How infertility manifests itself in men. Male infertility: which doctor should I go to and is it treated? The most common causes of infertility in men

Before talking about male infertility, you should understand the term “infertility”. This is not a diagnosis, this is a violation that occurs in marriage if the married couple has a regular sex life and is not protected in any way for twelve months.

In principle, it is impossible to clearly divide the problem of infertility into a female and a male factor, since often in infertile couples there are disorders in both partners. However, some authors believe that in 25-50% of cases, the cause of infertility is a man.

Signs of infertility in men

As a rule, there are no symptoms in the presence of infertility in men. Representatives of the stronger sex can feel great and look absolutely healthy. Like all normal men, they are able to have an active sex life and enjoy it.

They find out that they are sterile, most often by accident. For example, a couple decides to have a baby and stops using protection. A month, two, six, twelve, passes, and the pregnancy does not occur. The woman begins to be examined first. After all possible violations are excluded from her and the conclusion “healthy” is given, the man is examined.

He is prescribed a whole bunch of different tests, as a result of which signs of infertility in men are revealed - one or several types of disorders.

The main causes of male infertility

Male infertility has fewer causes than female infertility. However, this does not mean that it is easier to treat. Let's take a closer look at the causes of male infertility.

1. Sexually transmitted diseases. As a rule, it is sexually transmitted infections that become the main cause of the development of the inflammatory process in the male reproductive system. And also some microorganisms can directly infect the genitals and cause a deterioration in the quality of sperm. For example, the negative effect of chlamydia on the ability to conceive has been proven.

2. Inflammatory processes. Inflammatory processes are the main cause of impaired spermatogenesis (sperm production). Due to such common diseases as prostatitis and urethritis of various etiologies, sperm motility is significantly reduced, which can cause male infertility or a significant decrease in the chances of conception.

3. Injuries, tumors and injuries of other etiology... The effect of testicular trauma and tumors on reproductive function is obvious. However, there are other reasons for the development of infertility in men. For example, mumps ("mumps") suffered in childhood may well render a man infertile.

4. Disorders in the hormonal background. This reason is quite important both in the formation of both male and female infertility. However, in men, it becomes more relevant with age, when the production of such a hormone as testosterone decreases. As a result, erection and the process of ejection and production of sperm are impaired.

5. Congenital pathology of the genital organs. There are quite a few examples of such diseases: ranging from (the impossibility of exposing the head of the penis) and ending with the underdevelopment of the external genital organs, the incorrect structure of the internal genital organs. The reason for infertility in such cases is most often the impossibility of a man's full sexual intercourse.

6. Bad habits. Alcohol and smoking really significantly affect the quality of sperm: sperm move much slower, and, therefore, the probability of conception drops sharply.

7. Influence of high temperatures. It has been proven that too high a temperature negatively affects the processes of spermatogenesis, which can cause the development of male infertility.

8. Stress. Of course, this is not the most important reason for the development of infertility, but you should not forget about it. A modern man constantly lives in conditions of lack of sleep and constant nervous tension, which, of course, cannot but affect the function of the reproductive system.

9. Exposure to chemicals. Of course, the most harmful are various chemical industries. However, not many men are exposed to this harmful factor. But almost everyone "breathes" automobile fuel. It is worth remembering the extremely adverse effect of gasoline vapors on reproductive function.

Disorders of the male reproductive system leading to infertility:

1. the process of sperm production in the testicles is disrupted;
2. the process of delivery of sperm to the woman's vagina is disrupted;
3. sperm are unable to reach the egg and cannot fertilize the egg;
4. some male factors have a negative impact on the condition of the female genital organs. As a result, fertilization and / or bearing of the resulting pregnancy becomes impossible.

Male infertility risk group

Infertility develops in men who are exposed to stress, have congenital and genetic disorders, especially in semen, autoimmune diseases, hormonal regulation disorders, have suffered infectious diseases (mumps, typhoid fever, etc.), trauma and surgery of the scrotum and pelvic organs. And also those who have had contact with chemicals or ionizing radiation, suffer from hyperthermia and circulatory disorders, drug addiction, abuse alcoholic beverages or addicted to tobacco.

In these men, sperm activity sharply decreases, defects in their structure appear. Very often, the examination reveals sperm with two heads, an underdeveloped tail and other abnormalities.

The representatives of the stronger sex should pay special attention to the following: the amount of sperm secreted during intercourse, whether there is a violation of potency, whether there are pains in the genital area.

If at least one of these signs occurs, you should contact or andrologist as soon as possible. Only this specialist can establish the specific cause of this condition and prescribe the appropriate treatment. Grandmothers with the help of herbs, infusions, conspiracies and other folk methods are unlikely to help here. They will only take away invaluable time.

Types of infertility

There are several types of infertility:

Secretory infertility. The most common form of male infertility. The reason for its development is a dysfunction of the testicles, as a result of which either an insufficient number of spermatozoa is produced, or they are not sufficiently mobile. Treatment depends on the cause of the testicular malfunction. Most often, they resort to medication or hormonal therapy.

Immunological infertility. It is caused by the development of an autoimmune process, which can be triggered by various factors, including trauma. To combat this type of infertility, complex drug therapy is individually selected.

Obstructive infertility. Occurs when there is any obstruction to sperm secretion. It can be a cyst, tumor, or scar. Typically, this type of infertility is treated with surgical removal of the obstruction.

Relative infertility- the least researched form. This formulation is used when there are no abnormalities in the state of health, but pregnancy still does not occur. Quite often, stress is the cause of this type of infertility. Accordingly, it is not a reproductive therapist who treats him, but a psychotherapist.

Diagnosis of male infertility

First of all, the doctor should find out from the patient whether there are any complaints related to the reproductive system (pain in the lower abdomen, difficulty urinating, etc.). The next step is to take anamnesis. It is being investigated whether the man's close relatives had similar problems with conceiving a child, whether there are any chronic diseases. It is also important to find out what diseases the patient has suffered (special attention is paid to mumps, tuberculosis, orchitis and pathologies of the urinary system).

The most important step in diagnosing male infertility is sperm examination. If it is impossible to obtain sperm naturally, a special puncture is performed. The ejaculate is examined in the laboratory, after which a conclusion is made on the presence of sperm in the semen, their number and functional state.

Infection screening is also necessary. If no obvious inflammatory process is detected, then it is necessary to pass tests for sexually transmitted infections, as well as for latent infections. First of all, the discharge of the urethra and the secretion of the prostate gland are examined.

If no infectious pathologies and disturbances in spermatogenesis have been identified, they begin to study the hormonal background. To do this, examine the blood serum for the content of sex hormones.

Of the instrumental methods, ultrasound and thermography are most often used.

Sometimes male infertility develops as a result of a pituitary tumor. Despite the fact that in this condition the content of hormones in the blood is disturbed, their concentration does not change under the influence of hormonal therapy. If this pathology is suspected, it is necessary to perform an X-ray of the Turkish saddle and skull.

Male infertility treatment

After finding out the reason that caused the development of infertility, the doctor will select an individual treatment program for you. There are several stages of male infertility therapy:

Treatment with medication. Prescription of this or that medication depends on the cause of infertility. For example, to cure a sexually transmitted disease or an inflammatory process, antibacterial drugs are prescribed, if there are hormonal disorders, then they resort to hormone replacement therapy. If infertility has arisen due to a deterioration in the quality of sperm, then first of all it is necessary to take vitamin complexes, immunocorrective drugs, sometimes they resort to treatment with homeopathic preparations. By the way, diet has a pretty strong influence on changing the quality of sperm. Men with this ailment are advised to increase their intake of foods high in vitamin D. These include sea fish. The prophylactic intake of fish oil is also recommended. And do not forget that vitamin D is synthesized in the human body under the influence of sunlight.

Surgery. It is used, most often, for the treatment of obstructive infertility. Postoperative scars, varicoceles, hernias or tumors can act as an obstacle to sperm cells. Of course, this problem cannot be solved with the help of conservative methods of treatment. But even with the help of the operation, it is not always possible to achieve the desired result, especially if the patient has already reached adulthood. The chances of a surgical cure in adolescents are slightly higher, and the most favorable prognosis is achieved with surgery in childhood.

ICSI method. This method is one of the varieties of in vitro fertilization. It is also called "the introduction of the sperm into the cytoplasm." It is used when a man has normal sperm, but for some reason they do not reach the egg. The probability of conception with this method exceeds 60%. The procedure is performed under laboratory conditions. An egg is taken from a woman and the man's sperm are injected into it with the help of microinjections. Then, the already fertilized egg is "implanted" into the female genital tract. Further, the development of pregnancy does not differ from the usual one.

Sperm donation. This method is used in cases where a man's family has severe hereditary diseases, or there are no sperm in the semen at all. This method is rarely used. It consists in the artificial insemination of a woman with donor sperm.

There are also various unconventional treatment methods... Do not rely only on them, but they can perfectly complement the main components of therapy. Non-traditional treatment of male infertility includes herbal medicine, acupuncture and manual therapy.

Prevention of male infertility

It is necessary to start the prevention of male infertility from early childhood. It is very important in no case to miss preventive examinations with the surgeon. Also very important are factors such as adherence to the regime of work and rest, good sleep, frequent walks at a fresh age and moderate physical activity.

The completeness of the diet is also very important. It must contain sufficient quantities of meat, fish, eggs, nuts, herbs and vegetables. By the way, vegetarians are at risk of developing infertility, as they do not consume enough protein.

Also, do not spend too much time in baths and saunas, take hot baths for a long time. Excessively tight underwear also negatively affects spermatogenesis.

Regular sexual activity also plays an important role in maintaining male reproductive health. Naturally, with a permanent partner.

The problem of male infertility has always existed, but if earlier it was a verdict, then modern medicine offers various methods of treatment, which in some cases help to restore fertility. Signs and symptoms of infertility in men can be visualized or painful. The consequence of infertility and an alarming signal is the absence of pregnancy in a healthy partner for a long time, provided that the couple's sex life is regular.

External signs of infertility

Everyday bustle and dynamics of life distract men from their direct function - procreation. Symptoms of male infertility often go unnoticed until the process becomes irreversible.

Sex hormones and reproductive organs are responsible for male fertility. If, due to diseases or congenital defects, a hormonal imbalance occurs, then this is necessarily reflected in the appearance.

Some pathologies of the reproductive organs leading to infertility are also visually distinguishable. But in the presence of external signs, it still cannot be argued that a man is infertile. The diagnosis is made only after a detailed examination.

Physique unusual for a man

Nature inherent in the anatomical differences between a man and a woman, not only in the structure of the genitals, but also in the skeleton, appearance, distribution of body fat. Normally, a man's shoulders are wider than the pelvis, the mammary glands are indicated by muscles, a pronounced hairiness of the face, chest, and lower abdomen is characteristic. The declination of the male anatomy to the female type is a reason to suspect fertility problems.

Klinefelter's syndrome

The most pronounced external signs of infertility in men with. The disease develops at the chromosome level (violation of the combination) even during the conception of a child.

After puberty, the following symptoms begin to appear:

• the accumulation of fat around the waist, unnatural for young and active men;
• a small amount of hair both on the body and on the face: daily shaving is almost not required;
• high growth is combined with narrow shoulders and wide hips, atypical for men;
• the breasts are loose and enlarged;
• the testes are too small and hard.

At the same time, a young man can live a normal sex life, not realizing that there is a problem of infertility.

The examination, as a rule, reveals a complete absence of viable sperm in the ejaculate, a decrease in testosterone and an excess of growth hormone in the blood. An electroencephalogram is indicative, on which it is possible to determine the damage to the deep structures of the brain, which is characteristic of Klinefelter's syndrome.

Excess weight

A man who is overweight or with "beer belly syndrome" has every chance of being infertile. Excess lipids due to excess weight cause azoospermia (no sperm in the ejaculate) in 25% of men.

Fat is the source of the synthesis of female sex hormones (estrogen). As a result, their dominance over men begins, the production of testosterone is suppressed, and the production of prolactin is stimulated. In this case, not only spermatogenesis is disturbed, but also potency decreases. Long-term imbalance leads to breast enlargement, testicular atrophy.

An overweight man has every chance of being infertile

Another reason for the development of infertility in obesity is a sedentary lifestyle: an obese man, sitting for a long time, squeezes the veins and vessels that feed the testicles.

Changes in the appearance of the scrotum

Normally, the testicles should be the same, one may be slightly lower than the other. An increase in the size of the scrotum on one or both sides, as well as an atypical structure and color of its skin can be a sign of infertility.

Empty or semi-empty scrotum

There are cases of non-descent of one or both testicles into the scrotum - monorchism or cryptorchidism, respectively. This indicates a loss of fertility, since normal spermatogenesis is not possible in the peritoneum or inguinal canal. The problem is diagnosed in infancy, at the same time measures are taken for conservative treatment. Without proper therapy, the testicle atrophies, and may even be reborn.

Scrotal asymmetry

An inguinal hernia can cause scrotal asymmetry. When it increases in size, sinking deep into the inguinal canal, then one part of the scrotum becomes more pronounced than the other. A man with a hernia may not bother in everyday life, only periodically reminding of himself with pulling pains. Sexual dysfunction is not observed, the shape of the penis and its functions do not change. Accordingly, the man does not see the reasons to suspect that he is infertile.

The danger to fertility in this disease is that the vessels supplying the testicular tissue are compressed, and this is fraught with impaired spermatogenesis. There is a secretory form of infertility, which can manifest itself during spermogram, where it is too much or is found to be of low quality.

An inguinal hernia can cause scrotal asymmetry

Asymmetry of the scrotum in the form of a clear sagging on one side can cause varicocele, which is a pathological expansion of the venous plexus feeding the testicle. In the early stages, the disease remains unnoticed, but later the bulging veins become clearly visible, part of the scrotum has a grooved surface and sags, there is a constant feeling of heaviness in this area. With physical exertion, movement or intercourse, pulling pains are felt. In 35% of cases, the disease leads to secretory infertility, that is, disrupts the process of sperm formation. Microcirculation of blood does not provide the testicular tissues with nutrition and the required temperature regime, as a result, spermatozoa develop with defects.

One testicle becomes larger than the other with hydrocele (or dropsy) - the accumulation of fluid between the layers of the testis membrane. Male infertility against the background of a hydrocele appears for the same reasons as with a hernia: compression of testicular tissue, overlap of normal blood circulation and lymphatic flow, violation of the temperature regime. Complete atrophy of the affected testicle is also possible.

Externally, a man's hydrocele can be identified by the enlarged scrotum on one side. At the same time, the skin is smooth, but not taut. When probing, the movement of fluid is felt, the testicle itself is not palpable. If the congenital dropsy of the communicating type, then in the supine position, the fluid can migrate back to the peritoneum.

Even if the hydrocele has turned into a chronic form - it does not bother too much, does not manifest itself in pain, then it is not worth excluding the possibility of the gradual development of secretory infertility.

Redness and swelling of the scrotum on one or both sides

The scrotum turns red and swells due to inflammatory processes in the testicles (orchitis) or their appendages (epididymitis). Orchitis usually occurs against the background of mumps (mumps), pneumonia, influenza and paratyphoid fever, but infections such as chlamydia, gonorrhea, and mycoplasma can also provoke it.

In acute orchitis, the inflamed testicle increases in size, the scrotum turns red, becomes tense, elastic. There are severe pains that radiate to the sacrum and lower abdomen. A similar condition can last for 2 weeks, then spontaneously subsides, often turning into a chronic form. Without treatment, there is a great chance of developing infertility, and irreversible.

Low semen volume is diagnosed as hypospermia

In the chronic form, the testicle is slightly enlarged, compacted, minor pains occur periodically, mainly during physical exertion. Many men ignore these symptoms, and at this time there is a violation of the secretory function of the testicular tissue.

Decreased or no ejaculate volume

If during sexual intercourse little or no sperm is regularly released, then this is a reason to think about the development of infertility in a man.

Low semen volume

Hypospermia (oligospermia) is diagnosed if the volume of ejaculate does not exceed 1.5 ml. This may be the norm for men over 60, but not for young people.

The reasons may be as follows:

• pathological narrowing of the vas deferens (obstructive infertility);
• inflammation of the testicles and their appendages;
• pathology of the seminal vesicles;
• inflammation of the prostate;
• lack of testosterone;
• physical exhaustion;
• alcoholism.

Violation of spermatogenesis or pathology of the ducts excreting sperm leads to the release of a small amount of ejaculate, which is fraught with infertility.

Lack of sperm

The reason that semen is not ejected during orgasm may be due to the following:

• sperm and seminal fluid are not produced;
• The vas deferens is blocked due to narrowing or closure by adhesions and scar tissue
• sperm is moving in the wrong direction - retrograde ejaculation.

Recurrent aching pains in the lower abdomen are characteristic of chronic vesiculitis.

In some cases, sperm is not completely thrown into the bladder, some of it enters the urethra - partial retrograde ejaculation. With this form, there is a chance of conception. Retrograde ejaculation is caused by improper contraction of a narrow part of the bladder (neck) due to congenital or acquired defects. In addition to infertility, this pathology does not cause other problems at the physiological level in men.

Signs of infertility without external manifestations

Symptoms of infertility in men often do not appear externally. One can only suspect a problem in such cases by inner feelings. A number of diseases of the reproductive system are accompanied by pain in the groin, anus and scrotum, as well as a feeling of heaviness, discomfort during ejaculation.

Pain and discomfort in the lower abdomen

Periodic aching pains in the lower abdomen, anus, perineum are characteristic of chronic vesiculitis. The disease is an inflammation of the seminal vesicles, which contain matured sperm. May develop against the background of prostatitis, epididymitis, urethritis. In some cases, long nocturnal erections appear, frequent urination, accelerated ejaculation occur, and the quality of orgasm deteriorates. Infertility in men with such symptoms develops due to the spread of a chronic inflammatory process to the epididymis (epididymitis).

Aching pains in the lower abdomen, often against the background of difficulty urinating, can be early signs of prostate inflammation. Sperm are affected by the products of inflammatory reactions. Noninfectious prostatitis of autoimmune etiology can lead to autoimmune infertility.

Discomfort when urinating

Periodically fading pain and discomfort during urination are characteristic of urethritis of various etiologies and can cause infertility. Pathogenic pathogens in the genitourinary system significantly reduce the chances of successful fertilization. Chlamydia and mycoplasma at a critical concentration reduce sperm motility, provoke production.

The above signs of infertility in men may indicate the development of more serious diseases. If ignored for a long time, significant damage will be caused to health, and it will be difficult or impossible to restore fertility at all.

Sometimes this is a result of couples simply using the “wrong” timing for intercourse. There are also other early signs of infertility, which indicate that the attempt to conceive offspring will be unsuccessful.

Types of female infertility:

• Primary infertility - refers to the category of women who have never given birth;
• Secondary infertility - refers, respectively, to the category of women who at least once in their life have borne a fetus;
• infertility - refers to women who have an absence of ovaries or uterus, that is, it is impossible to restore the ability to reproduce;
• infertility - refers to the category of women in which the causes of infertility can be eliminated, just need appropriate treatment.

Photo: Swelling of the mammary glands in men

1. the absence of pregnancy in a partner with a regular sex life without the use of contraception;
2. lack or absence of sperm;
3. the presence of diseases and sexually transmitted infections;
4. the presence of other diseases (diabetes mellitus);
5. frequent headaches;
6. swelling in the breast;
7. hormonal deficiency;
8. chromosomal abnormalities;
9. lack of sexual desire;
10. testicular atrophy.

Types of male infertility:

1. Secret infertility. More common than others. The testicles are malfunctioning, they produce an insufficient number of sperm to fertilize an egg.
2. infertility. Observed after injury. For treatment, it is necessary to select drug therapy.
3. Obstructive infertility. A case where there are obstacles to sperm excretion. For example, a tumor or cyst. For the treatment of this type of infertility, surgical intervention is necessary.
4. Relative infertility. It is worth talking about this type of male infertility when the man is absolutely healthy, but the partner still does not get pregnant. Stress is the most common cause of relative infertility. In this case, you should contact a psychotherapist.

Signs of male infertility do not always make themselves felt, unlike female symptoms. Males can have an active sex life, be absolutely healthy and feel impeccable, since the symptoms do not always make themselves felt. Usually a man finds out about his infertility after a huge amount of time.

First, the couple decides to have a baby, but the woman does not get pregnant. After she undergoes an examination and finds out that she is absolutely healthy, the man is also examined. As a result of examinations, the cause of infertility is revealed. Special therapy is prescribed. Treatment of male infertility can be called a rather lengthy, but not a hopeless process.

• Hormone therapy. Treatment is prescribed when there are any malfunctions in the body and the functioning of hormones is disrupted.
• ... The essence of this method is the artificial introduction of sperm into the uterine cavity.
• Fallopian tube transplantation. The formation of the embryo occurs by combining the sperm and the egg in the laboratory.
• fertilization. The egg is fertilized in the laboratory. After the embryo has formed, it is inserted into the uterine cavity.

Over the past decades, there has been a significant breakthrough in medicine. Today, even those couples who were hopeless yesterday can conceive and give birth to a healthy child.

Infertility treatment with folk remedies

From childhood, a man and a woman need to visit doctors. This will help to identify violations in a timely manner and provide treatment. Lead a healthy and active lifestyle, have a regular sex life with a regular partner and a correct diet. Men should avoid tight underwear.
In ancient times, healers treated infertility with their proven methods.

• Quince juice. It should be drunk one tablespoon every evening from a young month to two-thirds of it.
• St. John's wort set fire to and soaked in smoke clothes and premises.
• Decoction of seeds helped with female infertility, profuse bleeding, bad mood and depression. To cure a man from infertility, the broth had to be drunk from autumn to spring.
• had a beneficial effect and promoted conception.
• Roses: white and pink - stimulated the work of the ovaries. Rose petals were collected and prepared from them water, syrup, oil.
• Chrysanthemums. The smell and petals added to the food helped with hormonal deficiencies.
• Sage. The infusion of seeds helped with both male and female infertility.

According to statistical information, the percentage of infertile couples varies from 10 to 25%, and the “culprit” in the absence of children is often a man. There are no external signs and symptoms of infertility in men. Infertility is said to be when the partner does not become pregnant within 12 months of regular sex without using condoms. Infertility is a violation of reproductive function, has many causes and provoking factors. Consider the main causes and types of pathology.

The causes of male infertility

Such is the reality that against the background of the absence of children in marriage, it is the woman who goes first to the doctor. Often, a comprehensive examination reveals that she is completely healthy, and the reproductive system is ready for conception. In this case, suspicions about the partner arise.

It is worth knowing: impaired male fertility is of a congenital and acquired nature. Congenital infertility develops due to various diseases associated with impaired testicular function (hypogonadism, cryptorchidism, etc.). Often, the cause is abnormal development of the urethra.

All provoking factors leading to the inability to conceive a baby, that is, to impaired reproductive function, in medical practice are divided into the main ones - they are most often found and additional ones - they act independently or in conjunction with the main etiology.

Diseases leading to infertility in men

The causes of acquired infertility in men are varied. In most clinical pictures, they are due to a past illness. Inflammatory processes of a chronic nature negatively affect spermatogenesis, provoke the formation of abnormal spermatozoa, which are incapable of penetrating the egg. In this case, signs of infertility in a man are associated with the course of a particular disease.

Pathologies leading to impaired fertility:

• Mumps (mumps)- an infectious disease, the development of which is provoked by a virus that infects the salivary glands. The pathogen is transmitted by airborne droplets, the course of the disease is intoxicating. The pathogen can penetrate into other glands in the body, leading to inflammatory processes;
• Sexually transmitted diseases- syphilis, gonorrhea, ureaplasmosis, trichomoniasis, chlamydia and other diseases transmitted during intimacy. Pathogens disrupt the normal structure of testicular tissue, upset the process of sperm formation;
• Hormonal imbalance in the body, caused by a tumor neoplasm or inflammation in the pituitary gland, secondary hypogonadism, and other diseases, lead to a decrease in the production of its own testosterone;
• Cryptorchidism is a pathological condition during which a man's testicles did not descend into the scrotum. They remain either in the abdominal cavity or in the inguinal canal;
• Dropsy of the testicle - a significant amount of exudate accumulates in the scrotum, which creates a certain load on the testicle, which disrupts blood circulation, a decrease or complete cessation of sperm production is observed.

Other causes of infertility in men are varicocele (varicose veins of the spermatic cord), intoxication with toxic substances, severe trauma to the perineal organs, hereditary predisposition, diabetes mellitus. And also, abnormal development of the reproductive system, oncological processes, obesity stage 3-4, diseases of the pancreas, adrenal glands, thyroid pathology, etc.

Factors contributing to the development of pathology

Along with diseases leading to impaired fertility in men, there is a considerable list of provoking factors that are the trigger for the failure. Their presence significantly aggravates the impact of the underlying cause.

Important: taking medications, in particular, antibiotics, hormonal drugs - androgens, cortisone, estrogens and pain medications based on narcotic substances, can lead to male infertility.

Factors contributing to the development of impaired fertility:

1. Work in hazardous industries, during which a man comes into contact with chemical and toxic substances, ionizing radiation, vibration, electromagnetic waves, etc.
2. Physical inactivity (low physical activity). Often combined with overweight.
3. Bad habits, in particular, the consumption of drugs, alcoholic beverages, smoking.
4. Constant wearing of tight underwear.
5. Exposure to extremely high or low temperatures.
6. Chronic stress, neurosis, depression.

Of course, at first glance, provoking factors are not "terrible", but their presence adversely affects the qualitative and quantitative characteristics of the semen.

Types of male infertility and their features

The etiology of impaired fertility in the stronger sex is so diverse that certain difficulties are created in its classification. For convenience, practicing medical specialists distinguish several forms of reproductive system dysfunction.

The types of infertility in men are represented by the following types:

• Secretory form. Against the background of this pathological condition, the inability of the testicles to produce motile sperm in the required amount is visible, or they have limited activity (flaccid) or are produced with defects, for example, a bifurcated head. Infertility of this type can be congenital or acquired;
• Excretory form. With this type of infertility, sperm mature normally, but their movement along the vas deferens is impaired - sperm cannot enter the urethral canal. Incorrect transport in most cases develops due to some kind of mechanical obstacle;
• Mixed form. This type of disease is diagnosed in cases where immunological infertility is combined with hormonal, or excretory with inflammatory processes, etc.;
• Immunological form. The most common cause is trauma to the testicles. The immune system plays a significant role in the disorder. The fact is that it perceives the testicular tissue as a foreign agent, after which it begins to attack them through the formation of antibodies;
• Relative form it is diagnosed in cases where a comprehensive and complete diagnosis has confirmed the health of a man and a woman, but the couple does not conceive. This type of fertility disorder is poorly understood, the reasons have not been established.

For your information, in 19% of cases of male infertility, endocrine factors are the culprit, in 16% - varicocele, in 10% infertility is due to chronic pathologies of the reproductive system, in 9% - sexually transmitted infections. The idiopathic form of male infertility (the reasons could not be established) is observed in 30% of paintings.

The symptoms of infertility in men are based on the factors that led to the onset of the pathological condition. The main manifestation is the absence of pregnancy. Therefore, the examination should be carried out not only by the partner, but also by the man himself.

Prevention of male infertility

The pathogenesis of impaired fertility in men has hundreds of reasons - and these are only those that are known to modern medical practice. There is no specific prophylaxis to prevent diseases of the reproductive system. The basis is a healthy lifestyle and taking care of your body.

Preventive measures include the following points:

1. Eliminate all bad habits, especially smoking herbs with narcotic properties. They not only lead to various diseases, but also upset full spermatogenesis.
2. Rational and balanced nutrition. Proper nutrition means avoiding spicy, pickled, spicy foods. It is necessary to limit the consumption of table salt, granulated sugar. The menu includes many seasonal vegetables, fruits, herbs - dill, parsley, basil.
3. Optimal physical activity, normalization of body weight. Lack of sports and a sedentary lifestyle are two factors leading to impaired blood circulation, congestion in the pelvic organs. In turn, this adversely affects the potency, the quality of the seminal fluid. Stagnation in the pelvis leads to hemorrhoidal disease, prostatitis, dropsy of the testicle, varicocele, varicose veins of the lower extremities. Men are encouraged to exercise in the morning or run. Against the background of excess weight, the concentration of estrogens in the blood, which are produced by lipid tissue, increases. To normalize hormonal balance, you need to lose weight.
4. Wearing quality underwear. We must give up swimming trunks, panties made of synthetic materials, tight jeans. This measure helps to normalize blood circulation in the body.
5. Avoid high temperatures. Refuse to visit steam rooms, baths and saunas.

Undoubtedly, adherence to all preventive measures is not a guarantee that a man will not face a reproductive disorder. However, practice shows that a healthy lifestyle is the normal functioning of all organs and systems.

Which doctor should I go to?

Urologists and andrologists specialize in infertility in the stronger sex. Since the disease develops due to the influence of many factors, the treatment is always combined. For the correct appointment of therapy, it is required to undergo a comprehensive and as deep diagnosis as possible.

Diagnostic measures include a large list of tests, medical procedures and procedures. This is due to the fact that it is very difficult to find the cause, and in some cases, it is not possible at all. Therefore, consultation of a neuropathologist, surgeon, therapist, endocrinologist and other doctors of narrow specialization is required. If genetic abnormalities are found, a visit to a geneticist is required.

In case of problems with conceiving a child, first of all, you need to visit a urologist / andrologist. Doctors treat infertility, recommend diagnostics, and give referrals to other medical specialists. If these doctors are absent in the clinic, then they visit a therapist - he will give a referral to another center where there is a urologist or andrologist.

Male infertility is not only a medical problem, but also a social problem. The prognosis is determined by the causes and etiological factors, the duration of the disease, the success of drug and surgical treatment, etc. According to statistics, approximately 40% of infertile couples become parents within several years after therapy.

Infertility in men is quite common. As a rule, the pathology does not make itself felt, until the moment of planning pregnancy. The main analysis for assessing the state of fertility is spermogram. Usually, with its normal values, there is no need for further research on the man. The likelihood of curing infertility depends on many factors and the type of pathology. The urologist and andrologist are involved in the therapy of this pathology.

Infertility reasons

According to statistics, about 40% of couples in the world have problems with conceiving, and most often the reason lies in limited fertility or male infertility. The latter is the result of many factors, for example: lifestyle, unhealthy diet, alcohol abuse.

Reasons for limited fertility:

• Severe stress, smoking, obesity, alcohol, certain medications, and poor diet can affect sperm count and quality. Therefore, a diet is recommended for men. Foods rich in selenium and zinc (meat, fish, eggs, oysters) are essential for the maturation of reproductive cells.
• Complications of sexually transmitted diseases can also lead to irreversible infertility. They provoke the development of inflammation in the male reproductive system. Some microorganisms can directly infect the genitals, causing disturbances in spermatogenesis (chlamydia).
• The childhood disease "mumps" is dangerous. When the disease occurs after puberty, the chance of infertility is over 25%. Mumps (the medical name for pathology) affects all the glands of the human body, from the salivary to the testes. Worsening the consequences of improper treatment of the disease, lack of vaccination.
• Autoimmune disorders. The immune system recognizes sperm cells as antibodies and tries to destroy them.
• Varicocele is an enlargement of the veins of the spermatic cord, which systematically degrades the quality of sperm and decreases male fertility. The ejaculate is produced weaker and becomes less mobile. The disease occurs in 20% of patients. And about 30% of infertile men suffer from this condition.
• Hypogonadism is a disease caused by a deficiency of sex hormones. As a result of their low concentration, testosterone decreases and sperm production decreases. Hypogonadism is usually diagnosed very early in childhood. The disorder can also be caused by a tumor in the pituitary gland or brain.
• Retrograde ejaculation. This problem is caused by the malfunctioning of the bladder sphincter. In healthy men, during ejaculation, it shrinks and sperm flows out of it. When the sphincter is not functioning properly, semen is released into the bladder. Retrograde ejaculation can be a complication of diabetes or after prostate surgery. This disease is temporary, sometimes it appears as a result of taking certain medications.

Infertility reasons

Depending on the reasons, the following forms of infertility are distinguished:

• Secretory. It is a violation of the production and maturation of sperm. It is temporary and permanent. Most often corrected by lifestyle changes, medication or surgery. May be permanent with congenital anomalies.
• Excretory. There is a difficulty in the passage of sperm through the vas deferens. The main reason is STD adhesions.
• Autoimmune. Production of antibodies to sperm.
• Combined. Disorders of sperm maturation and obstruction of ejaculation.
• Relative. It is considered as such if no diseases were detected during the period of attempts to conceive a child.

Fertility determination

It is possible to determine infertility at home by indirect signs. It is necessary to pay attention to the condition of the sperm. Often, with impaired fertility, it can have various inclusions, lumps or stretching white threads.

The complete absence of ejaculate also indicates a problem. This happens with chronic diseases of the genital organs, which lead to inflammation of the prostate or testicles. Another factor that can cause these symptoms is an anatomical disorder in the urethra and bladder sphincter. In this case, it is necessary to consult an andrologist for advice and treatment.

Pain after hard work in the lower abdomen may indicate varicocele, provided it is persistent. In the early stages, the disease has little or no symptoms.

False urge to urinate at night may indicate impaired fertility. They are a symptom of prostatitis. With inflammation of the prostate gland, the ureter is blocked. The prostate is responsible for the production of a substance that contains and transports sperm from the urethra.

Risk factors for infertility are diseases and pathologies such as:

• diabetes;
• endocrine disorders;
• decreased activity:
• growth of the abdomen and chest.

The main symptom is the non-occurrence of pregnancy during the year with regular unprotected sex and a normal menstrual cycle in a woman. In addition to these signs, it is impossible to accurately determine the presence of infertility at home, for this you need to consult a doctor and undergo laboratory tests.

Diagnostics

The main step in assessing male fertility is semen analysis. When preparing for it, the patient needs to refrain from intercourse for 5 days. This analysis examines sperm parameters such as liquefaction time, volume, viscosity, pH, percentage of live and motile sperm, their number in 1 ml and the total number after ejaculation. Morphology research is underway.

All these factors determine the suitability of the sperm and their ability to fertilize the egg. Ejaculate indicators are classified as follows:

When all parameters are normal, but there are still problems with conception, other studies are carried out:

• Sperm biochemistry. Not only the characteristics of the sperm, but also the composition of the semen have an influence on the quality of the ejaculate. It is necessary that useful substances are present in the right amount: citric acid, zinc, fructose and acrosin - a special sperm enzyme. Biochemical research allows you to determine their number. It is recommended to carry out the analysis several times with breaks.
• Electron microscopy. It is carried out for a more accurate study of the structure of the male reproductive cell. The test allows you to find out about the presence of genetic abnormalities. It is prescribed for suspicion of impaired sperm motility, morphology, with repeated termination of pregnancy at an early stage.
• Fragmentation of sperm DNA. The integrity of the genetic material is assessed. The presence of hereditary diseases that can be transmitted to the unborn child is determined. A study is prescribed for deviations in spermogram indices, early termination of pregnancy more than once, expansion of the spermatic cord and inflammation of the male genitourinary system.
• MAR test. The analysis helps to identify antibodies against sperm in the ejaculate. Under normal conditions, they should be absent, but with some deviations they begin to be produced. This leads to sticking of sperm among themselves and a significant decrease in the quality of the ejaculate. It is prescribed in case of infertility of unknown origin.
• Determination of the acrosomal reaction and acrosin. The acrosomal reaction occurs at the moment the sperm reaches the egg and consists in the release of a special substance - acrosine, which helps to destroy the outer layer of the egg. The probability of conception directly depends on this reaction.
• Male fertility chart. Comprehensive analysis that gives an idea of ​​the possibility of producing healthy offspring. Previously collected data is taken into account. An extended spermogram is performed, additional studies are performed to more accurately assess the state of the male body.

And only if these parameters do not deviate from the norm, it is recommended to additionally diagnose and treat the woman.