Male infertility reasons

Types of male infertility

Depending on the anatomical and functional disorders, the following types of male infertility can be distinguished:

• secretory infertility

  occurring due to disorder of spermatogenesis processes. The reasons may be short-term overheating of the testicles or the effect of toxic factors. With the elimination of the above factors, the spermogram parameters improve. Also, the reasons may be abnormalities in the development of the epididymis or autoimmune diseases;

• excretory infertility

  is characterized by impaired permeability of sperm through the vas deferens. The causes can be trauma, infection, or various neoplasms that can lead to the formation of adhesions;

• autoimmune infertility

  occurring when antisperm antibodies appear in a man's body as a result of the histo-hematological barrier disorder between the testicle and the blood. As a result, antibodies may appear, which lead to a decrease in sperm motility and subsequently to their death. Unfortunately, at a high concentration of antisperm antibodies (more than 50%), there is no effective treatment. In this case, IVF is recommended;

• combined infertility

  when there are factors of impaired spermatogenesis and the impossibility of ejaculation;

• idiopathic infertility

  when the obvious cause of man’s reproductive dysfunction has not been identified.

Examinations of a man is aimed at determining the cause of infertility (the recommended period is not more than 6 months):

• consultation of the urologist;
• scrotum ultrasound scan;
• determination of the hormone level (FSH, LH, Testosterone, TSH, Prolactin);
• biochemical blood test: (minimum lipid spectrum, glucose);
• sexually transmitted diseases;
• genetic tests: (karyotype, deletion of the Y-chromosome, mutations of the CFTR gene (cystic fibrosis) – for azoospermia indications, oligospermia; congenital developmental abnormalities;
• specialized tests: DNA fragmentation, MAR test, etc.

Spermogram

To diagnose the male factor of infertility, a spermogram is required. To obtain a high-quality result, you must adhere to the following rules:

• consultation of the urologist;
• scrotum ultrasound scan;
• determination of the hormone level (FSH, LH, Testosterone, TSH, Prolactin);
• biochemical blood test: (minimum lipid spectrum, glucose);
• sexually transmitted diseases;
• genetic tests: (karyotype, deletion of the Y-chromosome, mutations of the CFTR gene (cystic fibrosis) – for azoospermia indications, oligospermia; congenital developmental abnormalities;
• specialized tests: DNA fragmentation, MAR test, etc.

Explanation of spermogram results

1. normozoospermia – all parameters of the spermogram are normal;
2. oligospermia – a decrease in the volume of ejaculate;
3. azoospermia – the absence of spermatozoids in the ejaculate;
4. oligozoospermia – a decrease in sperm concentration;
5. asthenozoospermia – decreased sperm motility;
6. teratozoospermia – a decrease in the number of morphologically normal spermatozoids;
7. leukospermia – an increase in the number of leukocytes;
8. oligoasthenoteratozoospermia – decreased concentration, motility, and number of morphologically normal spermatozoids.

Treatment of male infertility

Depending on the type and cause of the male factor of infertility, the urologist prescribes treatment to improve the parameters of semen. Sometimes it is enough just to change a lifestyle and give up bad habits, but sometimes it is possible to get spermatozoids for IVF only with the help of a testicular biopsy (TESA).

The main methods of male infertility treatment are:

• medical treatment: the prescription of hormone therapy and vitamins allows to improve some semen parameters (for example, concentration and motility);
• lifestyle change: exercises, balanced diet, giving up bad habits (alcohol, smoking, marijuana, etc.);
• surgical treatment: the goal is to improve sperm quality, restore the permeability of the vas deferens, or obtain active spermatozoids for the subsequent IVF process.
• TESA – percutaneous testicular biopsy with obtaining material for artificial insemination.
• TESE – microscopic testicular biopsy.

Preventive measures of male infertility

• it is necessary to adhere to a healthy lifestyle (regular exercises, proper and balanced diet, restriction of fast food and sugary carbonated drinks).
• giving up bad habits (smoking, alcohol, taking drugs).
• avoidance of contact with hazardous chemicals in the workplace.
• if radiation or chemotherapy is required, it is necessary to create a bank of semen before it starts.