Today one of the urgent problems of the drug, the society is male infertility. This occurs with the same frequency that women lead to the personal tragedy, the men of the breakup of the family. The diagnosis of "infertility" there is a place in this case, if a couple wish to conceive, not using any type of contraceptive, but within 12 months of unsuccessful attempts. In this situation, the woman and the man should be examined with the aim of identifying the causes and correcting them.
Can cause infertility in men a number of pathological processes cause, prejudice the production of sex hormones, changes in the composition, properties, the sperm, the lack of ways of outflow.
- Violation of the nervous system. Spermatogenesis is regulated by complex physiological processes involving 4 structures: the cortex, the brain, the hypothalamus-pituitary and male gonads – the testes and other glands of internal secretion. The first stress-sensitive Central nervous system: severe trauma disrupts the hypothalamus, reducing the production of several hormones lead to a decrease in or complete absence of sperm in the ejaculate (oligo -or azoospermia, respectively). Psycho emotional stress, the balance of the autonomic nervous system. It can also lead to sterility in men, even when a satisfactory condition of the testes. Damage to the ilion-inguinal nerve (e.g., during the operation, the hernia and the postoperative period, because the scarring of the tissues of the genital tract) often causes degeneration and atrophy of the testes.
- Genetic, hereditary factors. The frequency of the congenital abnormalities of the testicles today, approximately 4-5 %, which means that there is a place where almost every twentieth man. The cryptorchidism (undescended testicle into the scrotum), monorchism (1 egg), Anorchia (congenital absence of the scrotum, both testicles), dysgenesis (impaired development) gonad, and other violations.
- The infection.
- Intoxication. Environmental, chemical, occupational hazards in the context of increasingly industrialization, because of infertility, the men more often. Intoxication acts directly on the testicular tissue or the nervous system in general, the consequences described in paragraph 1.
- Food additives, drugs, industrial compounds, pesticides – exposure to these factors a person is exposed to on a daily basis, and many mutagenic substances, damage to the fetal epithelium of the testicle. It's also very dangerous, in this regard, the exhaust gases of vehicles and lack of oxygen, especially on the background of stress, fatigue. The negative impact on the tissues of the testes produce sperm, some antibiotics and sulfonamides, nitro furans, and estrogens, as well as cytostatics. Chronic poisoning by nicotine, alcohol caused a significant change in the current in the form of reduced mobility and the emergence of pathological forms of spermatozoa.
- The supply deficit. Food factor is also very important for proper spermatogenesis. Pathological changes in the tissues of testes may lead not only to absolute fasting, but fasting, partial, and inadequate nutrition. Especially important for the balanced nutrition in children and adolescents. You should know that the degenerative changes not only in the tissues of the testes, but also in the hypothalamic-pituitary system.
- Ionizing radiation. Irradiation may be the direct causal factor of infertility (cell death in the embryonic epithelium), a mutagenic effect (leads to abnormalities in the process of sperm production in the offspring, burnt-out man).
- Pathology, endocrine-glands or other organs. One of the manifestations of certain diseases disorder of the testes. However, if the disease is not difficult, that these diseases are often not diagnosed because it is not expressed, and in the case of severe course of the underlying disease, the issue of fertility going to the second place and the main aim is that the patient is the elimination of the underlying disease under the supervision of a physician. After the recovery of spermatogenesis usually recovers.
- Overheating. The optimum temperature for the production of parts sperm – 2-3 °C lower than the temperature in the entire body. Overheating damages the testicular tissue leads to the degeneration. Even a brief rise in entire body temperature to febrile levels (39 °C and above) disturbs the process of formation of sperm, but it just keeps getting better after 2-3 months after recovery. It is important here as the total (infectious disease, work in hot shops), and local (hernia testicular, venous) hyperthermia.
- The hypothermia. Effect of the testis at low temperatures damage the cells to the sperm. However, in the case of infertility it is for this reason that it's pretty rare, because it is a violation of spermatogenesis requires that the testicle in the scrotum was exposed to a temperature of -10 °C during at least an hour.
- Disorders of the blood circulation. Spermatogenic epithelium is extremely sensitive to even short-term ischemia, thus, the disease violation of blood flow to the testicles (specifically, a hernia, or a hydrocele) may cause infertility. Furthermore, it contributes to the stagnation of blood in the genitals (for example, the venous (varicose veins on the testicle), anomalies of the structure of the venous plexus in the area of genitourinary organs other diseases).
- Traumatic injuries of the reproductive organs. Depending on the power of nature may cause injury, bleeding, inflammation, necrosis of the affected tissue, oblivion (blockage of the lumen), the famous tract, compression, and/or the blood vessels carrying blood to the testis, hematoma and other pathological changes. The result of reversible or irreversible pathological changes in the tissues of the testicles or a dominant tract.
- Autoimmune processes in the region of the skin. Spermatogenic epithelium work properly due to the presence between the blood and contents of the seminiferous tubules, the so-called haematoma-testis barrier, which is missing a few cells, and not let others. Result in overheating, hypothermia, infectious diseases, disorders of blood circulation, the permeability of the barrier increases, and the components of the semen into the bloodstream. Known antigens, so the body reacts by the formation of antibodies to the cells of the seminiferous tubules that sperm. The developing an autoimmune infertility.
5 forms of male infertility:
The assigned usually by reducing testicular function hypogonadism. There are 2 types of this condition: primary, and secondary.
The primary hypogonadism the pathological process is localized directly in the tissue of the testicle. It can also be congenital malformations or cryptorchidism, or the traumatic injury or infectious nature. This form of the disease accompanied by increased secretion of gonadotropins in the blood, the concentration increased.
Secondary hypogonadism occurs when the lesion is in the pituitary gland, the hypothalamus, endocrine organs. It develops in the tumors, neuroinfections, trauma, the brain, and drastically decreased the production of the gonadotropins, which failure, in the testes. With the defeat, the prostate, the study of blisters, as well as other endocrine glands are also developing testicular failure. The content of gonadotropins increase, decrease, or remain within, the normal value.
Result of the diseases and malformations of the accessory genital glands of the urethra, blockage of the lumen of the VAS deferens, and aspermatism. Ejaculate or you will lose the properties (due to the lack of sperm, or change the structure, properties), or a normal composition, but they didn't get into the female genital tract.
Aspermatism is called a condition characterized by a lack of ejaculation during intercourse. This occurs as a result of the violation of the functions of the nervous system (both Central and peripheral) can be considered a form of excretory infertility in men.
Can occur when immunologic incompatibility between a woman and a man, emerging in response to the receipt of the semen, which is the antigen, the woman's vagina. This is the so-called ISO-immune forms of infertility. The risk of such a conflict may be raised to the diseases, the immune system, the incompatibility of blood groups, as well as other factors.
Autoimmune form of infertility occurs when the violation of permeability of hema santo-testis barrier. The cause of this condition, as described above.
It combines the hormonal disorders, and selection component.
Such a diagnosis issued in the case, if after a full examination of the men and women pathological changes, none of them have been identified. The term applied with great caution, because it is not detected, a pathologist, does not mean that I don't – maybe this is due to the imperfection of the survey.
Signs of infertility in men
The leading symptom of infertility, men are not the pregnancy, the a regular basis (2 times per week) sexual intercourse for 12 months, provided that the contraceptives have not been used, the woman is completely controlled, and pathology is not revealed.
The volume of the diagnostic procedures include:
- General survey;
- the study of the sperm;
- diagnosis of excretory functions of the testes and other glands;
- the biopsy of the testes;
Basic principles for the treatment of infertility in men
Tactics of treatment depends on the reasons that led to the infertility.
Excretory infertility resulting from inflammatory processes in the genitals, the theme, the conservative therapy.
Occlusion (blockage of the lumen), the VAS deferens is usually removed surgically.
The effectiveness of treatment is determined by re-examination of the ejaculate, or other diagnostic methods.
- quit Smoking;
- to give up alcohol;
- not to certain drugs;
- to exclude the effect of harmful workplace factors, to change working conditions;
- to avoid emotional stress, fatigue;
- lead, active lifestyle;
- regularly, is fully covered.
It is also very important to respect the sexual life. Frequent sex reduces sperm able to fertilize, as the Mature sperm is reduced, and the young forms increase. The result is a rare sexual acts, the growing number of older sperm. The optimal duration of abstinence was 3-5 days. This should be taken into account in the days after the ovulation, the female partner, because in this period, conception occurs. After intercourse the woman should stay in a horizontal position for a 30-40 minutes.
Common medical event
The patient may be assigned:
- vitamin therapy;
- preparation of the phosphorus, glutamic acid;
- tincture Chinese Magnolia vine, Siberian ginseng;
- the top specialists – a neurologist, psychotherapist.
Treatment of secretory infertility
- Primary hypogonadism – androgen drugs.
- Secondary hypogonadism gonadotropins, swelling, or drugs that stimulate the secretion.
Treatment of excretory infertility
Depends on what the disease is caused by.
- When hypospadias and epispadias surgery. The total disagreement patient for surgery – artificial insemination (insemination).
- The chronic inflammatory diseases of the genital organs – medications, depending on the pathogen (antibiotics, sulfonamides, and others). Because these drugs also suppress spermatogenesis, apply them in parallel, the drugs, attention, the negative effect on the liver, and testes.
Direct reference to the obstructive azoospermia, when confirmed by the biopsy, the preservation of the spermatogenesis. The goal of surgery is to restore obvious to your excretory systems.
Treatment of immune infertility
The couples were encouraged to continue having sex with condoms, but only in the period of ovulation do not take precautions. The woman's body, reduced the number of antigens to the male, the sperm and the chance of fertilization increases. In parallel with this, the man or the woman (depending on the infringements) are prescribed to the antihistamines. Also, in order to ensure that the anti-allergic effect can be used glucocorticoids.
The chronic inflammatory process in the male body recommended intake of Immunostimulants.
The method of choice for the treatment of immune infertility, artificial insemination. The woman in the cervical canal or the cavity of this body is to inject sperm just received from her husband.
To prevent the development of infertility, the man should be attentive to the health, in time to treat diseases affecting the function of reproduction, or to prevent the development. It must also be noted that the system of work, rest, sexual activity, rational feeding, not promiscuity, not to uncontrolled drugs, to refuse, or at least limit the consumption of alcohol and Smoking.