents the appearance of children in the family - a lack of awareness of the physiological relationship between a woman and a man. There are spouses who do not understand that egg fertilization is not possible in cases of oral or anal intercourse. If partners practice these types of intimacy too often, the number of classical acts decreases accordingly, and the long-awaited pregnancy does not occur due to physical reasons. There are other examples from the practice of gynecologists. For example, one specialist shared a case from his own experience. Once a couple came to see him, and for a long time they did not manage to have a child. It turned out that the reason for this was an elementary ignorance of how to have sex, the woman turned out to be a virgin. The story does not sound entirely believable for our time, but the fact remains.

Diagnosis of male infertility

The causes of infertility in men are described above, and now a little about their diagnosis. Previously, of course, the doctor collects anamnesis (asks the patient), examines visually and conducts the necessary complex of general analyzes. The next step is a study of the ejaculate, called a spermogram. This laboratory test of the male material gives an idea of ​​its composition and properties. The spermogram is considered to be the basic study in the diagnosis of male infertility. And this is really so, the analysis is very informative, does not take much time, is simple and economical to perform, and the spermogram data cannot be obtained by any other diagnostic method. You should not forget about other analyzes and methods, because with their help you can detail the picture of a patient's health disorder.

To obtain the correct result, the spermogram is re-assigned, two, if necessary three times, in comparing the data, the specialist can more accurately make a diagnosis. That is why it is recommended to visit a doctor - a specialist in the field of male infertility with ready-made ejaculate analyzes.

Sperm analysis and values

Now a little more about the norms and possible inconsistencies in the indicators of the study of male material. The norm is the total amount of ejaculate that fits in a teaspoon, that is, from three to five milliliters. Smaller indicators indicate a decrease in the activity of the testicles and gonads. In the case of obtaining data indicating a semen volume of less than two milliliters, obtaining a zygote is practically impossible, even with the norm of other indicators. The quantitative characteristic is normal - the semen should not contain less than 20 million gametes. A low sperm count is called oligozoospermia. This deviation occurs due to abnormal (low) functioning of the testicles or in the presence of obstruction of the vas deferens. Azoospermia - the absolute absence of gametes in the ejaculate, is observed in the case of obstruction on both sides or deficiency of testicular activity. It is often perplexing for patients that conception is not possible with a low quantitative indicator (for example, one million units) of gametes in the ejaculate, because only one sperm is involved in the fertilization process. To clarify the situation, here are some figures.

After the eruption of male fluid, about 200 million gametes appear on the cervix, and only half of the mucous plug of the cervical canal is overcome. Only a small number of spermatozoa continue to move to the mouth of the fallopian tubes, and only two hundred biological units manage to overcome the fallopian tube and get to the egg. Thus, it becomes clear that the chance of fertilization in the presence of one sperm in the semen is negligible, like the jackpot in the lottery. The likelihood of pregnancy depends on the quality of male sperm, and sperm motility is one of its most important characteristics. In healthy ejaculate, the gametes move forward, sometimes chaotically.

If there are not enough motile sperm in the semen, asthenozoospermia is observed, and in the case of their complete absence - necrozoospermia. Experts say that the quantitative and qualitative (mobility) indicators of ejaculate are directly related to the regularity of sexual contacts between spouses. It is believed that for the third consecutive sexual intercourse sperm cells become unsuitable for fertilization. The fact is that there are medical statistics confirming the presence of the largest number of gametes in the sperm of a man who abstains from sexual intercourse for two or more days. In addition, in the case of frequent closeness of spouses, incompletely matured gametes penetrate into the sperm, which do not have the necessary vitality and mobility to fulfill their functionality.

Such a spermogram indicator as morphology gives an idea of ​​what percentage of gametes has the correct structure, and more than half is considered the norm. If this figure is less, it is worth talking about the presence of teratozoospermia. There is a misconception that an abnormal structure of the sperm cell can affect the usefulness of the future fetus, but the genetic information in any gamete is present in full. With an indicator below the norm, the probability of the very fact of conception decreases. This situation can occur due to a violation of the activity of the sex glands. In turn, the causes of their dysfunction are chronic prostatitis, vesiculitis, specific inflammatory processes, or the lack of regular sexual intercourse.

The norm is the absence of areas of accumulation of gemetes (aggregation). This violation is determined in some cases visually, such zones of the ejaculate have a high density and are white. Often, low sperm motility is accompanied by aggregation and many male health problems can also be its cause.

Another indicator, the excess of the norm of which indicates the presence of acute inflammation in the organs of the urogenital tract, is the content of leukocytes in the ejaculate. The norm is 1-2 in the field of view. In the case of the presence of more than the stated amount, the doctor prescribes a full examination for the detection of diseases such as epididymitis, orchitis, prostatitis, vesiculitis, urethritis and others like that.

Once again, I would like to emphasize the need for repeated spermogram, since most of its indicators can vary depending on various external factors and not only. A specialist gives a clear assessment of a man's ability to conceive based on a comparison of several data.

An obstacle in successfully overcoming the problems of male infertility is, among other things, called the psychological aspect. Almost every man, even knowing about his illnesses and possible negative consequences, is shocked when he hears the diagnosis of infertility addressed to him. The doctor's words about the impossibility of having children are shocking for a woman, but a man experiences this news even more difficult. According to psychologists, many men have the truth in their subconscious that the inability to conceive a child is tantamount to disability. The diagnosis of infertility causes enormous psychological trauma, which entails a threat to the normal life of a man. There are known examples when men could not come to terms with this state of affairs and successful marriages broke up, despite the fact that the other half tried to solve the problem of childlessness in other possible ways.

Often leaving the family leads a man to abuse alcohol or even drugs, such people deliberately try to escape from reality. Unfortunately, many representatives of the strong half of humanity stubbornly do not agree to any medical consultations and examinations, deep down in their hearts they are afraid to receive an answer about their male inferiority.

On the way to the cherished pregnancy, married couples are faced with many psychological moments that may well lead to the destruction of the family. To achieve conception, it is often necessary to follow the doctor's recommendations on the conduct of sexual activity, and this is associated with the destruction of the romanticism of sexual relations, reduced, so to speak, to closeness "on schedule." The psychological stress of both partners is great and there are frequent quarrels, mutual dissatisfaction, nervousness, as a consequence of the difficulty in the relationship. Experts agree that if one of the family members is diagnosed with infertility, it is necessary to involve the second spouse in the process of treating the other, joint visits to the doctor, participate in consultations and discussion of therapy methods. Such treatment brings partners closer together, makes it possible to share their experiences, support each other, which means that family relationships will not only not suffer, but will reach a new, more trusting level.

Male infertility treatment

Treatment of male infertility today is a painstaking and slow process. Unfortunately, the methods of modern therapy cannot boast of high efficiency. On average, 41% of married couples achieved the desired result, fulfilling all the appointments and recommendations of a specialist, at the same time, 31% of partners who did not follow medical instructions had conception.

Artificial insemination for pregnancy

Today, medicine offers several unconventional ways to achieve the desired spouses who are unable for a number of reasons to have children. One of these methods is artificial insemination. This is a procedure in which the ejaculate of a spouse or donor is inserted into the woman's vagina using special instruments. Thus, all the sperm ends up on the pharynx of the uterus, which is impossible with natural sexual intercourse, which means that the likelihood of successful fertilization increases by a hundredfold. If a woman's health allows her to become pregnant, and the level of full-fledged mobile gametes in her partner's sperm is below normal and there are very few chances to conceive a child naturally, doctors use the method of artificial insemination, in which in this situation the result will be positive. Donor ejaculate is used in a situation where the husband's sperm is completely devoid of spermatozoa or their mobility is severely impaired. The material for the operation is fresh or frozen semen. One of the uses for frozen semen is donor ejaculate, which is stored in a sperm bank.

IVF as a treatment for male infertility

At the end of the seventies of the last century, a new method of dealing with various forms of infertility appeared - in vitro fertilization or IVF. This medical method revolutionized medicine and gave hope to a large number of spouses to find a full-fledged family. With IVF, fertilization of the egg is performed in a special vessel - a Petri dish, and then the zygote is placed in the woman's uterus. This method of conception is possible if there is at least one full-fledged male gamete in the partner's ejaculate and sufficient activity of the partner's ovaries.

For the first time, the IVF process gave a positive result in a woman with removed fallopian tubes after an inflammatory disease. Modern medicine has hundreds of children born as a result of IVF. This method of artificial insemination often makes it possible for spouses to have children who, under no other conditions, can achieve pregnancy.

The disadvantage of the IVF method is its not small cost for patients, apart from the high requirements for medical equipment and the qualifications of the personnel of the medical center. This procedure is complex, multi-stage, requiring careful preparation of women and men. According to statistics, in order to be successful, spouses need to go through an average of four procedures. The cost of one ranges from $ 4,000 to $ 8,000.

Surrogacy

Another alternative method to get the long-awaited offspring is surrogacy. They resort to him in situations when the spouse does not have the physical ability to bear the child, but her ovaries are normal and the eggs are full. Fertilization of an egg with the sperm of a spouse or donor (in case of male infertility) occurs as in IVF, but the zygote is transferred into the body of the donor woman. It is she who bears and gives birth to a child, who is then passed on to biological parents. Surrogacy is always surrounded by a huge number of disputes, various scandalous situations and complex lawsuits. And from an ethical point of view, this method does not have an unambiguous assessment by the public and by doctors. There are many examples of the refusal of female donors to give their children to their legal parents, or vice versa, the father and mother do not want to take a child born with health problems, referring to the fact that it is the surrogate mother that is the cause of the baby's ill health. All this became the reason that in some countries (for example, in several states of the USA) surrogacy is illegal. However, one should not discount the fact that many childless couples were able to have a child solely thanks to this method.

There are situations when the infertility of a husband or wife cannot be treated and medicine is unable to help, and then the only opportunity for them to be parents is adoption. An interesting fact is that many spouses, having adopted a child, soon become the parents of their own baby. Medicine explains this by the fact that the spouses stopped making extra efforts to achieve pregnancy, which in turn had a beneficial effect on the health of the spouses.

Summarizing all of the above, I would like to note that, despite the fact that male infertility is a serious problem for modern specialists, medicine can still offer ways to recover, and patients can find an acceptable option for themselves, even in the most critical situation.

And finally, some emphasis on significant points regarding male infertility.

In childless couples, in 45% of cases, the reasons for not getting pregnant are male diseases, and in 15% - immunological incompatibility. Therefore, I would like to repeat that the spouses should deal with the issues of the absence of children together, without shifting all the responsibility to the woman.

Experts recommend seeking advice from partners if there is no pregnancy with regular sex life without the use of contraceptives throughout the year. The best option would be to jointly contact the spouses to a medical center for examination by a gynecologist (for a woman) and a urologist or andrologist (for a man). In this case, doctors will have the opportunity to receive additional information from each other, discuss and adjust the treatment process, which means that the effectiveness of therapy will increase.

The reasons for a man's inability to conceive a child can be not only inflammatory diseases, venereal infections, but also excessive smoking and alcohol addiction, drug addiction. During the process of therapy, a man should not only follow the instructions of the attending physician regarding the intake of drugs and procedures, but pay close attention to his lifestyle - to put it in order.

Before seeing an infertility specialist, a man is recommended to undergo a spermogram.

Do not forget about the available alternative methods of conceiving a child. This should be discussed with the attending physician if it is not possible to cure male infertility with traditional therapy.

The last thing I would like to say is not to despair and give up. There are a huge number of cases of the birth of children in families that medicine could not help. There is a place in our life for a miracle.

Infertility in men - This is the lack of conception of a child for 12 months, subject to regular sexual intercourse. This means that the partner is fertile and healthy.

Characteristics of the male reproductive system

The male reproductive organs are divided into internal and external. The testicles are used to produce sperm and the hormone testoterone, whose function is to create sexual characteristics. Sperm from the testicles is sent to the tubules of the epidyrmis, where it is stored and nourished when it matures. After maturation, the sperm flows through the vas deferens into 2 sac-like glands, in which it is stored. The entire sperm production process takes about 72 days. During ejaculation, semen, mixing with fluid from the prostate, forms semen.

The fundamental factor in a man's fertility is spermatogenesis - the development of mature, normal sperm in him. The production of sperm is carried out and controlled by 3 hormones - FSH, LH, testosterone. The hormones FSH and LH have an effect on the testes, namely: FSH stimulates sperm production in cells called Sertoli, and LH stimulates testosterone production in Leydig cells. Immature sperm, located in Sertoli cells, matures, turning into spermatozoa, which cannot be motile without passing through the epididymis. Having acquired mobility, the sperm is in the vas deferens until the moment of ejaculation.

Causes of infertility in men

After the moment of ejaculation, the sperm in the female body, while maintaining the possibility of fertilization, can remain for 48-72 hours. In this regard, in order to conceive a child, you must have intercourse every two to three days after the onset of ovulation. A very important point for fertilization is sperm motility, not just sperm count. A man can have the ability to fertilize (be fertile) even with a small number of spermatozoa, but only if they are quite mobile. Male infertility can be influenced by:

Forms of male infertility

Male infertility has 2 main forms:

1. Secretory;
2. Obturation.

Secretory form of male infertility characterized by a violation of the formation of sperm in the testes, a violation of their mobility, as well as the presence of defects in the structure of sperm. This form of the disease is based on some kind of effect on the testicles.

Obstructive form of male infertility characterized by the presence of an obstacle in the path of sperm to the urethra.

Characteristics of the secretory form of male infertility

Most often, the production of spermatozoa in this form of infertility is disturbed due to - varicose veins of the testicle. In this case, the veins of the testicle greatly expand, and cannot fully perform the function of the outflow of blood from the testicle. As a result, blood stagnation occurs, there is a violation of the blood supply to the testicular tissues and inhibition of its functions. , most often, left-sided, however, with the progression of the disease, there is a violation of the blood supply and a healthy testicle. All of the above leads to a decrease in the production of sperm by the testes and to secretory infertility in men.

Infertility in men has similar symptoms. With this disease, a significant amount of fluid accumulates in the scrotum, compressing the testicle. If the disease is left untreated, this pathology leads to impaired blood supply to the testicular tissue, which leads to infertility. A similar result may appear.

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Almost every woman in her life with such an unpleasant disease of the rectum as hemorrhoids. In the initial stages, the treatment of hemorrhoids is reduced by the use of drugs (suppositories, ointments), but at advanced stages it is necessary to resort to surgical methods of treatment. In this case, the use of a laser will be quite successful. This method gives a very stable and good effect without relapses. Delete ..

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Contents Causes of the appearance of crunch in the joints Symptoms of the disease The appearance of crunch in the joints is a fairly common phenomenon that people of almost all age groups face. Quite often, many parents observe this in their children also at different ages. Before sounding the alarm, therefore, it is worthwhile to figure out why the joints of a child crackle. Causes of joint crunching Among ..

Contents Causes of discharge in girls Symptoms accompanying discharge in girls Vaginal discharge is observed in both women and girls. From the very birth the girl has discharge, which is subdivided into: Physiological; Pathological. Physiological discharge in girls is normally light, mucous, and threadlike inclusions may be present in them. Pathological discharge - copious, with traces.

Contents How does hemangioma arise? Reasons for the appearance of hemangioma Removal of hemangioma in newborns Hemangioma is a vascular formation of a benign character that has arisen due to changes in the walls of blood vessels. This disease affects one in 10 children born. Hemangiomas are tumors of various sizes and colors that form on the face, scalp, genitals, and other parts of the body. Education can manifest ..

IVF is a method of in vitro fertilization, when sperm are added to the egg. ICSI is the process of transferring a specific single sperm “manually” into an egg cell. If in these programs, the attempt to achieve pregnancy did not materialize, the couple is asked to find a sperm donor.

Conclusion

There is a cliché in society for some unknown reason that infertility is a woman's fault. However, at present, statistics have proven that worldwide infertility occurs in 15% of the total population in each country, and 5% of them are genetic mutations and idiopathic causes, which are almost impossible to correct.

The ratio of male and female factors in the causes of infertility is 40:60, so you shouldn't "blame" someone else, this reason is common and you need to solve it together. With adequate treatment and timely consultation with a reproductive physician, the chance of onset increases many times over.

Video: Male infertility. Urologist, andrologist, sex therapist Alexey Kornienko

In modern life, more and more men suffer from violations of the ability to fertilize the female egg. Timely treatment of male infertility often restores fertility. The reasons for this phenomenon can be caused by congenital anomalies in the development of the genital organs. Hormonal disorders that occur due to testicular failure are common causes. Acute diseases of these male genital organs can cause obstruction of the vas deferens, arising against the background of epididymitis or orchitis. Disorders in the thyroid gland, hypothalamus and pituitary gland are also the causes of male infertility. Trauma, the consequences of surgical interventions on the bladder, prostate, urethra and varicocele in history are often the causes of infertility in men. Chronic urinary tract infections lead men to have problems conceiving. In all these conditions, infertility occurs due to a violation of sperm production, their delivery or the inability of male germ cells to fertilize an egg due to their pathologies.

The fact that a man suffers from infertility can be assumed if his partner is not protected during sexual intercourse, but does not become pregnant during the year.

Treatment of male infertility begins after contacting a specialist, an andrologist.

At the same time, his partner turns to a gynecologist to find out the reasons for infertility.

An infertile couple must undergo a comprehensive examination, because the reason may be not only in the man, but also in the woman, or in both spouses at once. A visit to an andrologist will help a man to identify the cause of infertility and begin, if necessary, treatment that will increase the chances of conception in the natural cycle. The causes and treatment are interrelated. To start treatment, you need to identify the causes, and this can only be done in modern well-equipped laboratories and diagnostic centers. Accurate diagnosis provides effective treatment for male fertility disorders.

How is the examination done to determine the causes of infertility?

Women are referred for examination by a gynecologist, and in men, an andrologist conducts an examination to establish whether there is male infertility. To check the health of a man and his internal organs, the andrologist will prescribe tests and studies after the initial examination. This could be:

• spermogram;
• Genital ultrasound;
• dopplerography of the vessels of the small pelvis;
• blood test for sex hormones;
• analysis for genital infections;
• immunological analysis;
• Analysis of urine;
• study of the secretion of the prostate gland.

When confirming the diagnosis of infertility, the andrologist prescribes treatment in order to eliminate the causes that caused this condition. In each case, male infertility is treated according to an individually drawn up plan. Fertility treatments can vary. The andrologist chooses appropriate tactics, which may include conservative surgical and medical methods, or a combination of both.

Forms of infertility in men

There are two forms of male infertility. One of them is an obstructive form of infertility, which is treated only with the use of surgical methods. The purpose of the surgery is to restore areas of the vas deferens that are blocked for some reason.

The most common is inflammation of the epididymis, which is called epididymitis. After its acute form, adhesion and clogging of the ducts of the epididymis occurs, which prevents the sperm from penetrating into the seminal vesicles. A similar pathology can occur due to mechanical damage caused by injuries of a different nature. Among the common diseases that affect the patency of the duct are tuberculosis and syphilis. Obstruction of the vas deferens can be unilateral and bilateral. Treatment of infertility associated with similar causes occurs only with the help of surgical intervention. During surgical treatment, the causes of male infertility are eliminated, which cannot be eliminated in any other way.

The second is the secretory form, which is that the male testicles are unable to produce the amount of sperm needed for fertilization. The reasons for this may be different, and the examination helps to identify and treat them using complex therapy.

Secretory form of male infertility and its treatment

The secretory form of male infertility occurs due to the undescended testicles into the scrotum. The disease is called cryptorchidism. It develops during childhood. If by the age of seven the boy's testicle has not descended into the scrotum, then timely treatment of cryptorchidism can relieve problems with infertility in adult men. If there is no treatment, then the function of the testicles will be significantly reduced.

A previous illness with mumps or mumps can also lead to a significant decrease in spermatogenesis due to orchitis and the development of male infertility.

Radiation, powerful electromagnetic waves and high temperatures, tight underwear and outerwear often lead to secretory forms of the disease. The harm of radioactive radiation and toxic substances, constant contact with lead, arsenic, oil products and paints and varnishes leads to infertility in men.

To treat this type of infertility, you need to protect yourself from the influence of harmful factors. Avoiding harmful factors in a man's life leads to better health and increased fertility. These include poor nutrition, smoking, alcohol cravings, stress. It is enough for the treatment of complex therapy with vitamin-mineral complexes and changes in nutrition, and there will be an improvement in the spermatogenesis of the secretory form of male infertility.

How is infertility caused by infections in men treated?

When infectious diseases of the genitourinary system are detected, the andrologist prescribes a course of antibiotics and drugs that improve the immune system. A vitamin-mineral complex is added to the antibiotic treatment, which improves the general condition of the body, and a specific diet is recommended.

When infertility occurs due to chronic damage to the body by various infections, treatment will depend on the degree of damage to the pelvic organs. It may be necessary to undergo surgery to restore the pathways along which sperm are supposed to move. Treatment of infertility in men with a low hormonal background requires the appointment of hormone replacement therapy. This can be testosterone injections or the use of other methods in which the male hormone begins to actively enter the body of a man suffering from an androgen deficiency.

Immunological male infertility can develop due to any cause that causes diseases of the genitourinary system. If immunological infertility is detected, then treatment begins with the elimination of those factors that led to its appearance. Treatment should include systemic enzyme therapy and hormone therapy.

When treating any form of male infertility, first of all, the true causes of the disease are eliminated. For this, rehabilitation and restorative therapy is carried out, which allows and normalizes the process of spermatogenesis. Much fertility treatment will depend on the patient. Compliance with the doctor's prescriptions, discipline in taking medications, proper nutritious nutrition will help get rid of diseases and restore fertility. A healthy lifestyle, playing sports, giving up bad habits bring healing to the male body and improve potency.