Symptoms, causes and treatment of male infertility

Content

Not so long ago, women were blamed for familial infertility. Today, existing statistics suggest that in about half of the cases, the inability to have children in a pair is due to male infertility. And no matter how opposed the representatives of a strong half of humanity, the fact remains.

What it is?

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

Men do not like to admit that the reason for the wife’s infertility may not lie in her. For such “stubborn people”, the Ministry of Health has the statistics: only 40% of cases, the cause of the absence of children in a marriage is female infertility. In 45% of the reason lies in the male factor, and the remaining 15% include cases of genetic incompatibility of partners and rare forms of infertility.

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

They talk about infertility when a couple cannot conceive a child with regular unprotected sex throughout the year. For couples in which the age of spouses is over 35 years, the period of six months is considered the “critical” period. If during this time all attempts were unsuccessful, conception is questionable and a survey is scheduled.

It is necessary to pass it both to the woman, and the man. Only then can you establish the cause and find a way to eliminate it.

Norm

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

Young sperm originate in the testicles. This process begins at puberty in boys and continues throughout the life of the stronger sex. From the testicles, the young sperm cells enter the seminal ducts, the tubule, and at the time of ejaculation, the mature cells mix with the seminal fluid, with the secretion of the prostate gland, and enter the female genital tract.

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

In a healthy male ejaculate, both live and dead spermatozoa, and motile and sedentary cells are always present. It is important that the ratio of healthy and strong sperm is sufficient for fertilization, because only the most hardy specimens will reach the egg cell.

It is not enough to develop cells - they still need to mature, passing through the canaliculi, as well as gain access to the secretory products of the male body. Male infertility is usually divided into three large types:

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

There are also more rare forms of infertility, usually genetic, in which healthy and viable germ cells are not produced at all or are produced, but critically low. But such cases in the practice of a fertility doctor are rare.

Causes of infertility

Secretory infertility

The reasons why men become incapable of fertilization are many and many-sided. In all cases, except for congenital genetic infertility, they, one way or another, are associated with harmful effects on the processes of spermatogenesis or mechanical release of ejaculate.

The secretory form of male infertility is most often associated with impaired sperm production. The testicles do not produce enough healthy cells. In addition, all the morphological changes in the male sex cells, as well as violations of their mobility and viability, are usually attributed to the secretory form. If the sperm cell is not fast enough, and it has malformations and anomalies (two heads, two tails, no tail, and other variations of a distorted shape), then independent conception is unlikely.

Varicocele is the most common cause of secretory infertility. With varicose veins, the outflow of blood from the scrotum becomes difficult - there are "stagnation", which gradually leads to inhibition of testicular function. Unilateral varicocele often becomes a bilateral form.

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

The tissue that produces the young sperm is very susceptible to the influence of fluid pressure. Therefore, infertility often develops on the background of dropsy of the testicle, as well as the existing inguinal hernia. The cause of infertility may be cryptorchidism or undescended testicles in the scrotum.. The risk of negative consequences is high if the boy did not receive adequate treatment before the age of seven.

Mumps (infectious parotitis), transferred as a boy to childhood, also represents a great danger to its reproductive function in the future. Mumps virus affects the glandular tissue, salivary and sex glands are affected.

The epithelium, which is capable of producing new sex cells, is very sensitive to radioactive radiation. Therefore, infertility and reduced reproductive functions are often diagnosed in men who live in unfavorable, in terms of radioactive background, localities, and also work in hazardous industries where there is contact with radioactive substances.

Recently, doctors and scientists are increasingly talking about the impact on the spermatogenic epithelium and electromagnetic radiation, so wearing a cell phone on a belt is not only unfashionable, but also dangerous if a man plans to become a dad.

A special place in the causes of secretory infertility is given to the effects of hot temperatures. The testicles are brought by nature outside the human body - they are always colder, their temperature is below body temperature. With prolonged and frequent exposure to high temperature, all stages of spermatogenesis are violated. Therefore, with complaints about the inability to conceive a child to the doctor, men more and more often come to work in hot shops, as well as lovers to take a steam bath, sit with friends in a sauna.Even lovers of a risk to soak in the hot tub.

If after water procedures you do not take a cool shower, normalizing the temperature in the scrotum, the man risks becoming infertile.

Dangerous and heated car seats. Of course, it is very convenient, pleasant and comfortable to sit on a warm seat in winter, but we must not forget that the scrotum is also heated, and spermatogenesis is disturbed. Tight underwear, swimming trunks, thongs, as well as tight jeans, tightening the hips and scrotum, lead to disruption of the blood supply to the testicles and pathological changes in the spermatogenic epithelium.

Secretory infertility can develop on the background of syphilis, tuberculosis, gonorrhea. Often, sexual functions are suppressed under the action of anticancer drugs, antibiotics and hormonal drugs. Therefore, after a course of chemotherapy in the treatment of oncology, the reproductive abilities of men are insignificant, or sterility is diagnosed. Professional athletes who use steroid hormones to create beautiful reliefs of the body, also often face the problem of infertility.

Temporary infertility can also develop in men who, for a long time and over a long period of time, experience severe stress and anxiety. Secretory forms of infertility are found in men who abuse alcohol and nicotine. Even a couple of bottles of beer after work is a serious claim for spermatogenesis abnormalities. Vegetarianism often leads to infertility - the lack of animal protein in the body provokes a violation of the process of production of motile and active sperm.

Improper diet, especially the fascination with fast food, can suppress the production of male sex hormones, which will gradually lead not only to obesity, but also to a decrease in fertility. In addition, a large number of concentrates and stabilizers of taste, as well as preservatives, causes mutations of sperm, making them unsuitable for conception.

Obstructive infertility

The causes of this form of pathology are rooted in a mechanical obstacle in the path of sperm. Most often the root cause lies in the blockage of the ducts. This is mainly due to inflammatory processes, which include epididymitis, as well as orchitis and cysts. Chronic prostatitis can also lead to obstruction.

Sometimes the cause of the blockage of the region of the vas deferens lies in syphilis or tuberculosis, but this is relatively rare. Much more often, injury to the duct site becomes possible after injury to the scrotum in a fight or gym.

Other reasons

Infertility in a man can be primary (from birth) and secondary (acquired), so about 10% of couples cannot conceive a child, although each spouse has children from previous marriages. An old injury or inflammation can lead not only to the blockages described above, but also to inadequate reactions of male immunity. In the body of the representative of the stronger sex, antisperm antibodies begin to be produced, which destroy spermatozoa.

Such immune and autoimmune forms of infertility are difficult to treat, it is not always possible to cope with them. But for such men, the chance to become fathers still exists - they come to the aid of reproductive assistive technologies, such as IVF and ICSI.

Symptoms

No specific symptoms of male infertility have, if it is not associated with inflammation. A man can for a long time not realize that he has any problems with reproductive function, and only a visit to the doctor after a year of planning a pregnancy helps to identify the problem.

In some cases, symptoms may occur. A man may note that the sperm has changed color and contains impurities of pus or blood, and also has an unpleasant smell. A small amount of ejaculate should also alert, as well as increased viscosity, the presence of large mucous clots in the ejaculate.

If the reproductive impairment is associated with an inflammatory process, the man will complain of pain, fever, pain during urination. When blocking may not occur ejaculation per se, although the man will experience orgasmic sensations.

In the event that infertility occurs as a result of chronic, neglected inflammation or infection, there will be practically no symptoms and signs of pathology.

Diagnostics

It is diagnosis that most often scares men who are faced with the problem of infertility in the family. But there is nothing to fear - most forms of pathology can be successfully treated, however, provided that the diagnosis was complete and timely. While the woman is being examined and tested by her gynecologist, it is advisable for a man to visit an andrologist urologist. The doctor will find out all the features of a man’s life: the frequency of sexual contacts, the place of work, the presence of past injuries, inflammatory or infectious diseases, after which he will prescribe general blood and urine tests, a smear from the urethra on the microflora and spermogram. It is the spermogram that is considered the most complete and detailed examination of the male fertility.

It is recommended to take a sample of ejaculate after 4-5 days of abstinence and sexual rest. Longer abstinence adversely affects the characteristics of sperm - it becomes more viscous. Failure to comply with sexual rest can make the ejaculate more fluid.

You can donate spermogram in the clinic through masturbation, or at home, by collecting sperm through masturbation or interrupted sexual intercourse. In the second variant, it is important to deliver the container for biomaterials to the clinic as soon as possible, because in an hour the ejaculate will begin to lose its properties, and the conclusion may be wrong.

The amount of ejaculate in the norm is about 3-4 ml, which is conditionally equal to the volume of one teaspoon. If the amount is less, it will be a dysfunction of the testicles. If there are less than 20 million spermatozoa in 1 ml of sperm, a man will be diagnosed with oligozoospermia. If no sperm is found in the sample at all, which happens when both seed canals are blocked at once, the doctors will diagnose azoospermia.

When at least half of the detected sperm are mobile and can not just move, but move straight and with sufficient speed, this is considered normal. If the number of such mobile and straight-moving sperm cells turns out to be low, then asthenozoospermia will be diagnosed. In the case when motile sperm are not found at all, a diagnosis of “necrospermia” will be established.

Normally, about half of the sperm must be morphologically healthy. During the MAP test, the patient's cells are compared to the existing standard within the frame of the semen - all defective cells are rejected. If the head, tail or neck of the sperm cell does not meet strict reference requirements in appearance, the cell is also rejected. For conception it is necessary that in the seminal fluid of a man was not less than 40% of healthy and full cells.

If the lumps are detected visually in the ejaculate, the sperm is not homogeneous, then it is possible that the spermogram will show the presence of agglutination. It reduces the motility of the germ cells, making conception difficult or impossible. If the spermogram shows an increase in the number of leukocytes, the doctor may suspect the inflammatory process and refer the man for an additional examination - an ultrasound scan, as well as be tested for sexually transmitted infections and genital infections. Similarly, the doctor will do when detecting pus in the semen (pyospermia).

These spermograms are considered non-permanent, and even the time of day may affect certain characteristics of the study. Therefore, a man should prepare for the fact that, perhaps, the analysis will have to pass again to check the fertility in the dynamics.

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

Treatment

Cure male infertility is quite possible. The exceptions are cases of genetic, congenital infertility. For example, the absence of glandular tissue producing sperm, or malformations of the vas deferens that cannot be eliminated. In all other cases, doctors can offer an individual treatment regimen. Infertility in a man can be cured, according to statistics, in 85-90% of cases.

Treatment directly depends on the true cause of the pathology. If it lies in the varicocele or inguinal hernia, then the man needs to undergo a surgical operation, after which he can fully become a dad, because the cause of infertility will be eliminated. When inflammation is established, the exact localization and degree - with 1 and 2 degrees, treatment can take place at home, more advanced forms require hospitalization in the hospital. When blocking the seminal ducts is often appointed surgery, which completely removes the obstacle in the path of germ cells.

DAntibiotics, anti-inflammatory drugs are used to treat inflammatory processes. After completing the course of treatment, fertility is checked once again and a course of therapy supporting spermatogenesis is prescribed.

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

All men who are treated for infertility, recommended correction of lifestyle, and very often it already has a decisive effect, and pregnancy occurs. Correction involves reducing excessive physical exertion to moderate, avoiding nicotine and alcohol, proper nutrition, which should be rich in animal proteins and fats.

A man must put his weight in order: he must lose weight or gain the missing kilos in order to reach the physiological norm. It is useful to refuse to work at night, because during a night's sleep, the body produces the necessary hormones that are involved in the reproductive system. Work in hazardous production is a reason to find another income with the lack of contact with heavy metal salts, paints and varnishes, nitrates.

Those who like to take a steam bath or sit in a sauna are advised to reduce such activities to a minimum, and it is better to abandon them altogether. All factors of overheating and compression of the scrotum should be excluded. You need to wear loose panties such as "family" pants free cut. Sexual contacts are recommended regular: at least twice a week so that the sperm has time to be effectively updated.

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

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

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

Insemination by donor sperm

Modern reproductive technologies make it possible to fertilize a woman even with her husband’s dead spermatozoon, however, provided that the germ cell does not disrupt the structure of the head and there is no disturbance in the DNA information. In this case, fertilization is carried out in a microscopic way, having previously taken away the egg from the woman. If conception took place, the embryo is placed in the uterus and retained with hormonal therapy.

Hormone therapy

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

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

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

Most often, hormonal treatment is carried out on the stimulating method. It is based on the introduction of small doses of hormones, which, on the contrary, stimulate the process of sperm production, but at the same time they have no effect on the pituitary and hypothalamus. The course of treatment is long: from the beginning it takes from 9 months to one and a half years.. All this time, the man will have to hold spermogram every three months (this is how long one cycle of spermatogenesis lasts) to determine the effectiveness of the treatment provided.

In some cases, doctors do not go for hormone therapy. If they believe that such treatment does not have prospects, then they immediately recommend assisted reproductive technologies or other options.

Psychology

Not for nothing a man who is treated for infertility, sedative sedatives are recommended. The psychological consequences that may follow the news of the inability to conceive a baby can be devastating. Stress itself affects the aggravation of the situation. To this is added depression, loss of interest in sexual relations with his wife, loss of tenderness in a relationship with a partner.

However, pills and decoctions of herbs, acting as a sedative, are not all. A man needs to be helped to come to an understanding of the simple truth that is obvious to every woman: the biological father is not yet a father, but the one who raised and raised is a real father.

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

Very often, the man who accepted the situation, accepted it, stopped nervous and worried, suddenly becomes the biological dad for everyone.The fact is that stress hormones block the production of sex hormones, adversely affect the level of testosterone. When the stress factor disappears, the man becomes calmer, and after a while, the sperm performance improves.

The most common example is adoption. When there is no hope of treatment and other ways, everything has been tried, the couple makes a decision to adopt the baby. They calm down, focus on raising a child, often experience positive emotions and suddenly become pregnant.

Treatment of folk remedies

Alternative medicine has accumulated a great many recipes and methods that, according to healers, increase male fertility. It should be noted that all the recommendations are based on the observance of a healthy lifestyle, and in this the traditional healers fully agree with their colleagues in the field of official medicine. If a man continues to abuse alcohol, drugs, nicotine, lies on the couch and does not want to lose any of his 200 kg, then no popular and traditional means will not help.

Traditional medicine should be regarded as an auxiliary therapy in the treatment of infertility in men. She does not in any way cancel the traditional treatment, which is chosen individually, but can enhance the effect and help a man to become a dad.

Also, do not practice the treatment of folk remedies without the consent of your doctor, because the herbs are not as harmless as it may seem.

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

Since ancient times, healers revered St. John's wort for the fact that it enhances masculine power. The dried branches of this grass burn and fumigate with them the room in which the man is located, once a day. Inhalation of this smoke has a positive effect on sperm production. Men living in mountainous regions and in the south, have long used fresh quince juice, drinking it in a tablespoon in the evening before bedtime.

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

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

Instead of tea, a man can offer a decoction of adonis or rosehip. Traditional medicine appreciates for male health and Adam's root. It can be purchased at pharmacies. Two tablespoons of the root for a thermos boiling water insist at least a day, after which they offer the man two tablespoons three times a day.

For a long time, infertility in men was treated with leeches. Hirudotherapy can achieve a point effect. For example, the leech installed in the biologically active point improves blood circulation in the pelvic organs, which has a positive effect on any stage of spermatogenesis. Special substances that leeches excrete into the human body, reduce fibrinogen levels, make blood more fluid.A man will surely mark a general improvement in his state of health, strengthening of immunity, and after a while it is possible that he can become a dad.

Hirudotherapy sessions should be conducted by qualified specialists. Leech should be used only once. A clinic that provides such services must have all permits and certificates in order. When male infertility leeches put on the area around the anus, in the perineum, capture the tailbone and sacrum.

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

Homeopathic remedies that are advertised by manufacturers as very effective for infertility usually cost much, but, alas, do not possess proven effectiveness, as "Kagocel»With chickenpox. Therefore, special hopes for them are not worth it.

Reviews

Men themselves rarely leave reviews on the treatment of infertility in men, since this is a delicate topic, and men prefer to keep silent about it. But women very actively discuss various treatment regimens of their spouses, emphasizing that the success of therapy is 80% dependent on the woman. It is women who have to be controlled so that the husband during the long course of treatment does not forget to take the prescribed medication, and it is they who care about proper nutrition and maintaining a healthy lifestyle for the man.

Treatment of male infertility is a common, family affair. Much depends on the overall focus on the ultimate goal. In most cases, according to women, to cope with the problem still fails, and pregnancy occurs naturally.

The best reviews of women leave about the preparations "Spermaktiv", "SpermaPlant", "Speroton", "Spermastrong". Among the vitamins celebrate "Selentsink", as well as "Duovit" and "Alphabet" marked "For men."

Units use the help of a psychologist - women usually fail to lure her husband to such a specialist.

About the causes of male infertility, see the following video.

Information provided for reference purposes. Do not self-medicate. At the first symptoms of the disease, consult a doctor.

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