Infertility refers to the inability of couples to achieve conception regular unprotected sexual intercourse for 1 year . It also includes the inability to carry a pregnancy to the delivery of a live baby.
Although some people still think of fertility as a woman's problem in 20 percent of infertility couples, the problem is solely with the male partner., Infertility in a man may be the only reason that a couple can't conceive, or it may simply add to the difficulties caused by infertility in his partner.
So it's crucial that men get tested fertility as well as women. it's also important that men do it early. Though some guys may want to put off being tested, possibly to avoid embarrassment early testing can spare their partners a great deal of unnecessary discomfort and expense. It's also a good way to quickly narrow down potential problems. Not being able to conceive a child can be stressful and frustrating, but a number of male infertility treatments are available.
Signs and symptoms.
Duration of infertility
Previous fertility in the patient and the partner.
Timing of Puberty( early, normal,or delayed)
Childhood urologic disorders or surgical procedures.
Sexual history.
Testicular cancer and treatment.
Social history( smoking and alcohol use )
Medications
Family history
Spinal cord injury
Pre testicular cause
Hypogonadism due to various causes e.g obesity
Drugs alcohol
Blockages, birth defects, or physical damage
Hormonal problems.
Tobacco smoking
DNA damage.
Testicular factors
Testicular factors refer to conditions where the testes produce semen of low quantity and or poor quality despite adequate hormonal support and include.
Varicocele that is present in 15 percent of normal men and about 40 percent of infertile men. It probably causes upto 35 percent of primary infertility and 69_ 81 percent of secondary infertility. Varicoceles are enlarged varicose veins that develop in the scrotum and prevent blood from following properly.
Age
Genetic defects on the Y chromosome ( y chromosome microdeletions )
Abnormal set of chromosome
Neoplasm eg Testicular cancer
Idiopathic failure like idiopathic oligospermia .
Cryptorchidism, hydrocele,mums malaria
Trauma
Acrosomal defects affecting egg penetrating.
Radiation therapy to a testis decreases it's functions.
Post Testicular causes
Decrease make fertility, due to conditions that affect the male genital system after Testicular sperm production and include defects of the genital tract as well as problems in ejaculations.
Vas deferens , often related to genetic markers for Cystits fibrosis.
Infections e.g prostatitis.
Impotence
Sexual problems
Erectile dysfunction( impotence) and premature ejaculation. It can be caused by psychological problems such as anxiety,. guilt or low self esteem. It is also caused by physical problems such as diabetes high blood pressure high cholesterol and heart disease.
Sexually transmitted diseases or other infections e.g. Chlamydia and gonorrhoea.
Risk factors to male infertility
Smoking drugs overweight
Over heating the testicles
Having experienced trauma to the testicles.
Having a prior vasectomy or major abdomeninal or pelvic surgery.
Diagnosis
Presence size of testicles
Enlargement or tenderness
Swelling
Spermatic cord
Penis for anatomic abnormalities
Rectum abnormalities of the prostate
Semen volume normal 1.5 _5 ml
Semen quality
Sperm density normal more than 20 million sperm / ml
Sperm motility normal more than 60 percent of sperm having normal movement.
Sperm morphology more than 60 percent of sperm should be normal and fewer than 2_3 percent should be immature.
Signs increased no of white blood cells in the semen
Semen deficiencies
Oligospermia complete lack of semen
Hypospermia reduced semen volume
Azoospermia absence of sperm cells in semen
Teratospermia increase in sperm with abnormal morphology
Asthenozoospermia reduced sperm motility
Other lab test may be helpful
Antisperm antibody test.
Hormonal analysis
Imaging studies
Transrectal ultrasonography
Scrotal ( detect signs of Testicular dysensis testicular cancer
Vasography
Doppler ultrasonography for varicoceles
Testicular biopsy
Blood sample common hormonal test
Treatment
Agnus
Arg met
Caladium
Conium
Damiana
Floric Acid
Graphite
Lycopodium
Nuphur luteum
Phosphorus
Phosphoric acid
Thuja
Tribulus terre.
Turnea
Selenium
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