Male Fertility: Disorders, Causes and Treatment

La male fertility It is a topic of great importance for reproductive health and family planning. This article will address the most common alterations and causes of male infertility, such as low sperm production, quality and mobility, and other factors that can affect male fertility, such as age, lifestyle and pre-existing medical conditions.

It is important to understand that the Male infertility is not a topic that should be treated with shame or stigma, and that there are treatment and support options for couples facing fertility issues. By learning more about the causes and available treatments, you can help address male infertility effectively and improve your chances of conceiving a healthy child.

What is fertility?

It is the capacity for reproduction or fertilization that we humans have, a function created for the purpose of survival and preservation of the species. It depends on the combination of multiple biochemical, hormonal, cellular factors, among many others, and not only physical, but involves all areas of the being, the best possible scenario being that of a couple with a psychobio-spiritual agreement and a life plan. It requires such high-pressure timing and perfection that it is thus considered the miracle of life.

What is infertility?

We define infertility as Situation presented by a couple who maintains constant sexual activity, without using contraceptive methods, and is unable to conceive a pregnancy in the first year, or in some definitions, the inability to give birth to a live baby, although rather than infertility the latter refers to recurrent pregnancy loss.

In turn, we divide it into Primary, when the couple has never had a child, or Secondary, when one of the two has had a child previously but they are unable to conceive again.

Infertility figures

Infertility is classified as a global health problem, according to the WHO, it is identified 48 million of couples with infertility, also reporting that 186 million people in the world suffer from this pathology.

The European Society of Urology mentions that approximately 15% of couples do not achieve pregnancy during the first year, so they seek medical treatment. 

For its part, a European study based on andrology and gynecology units in Belgium reports that infertility rates can be as high as 30%.1 each 8 couples have trouble conceiving their first child, and 1 each 6 when trying for the second time. Although in developing countries there are values ​​of 1 in 4.

Male Factor

According to the different series of cases reported in different clinical studies, it is found that the male factor as the sole responsible for infertility contributes to 20-30% of cases, although in the overall shared responsibility it contributes to 50% of cases.

On 50% of couples who do not spontaneously conceive a pregnancy an associated male factor is found, usually semen abnormalities.

It has been found that el 30 – 40% of male infertility cases have no identifiable cause, what we call Idiopathic Male Infertility. To reach this diagnosis we must perform targeted analytical studies which must be completely normal including the seminogram without alterations, just as the couple must be in perfect health. Coming to the conclusion that up to 20 – 30% of couples suffer from unexplained infertility.

But still There are up to 70% of causes that we can study and detect in time, which is not a negligible percentage, so we invite you to consult experts in the sector and schedule your information appointment as soon as possible at Clínicas Dr T.

Consequences of Infertility

The disorders and causes of male infertility can have significant consequences on the life of a couple who wishes to have children. Some of the most common consequences include:

1. Difficulties conceiving: Male infertility can make conception difficult or impossible, which can be very stressful and emotionally difficult for couples who want to have children.
2. Emotional problems: Male infertility can affect a man's self-esteem, self-confidence and emotional quality of life. This can have a negative impact on his relationship with his partner and his life in general.
3. Financial stress: Fertility treatments can be expensive, and this can create financial stress for couples seeking to conceive. Diagnostic tests and treatments may require multiple visits to specialized doctors, surgical procedures, and/or hormonal treatments, which can be costly.
4. Changes in daily life: Male infertility treatments and alterations may require significant changes in daily life, such as abstaining from sexual intercourse for a certain period, taking specific medications, making dietary or lifestyle changes, and undergoing invasive procedures.

Overall, male infertility can have a significant impact on the life of a couple who wants to have children. It is important to seek treatment and medical support to address the underlying causes of infertility and improve the chances of conceiving a healthy child.

Causes of Male Infertility

Among the causes of male infertility, according to the European Association of Urology (WATER):

• Primary Hypogonadism of unknown cause: The testicle is the gland that suffers from the pathology with the inability to produce sperm and testosterone, in a large proportion we do not find the cause of this disease.

• Secondary Hypogonadism (Hypogonadotropic): The failure is found at the level of the Hypothalamus and Pituitary, in which the FSH hormones and LH hormone to stimulate the testicles.

• Idiopathic infertility: As previously explained, it is male infertility in which the causes of its origin cannot be found and the sperm count is normal, as is the study of the partner.

• Undescended testicles: It is an alteration in the normal mobilization of the testicles from the abdomen to their scrotal sac during the fetal period. This prevents their correct maturation and function, affecting their production of sperm and testosterone.

• Torsion or testicular trauma: Torsion is an entity in which the testicle rotates on its own axis, strangling the blood vessels and their irrigation, which leads to necrosis or death of the testicle if it is not treated with the urgency that the situation warrants. On the other hand, the same can cause a direct trauma to the testicles, such as a blunt blow (a kick), a traffic accident as a motorcyclist, or even on a bicycle, etc., which will leave it without function.

• Antisperm antibodies: autoimmune, that is, the immune system attacks its own body, in this case the sperm, altering its function.

• Testicular Tumor: Naturally, a tumor that develops in the testicle will affect its anatomy and function. It is important to perform a testicular self-examination and seek medical attention in time. Other types of neoplasia such as leukemia, lymphoma, and sarcoma can also affect the testicle.

• varicocele: are the varicose veins of the veins that have the function of draining blood from the testicle, this in turn generates alteration of the function of the production in quantity and quality of semen as well as of its sperm and also of testosterone (varicocele and testosterone).

• Erection and ejaculation disorders: In erectile dysfunction, which is related to low testosterone, failure to achieve adequate erection will not result in the penis entering the vaginal canal, just as premature ejaculation will not achieve the precise expulsion of semen in time and place, since it will not reach the cervix, the starting point for the advancement of sperm.

• Others: Cystic Fibrosis (in which there is congenital bilateral absence of the vas deferens), Klinefelter Syndrome (which presents primary hypogonadism), Constitutional delay of puberty, vasectomy, etc.

Causes of Female Infertility

Here we will also mention the most frequent causes of infertility in women:

• hypogonadism Hypogonadotropic: This means a failure from the Hypothalamus and Pituitary gland, in which the hormones FSH and LH are not produced to stimulate the ovaries.

• Infections of the genital tract and reproductive organs, one of the most frequent is Pelvic Inflammatory Disease caused by Sexually Transmitted Diseases (STDs) such as those caused by the bacteria Neisseria gonorrhoeae or Chlamydia trachomatis.

• Endometriosis: It is a disease in which the tissue of the endometrium (internal part of the uterus) leaves the uterus and implants in any part of the fallopian tubes, ovaries and even other adjacent organs. When it is located in another part of the body where it does not correspond, it causes inflammation, pain and damage to the organ where it is located.

• Polycystic Ovarian Syndrome (PCOS): It is a pathology in which the structure of the ovaries is altered, filling them with multiple cysts, with alteration of the normal production of the hormones necessary for fertility.

• Others: Uterine fibroids, endometrial polyps, cystic fibrosis, ovarian failure, bicornuate uterus, uterine agenesis, ovarian agenesis. Turner syndrome, Rokitansky syndrome, adrenal disorders, etc.

Hypogonadism (Low Testosterone) and Infertility

El hypogonadism It is a condition in which there is low testosterone, and in turn it has several causes, you can find more information in this article hypogonadism, studies show a strong association between this and infertility, especially in those where the cause is an absence or low production of male hormones sexual FSH and LH, produced in the pituitary gland, after being stimulated by the hypothalamus. 

In the absence of these hormones there is no stimulation of the testicles, so they will not produce sperm or testosterone, which leads to infertility and testosterone deficiency, this situation then leads the man to present symptoms such as fatigue, low libido, and disorders such as Erectile Dysfunction and Premature Ejaculation, factors that as we have mentioned worsen the situation.

Thus we see that the patient enters a cycle of infertility, low testosterone, low sexual desire and inability to achieve intercourse.

For all these reasons, it is essential to consult promptly for the identification and treatment of hypogonadism and in turn of the infertility caused by it. If you think you may suffer from hypogonadism, do this online testosterone test which will take you less than 5 minutes.

How to read your semen analysis?

It is definitely necessary to consult with your doctor so that you can understand your results clearly and, above all, propose a management or treatment plan. However, here we provide you with some tips so that you can understand and have some peace of mind, because we know that a properly informed patient is a calmer patient, with less anxiety and better results.

The WHO Manual is the guide that dictates the reference ranges, which is taken by the different medical societies, and according to this we base our indications of the BASIC EXAMINATION of the spermiogram, below the lower limit of normality, which means that below this it could begin to be considered abnormal:

1. Total number or quantity of sperm: 39 million.
2. Semen volume in ml: 1,4 ml
3. Total motility: 42%

It should be noted that no single parameter is diagnostic of infertility, so a medical evaluation is required to reach this conclusion.

Diagnoses of a Spermogram (Seminogram)

We know that diagnoses in medical terms can generate uncertainty and some fear in patients, to avoid this we will explain in understandable language each of the possible results of your semen analysis, according to the WHO and the guidelines of UAE, we must consider these results:

azoospermia: 0 sperm. 

Oligozoospermia: < 15 million 

Asthenozoospermia: < 32% progressively motile sperm.

Teratozoospermia: < 4% of normal forms.

Necrozoospermia: > 42% of sperm are lifeless.

To understand these terms we must know that they are compound words, so we must break down the meaning of each component, like this:

A – ZOO – SPERM – IA:   

A = WITHOUT, NOT.   ZOO = LIVING BEING   SPERM = SEED, SEMEN.   IA = QUALITY

Absence of sperm in the seminal fluid. Requires specialized intervention and requires assisted reproduction assistance.

OLIGO – ZOO – SPERM – IA:   

OLIGO = LITTLE, SCARCE.  ZOO = LIVING BEING   SPERM = SEED, SEMEN.  IA = QUALITY.

Low or scarce amount of sperm in the seminal fluid. This requires studies; in cases where the deficit is very marked, in vitro fertilization may be used to conceive.

A – STEN – ZOO – SPERM – IA:   

A = WITHOUT, NOT.  GEMSTONES = VIGOR, STRENGTH   ZOO = LIVING BEING   SPERM = SEED, SEMEN.   IA = QUALITY

Decreased sperm motility. This term refers to the lack of vigour or strength of the sperm to move and advance towards the egg. It requires intervention with assisted reproduction.

TERATO – ZOO – SPERM – IA:   

Terato = MONSTER   ZOO = LIVING BEING   SPERM = SEED, SEMEN.   IA = QUALITY

Sperm with a distorted or abnormal shape. This alteration prevents the sperm from fertilizing the egg, causing sterility. Antioxidants, among others, may be required for its management.

NECRO – ZOO – SPERM – IA:   

NECRO = DEAD  ZOO = LIVING BEING   SPERM = SEED, SEMEN.   IA = QUALITY.

Dead sperm in seminal fluid. This may be a one-time occurrence in the sample and requires confirmation. Its management requires expert assessment, including assistance with in vitro fertilization to achieve conception. 

Treatments

There are treatments aimed at the cause of infertility, and also aimed at achieving the parents' desire for conception, that is, achieving pregnancy. To do this, it is advisable to first perform a thorough diagnosis with the relevant tests and studies. Once the cause has been identified, therapy can be directed.

Among the management options if the cause is hormonal, it can be corrected by achieving adequate hormonal levels. Clinical guidelines indicate that if the male has hypogonadism and at the same time has a desire to become a father, he requires management with hormonal therapies aimed at stimulating the testicles. Specifically, the standard treatment is with gonadotropins, and not directly with testosterone. 

In this scenario, the priority is to preserve fertility while increasing testosterone production to physiological levels that correct the symptoms of Erectile Dysfunction, Premature Ejaculation and Low Libido, essential elements for adequate and multifactorial management in favor of fertility.

For this reason we encourage you to request your free information appointment, tell us your symptoms and we will guide you to an accurate diagnosis and management for your particular case, in Dr. T Clinics We have what it takes to do so.

Recommendations

Below are a series of medical recommendations to take into account:

1. Get information from reliable sources of medical information.
2. Don't get anxious about altered results, consult immediately.
3. Seek specialized help. At Dr T clinics we can offer you the entire diagnosis and treatment process with expert support. You can schedule your free information appointment to listen to you and propose a study and management plan.
4. In men, a hormonal study is essential that includes FSH, LH, Prolactin, 17 Beta Estradiol, Total and Free Testosterone, SHBG, as a minimum for a diagnostic approximation, and additionally Albumin, Cortisol, Vitamin D 25 hydroxy, TSH, T4L, T3L, Complete blood count, Lipid profile, Renal profile, Liver profile, Ions, etc. to make the diagnostic exercise even more accurate.
5. If the woman in the couple is over 35 years old and has tried for at least 6 months without achieving conception, it is worthwhile to consult for studies as soon as possible.
6. A balanced diet and a healthy lifestyle, without consuming toxic substances such as alcohol, cigarettes, etc. are essential to improve the chances of a successful and healthy conception.

You may want to read: How to increase testosterone naturally

 

BIBLIOGRAPHY/CYBERGRAPHY

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