From the medical standpoint, a couple is considered to be infertile if there has been no pregnancy after one to one-and-half years of unprotected sexual intercourse. For the fertility process to proceed smoothly, both the man and the woman should be healthy and normal. Normally a woman is always blamed when a couple can't have a child. The investigation for infertility begins and ends with التفتيش الميكروسكوبي للخصية evaluation of the wife alone. This, however, is not true. Approximately 15-20 percent of all cohabiting couples are infertile. In 50 percent of cases it is the male reproductive factor or the husband who is responsible for the infertility. This means that nearly 7.5 to 10 percent of all men in the reproductive age group are infertile i.e. incapable of fathering a child.
Male infertility is due to low sperm production, misshapen or immobile sperm, varicocele or blockages that prevent the delivery of sperm. Illnesses, injuries, chronic health problems, problems with erection and ejaculation, hormonal problems, genetic problem, lifestyle choices and other factors like environmental toxins and radiation can play a role in causing male infertility. Unhealthy eating patterns, stress, obesity, being overweight or underweight may also prove to be the risk factors.
Some of the factors that play an important role in male infertility are:
Sperm motility: Sperm motility is the ability of sperms to move towards the egg which results in its fertilization. Sperm which do not properly swim will not reach the egg in order to fertilize it.
Sperm count: Sperm count is the quantity of sperms or cells, the more the sperms more are the chances of normal pregnancy. A healthy sperm count should total about 20 million sperm per milliliter and the normal semen volume per ejaculation is 2 ml. Azoospermia is a condition in which there is complete absence of sperm. It can also be congenital. Correctible causes must be found and treated. Even then if there are no sperm in the ejaculate, sperm can often be harvested and used to achieve fertilization.
Sperm morphology: Sperm morphology refers to the size and shape (form) of an individual sperm which is evaluated during semen analysis. According to WHO manual of 1989, morphology is considered normal if it is around 30% or more.
Deficiency of any of these factors can result in the male infertility.
Evaluation of Male Infertility.
Fertility in men requires normal functioning of the hypothalamus, pituitary gland, and testes. Therefore, a variety of different conditions can lead to infertility. The evaluation of male infertility begins with a visit to a urologist. The urologist will begin with a basic interview and exam including
* A full medical and reproductive history, along with any surgeries you've had and medications you're taking. * Lifestyle questions, including exercise, smoking, and drug use. * Physical exam. * Frank discussion about your sexual life, including any problems with sex or previous sexually transmitted diseases.
In any evaluation for male infertility, the man will need to provide a sample of semen for analysis. The doctor will want the man to give the sample there or at least someplace nearby, since it's important that the analysis take place quickly.
How is male infertility treated?
The treatment for male infertility depends on the specific problem. In some severe cases, no treatment is available. However, many times there are a mix of medications, surgical approaches and assisted reproductive techniques (ART) available to overcome many of the underlying fertility problems. The options are:
Surgery: Minor outpatient surgery called varicocelectomy is frequently used to repair dilated scrotal veins (varicoceles). Studies have shown that repairing these dilated veins results in improved sperm movement, concentration and structure. In some cases, obstruction causing infertility can also be surgically corrected. In the case of a previous vasectomy, surgery using an operating microscope has been found to be very successful in reversing the obstruction.
Medication: Drugs are key in correcting retrograde ejaculation and immunologic infertility. In addition, pituitary hormone deficiency may be corrected with drugs such as clomiphene or gonadotropin.
If these techniques fail, fertility specialists uses high-tech assisted reproductive techniques that promote conception without intercourse. Depending on the problem physician may suggest
Intrauterine insemination (IUI): By placing sperm directly into the uterus via a catheter, IUI bypasses cervical mucus that may be hostile to the sperm and puts them close to the fallopian tubes where fertilization occurs. IUI is often successful in overcoming sperm count and movement problems, retrograde ejaculation, immunologic infertility and other causes of infertility.
Intracytoplasmic sperm injection (ICSI): A variation of in vitro fertilization, this procedure has revolutionized treatment of severe male infertility, permitting couples previously thought infertile to conceive. It involves injecting a single sperm directly into the egg with a microscopic needle and then, once it is fertilized, transferring it to the female partner's uterus. Your doctor is likely to use ICSI if you have very poor semen quality or lack of sperm in the semen caused by an obstruction or testicular failure. In some cases, sperm may be surgically extracted from the testicles or epididymis for this procedure.
Modern scientific technologies like ART, ICSI, and IUI have made the treatment of male infertility easy. However, this treatment can be very expensive and can burn a hole in your pocket. Today inexpensive methods are also available without any compromise on the treatment and methodology. Awareness of the magnitude and importance of the male factor in infertility is relatively recent. Tremendous advances have been made in andrological research over the past few years. If not today, one can envisage in the conceivable future, a situation where all males (and females) with infertility can be completely cured.
Always remember that infertility can be cured like any other disease and it does not mean that your masculinity is at stake. By being fit you can fight infertility. So it's crucial that men get tested for fertility as well as women. Yes, it can be embarrassing, but discovering male fertility problems early can mean earlier treatment and a successful pregnancy. Male infertility testing can also spare women unnecessary discomfort and expense.
Male infertility treatment gets better and more target specific as research becomes more thorough and technology becomes more intelligent. Depending on your age, medical history, tolerance to medications and certain male infertility treatments, and your preference, there will certainly be something you can take advantage of to improve your chances of fertility.
One of the more practical ways to start pregnancy is having intercourse every other day. Getting your regular dietary allowances of Vitamin C, B-12, E, zinc, and selenium may improve your sperm quality. Medications and therapies may address sexual intercourse difficulties, such as premature ejaculation or erectile dysfunction. Hormone treatments may also boost your chances to get your partner pregnant. Surgery can repair an obstructed vas deferens. The more expensive and aggressive male infertility treatments are also called assisted reproductive technology. Artificial insemination, in vitro fertilization, gamete intra-fallopian transfer, and intrauterine insemination are a few of treatments that fall under this category.
Every male infertility treatment, whether natural or medical in nature, starts with yourself. Find balance within yourself first by reducing stress and other volatile emotions. It helps to release stress through yoga, meditation, or even contact sports. Although some males are adverse to talking, your partner and someone you trust would not mind talking to you about your feelings. After all, your side of the story matters a lot. If it becomes unbearable, consider going to counseling. Help does not diminish the fact that you are a man. Getting help is the responsible and wise way to avoid bad decisions.
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