Male Infertility : Causes-Symptoms-Diagnosis-Treatment

 What is Male Infertility?

A couple is taken into account sterile if they need been unable to urge pregnant once one year of frequent unprotected sexual intercourse. Male physiological condition is employed to classify infertility when the feminine partner is understood to be fertile.Infertility could be a drawback together with your genital system that stops you from impregnating a female.

Male Infertility

If a male and a female have perennial unprotected sex for over a year and also the female doesn’t get pregnant then you, she, or each of you will have infertility issues.nfertility is a common issue, with quite 5 million couples within the u.  s. managing this problem. Infertility affects one in each six couples who try to conceive. In a minimum of 1/2 all cases of infertility, a male issue could be a major or conducive cause. This suggests that regarding 10% of all males within the U.S. who are trying to conceive suffer from infertility.

1. Male reproductive system

The male reproductive system is a complex and essential structure that carries out the essential function of producing offspring. This system includes the testes, which produce sperm; the epididymis, which stores sperm until they are injected into the vas deferens; and the prostate, which produces seminal fluid.

• Internal reproductive organs

1. Testes

2. Epididymis

3. Vas deferens

4. Seminal vesicles

5. Prostate

6. Bulbourethral glands

• External reproductive organs

1. Penis

2. Scrotum

Medical terms

• Nearly 1 in 7 couples is infertile, which means they haven't been able to conceive a toddler even if they've had frequent, unprotected sexuality for a year or longer. In up to 1/2 these couples, male sterility plays a minimum of a partial role. Male infertility is often caused by low sperm cell production, abnormal sperm operation or blockages that stop the delivery of sperm. Illnesses, injuries, chronic health problems, mode selections and different factors might contribute to male infertility. the shortcoming to conceive a child can be disagreeable and frustrating, however variety of treatments are obtainable for male infertility.Infertility is usually outlined because the inability of one or two to conceive even when one year of unprotected, frequent sexual intercourse. The male is only accountable in about 20% of cases and may be a contributing factor in another 30% to 40% of all sterility cases. As male and feminine causes typically co-exist, it's vital that each partner is investigated for infertility and managed together. This activity highlights the etiology and medical specialty of male infertility. It also reviews the analysis and management of male infertility still as the role of the interprofessional team in evaluating and treating patients with this condition.Infertility is sometimes outlined because the inability of one or two to conceive even when one year of unprotected, frequent sexual intercourse. It affects about 15% of all couples within the US and a minimum of one hundred eighty million worldwide. Male sterility is defined as the inability of a male to form a fertile female pregnant, additionally for a minimum of at least one year of unprotected intercourse. The male is only to blame for about 20% and may be a contributing factor for another 30% to 40% of all infertility cases. As male and feminine causes typically co-exist, it's vital that each partner is investigated for sterility and managed together. Overall, the male issue is considerably tributary in concerning 50% of all cases of infertility. There are many reasons for male fertility to occur, together with each reversible and irreversible condition. different factors that would influence every of the partners can be their age, medications, surgical history, exposure to environmental toxins, genetic problems, and general diseases. The key purpose for evaluating a male for infertility is to spot his contributing factors, provide treatment for those who are reversible, confirm if he's a candidate for assisted  fruitful techniques (ART) and offer direction for irreversible and untreatable conditions. In rare cases, male sterility can be a herald to an additional serious condition. This is often an extra reason to try to do a comprehensive analysis of the male partners of unfruitful couples; so any significant, underlying medical conditions can be known and treated. 
• Male infertility is a common issue that affects the reproductive health of men around the world Male infertility refers to when a man has problems in conceiving a child through sexual intercourse due to low sperm count reduced sperm quality or other factors preventing conception It is estimated that one in six couples are affected by male infertility and approximately 30% of cases remain unexplained with no known cause There are many things that can affect male fertility such as stress lack of exercise smoking and excessive drinking The most common causes of male infertility include hormonal imbalances varicocele (enlarged veins on the testicles) and infections affecting the reproductive organs.

Infertility is a big problem around the world Each year millions of couples struggle to conceive and are unable to have a baby Male infertility can be responsible for up to 50% of these cases If you are dealing with male infertility it is important to seek treatment as soon as possible to avoid further damage and ensure that your ability to conceive a child in the future is not harmed.

Symptoms Male infertility

You may have male physiological state if your feminine partner has not become pregnant after one year. this implies 1 year of standard sex associatey|with none} birth control. Your aid supplier can check each of you and your partner to search out the explanation for infertility.The main sign of male infertility is the inability to conceive a child. There are also no obvious signs or symptoms. In some cases, however, an underlying downside like an hereditary disorder, secretion imbalance, expanded veins round the ball or a condition that blocks the passage of spermatozoa causes signs and symptoms. Signs and symptoms you will notice include:

• Problems with sexual function — for example, difficulty with ejaculation or small volumes of fluid ejaculated, reduced sexual desire, or difficulty maintaining an erection (erectile dysfunction)

• Pain, swelling or a lump in the testicle area

• Recurrent respiratory infections

• Inability to smell

• Abnormal breast growth (gynecomastia)

• Decreased facial or body hair or other signs of a chromosomal or hormonal abnormality

• A lower than normal sperm count (fewer than 15 million sperm per milliliter of semen or a total sperm count of less than 39 million per ejaculate)

When to see a doctor

See a doctor if you've got been unable to conceive a toddler when a year of regular, unprotected intercourse or sooner if you have any of the following:

• Erection or ejaculation problems, low sex drive, or other problems with sexual function

• Pain, discomfort, a lump or swelling in the testicle area

• A history of testicle, prostate or sexual problems

• A groin, testicle, penis or scrotum surgery

• A partner over age 35

Our caring team of Mayo Clinic experts can help you with your health concerns. Visit Mayo Clinic Men's Health to get started.

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Causes Male infertility

There are multiple causes for male infertility, which may be loosely classified because of their general underlying etiology.  These embrace endocrine disorders (usually due to hypogonadism) at an calculable 2% to 5%, spermatozoon transport disorders (such as vasectomy) at 5%, primary male reproductive gland defects (which includes abnormal sperm parameters with none specifiable cause) at 65% to 80% and disorder (where an unfertilized male has traditional sperm and humor parameters) at 10% to 20%.These are broad estimates solely as correct statistics are untouchable due to general underreporting, cultural factors, and regional variations.  Patients sent to a tertiary referral center are more likely to have their condition reported, whereas non-public patients might ne'er have their information collected.

Male fertility is a complex process. To get your partner pregnant, the following must occur:

• You must produce healthy sperm. Initially, this involves the expansion and formation of the male generative organs throughout puberty. a minimum of one in all your testicles should be functioning correctly, and your body must manufacture androgenic hormones and different hormones to trigger and maintain spermatozoon production. 

• Sperm has to be carried into the semen. Once sperm is produced in the testicles, delicate tubes transport them until they mix with semen and are ejaculated out of the penis.

• There needs to be enough sperm in the semen. If the amount of spermatozoa in your seed (sperm count) is low, it decreases the chances that one in all your sperm can fertilize your partner' egg. an occasional sperm count is fewer than fifteen million sperm per cubic centimeter of semen or fewer than thirty-nine million per ejaculate. 

• Sperm must be functional and able to move. If the movement (motility) or operation of your gamete is abnormal, the sperm might not be able to reach or penetrate your partner' egg. 

Medical causes

Problems with male fertility can be caused by a number of health issues and medical treatments:

• Varicocele. A distention could be a swelling of the veins that drain the testicle. It's the foremost common reversible reason behind male sterility. Though the precise reason that varicoceles cause infertility is unknown, it's going to be regarding abnormal blood flow. Varicoceles cause reduced spermatozoon amount and quality. 

• Infection. Some infections will interfere with spermatozoa production or sperm health or can cause scarring that blocks the passage of sperm. These embrace inflammation of the channel (epididymitis) or testicles (orchitis) and a few sexually transmitted infections, as well as sexually transmitted disease or HIV. Though some infections may result in permanent male reproductive gland damage, most frequently sperm can still be retrieved. 

• Ejaculation issues. Retrograde ejaculation happens once ejaculate enters the bladder throughout sexual climax rather than rising out the tip of the penis. numerous health conditions will cause retrograde ejaculation, as well as diabetes, spinal injuries, medications, and surgery of the bladder, prostate or urethra. 

• Antibodies that attack sperm. Anti-sperm antibodies are immune system cells that mistakenly identify sperm as harmful invaders and attempt to eliminate them.

• Tumors. Cancers and harmless tumors will have an effect on the male fruitful organs directly, through the glands that unharness hormones concerning reproduction, appreciate the pituitary gland, or through unknown causes.  In some cases, surgery, radiation or therapy to treat tumors can affect male fertility. 

• Undescended testicles. In some males, throughout vertebrate development one or each testicles fails to descend from the abdomen into the sac that unremarkably contains the testicles (scrotum). shriveled fertility is a lot of seemingly in men who have had this condition. 

• Hormone imbalances. Infertility may end up from disorders of the testicles themselves or AN abnormality affecting different secretion systems as well as the hypothalamus, pituitary, thyroid and adrenal glands. Low androgenic hormone (male hypogonadism) and other hormonal issues have a variety of potential underlying causes. 

• Defects of tubules that transport sperm. Many different tubes carry sperm. They will be blocked because of numerous causes, as well as unintended injury from surgery, previous infections, trauma or abnormal development, reminiscent of pancreatic fibrosis or similar heritable conditions. Blockage can occur at any level, including within the testicle, within the tubes that drain the testicle, in the epididymis, in the vas deferens, close to the ejaculatory ducts or in the urethra. 

• Chromosome defects. Inherited disorders admire Klinefelter' syndrome — during which a male is born with 2 X chromosomes and one Y chromosome (instead of 1 X and one Y) — causing abnormal development of the male generative organs. Different genetic syndromes related to physiological conditions embody mucoviscidosis and Kallmann' syndrome. 

• Problems with sexual intercourse. These will embrace hassle keeping or maintaining an erection decent for sex (erectile dysfunction), premature ejaculation, painful intercourse, anatomical abnormalities resembling having a epithelial duct gap at a lower place the member (hypospadias), or psychological or relationship issues that interfere with sex. 

• Celiac disease. Celiac disease may be an organic process disorder caused by sensitivity to a supermolecule found in wheat known as gluten. The condition could contribute to male infertility. Fertility may improve when adopting a gluten-free diet. 

• Certain medications. Testosterone replacement therapy, long sex hormone use, willcer medications (chemotherapy), some lesion medication, some inflammatory disease drugs and bound different medications can impair sperm cell production and reduce male fertility. 

• Prior surgeries. Certain surgeries might forestall you from having spermatozoan in your ejaculate, as well as vasectomy, pocket or male reproductive gland surgeries, prostate surgeries, and huge abdominal surgeries performed for testicular and body part cancers, among others. 

Environmental causes

Overexposure to bound environmental parts akin to heat, toxins and chemicals will cut back spermatozoon production or sperm function. Specific causes include:

• Industrial chemicals. Extended exposure to sure chemicals, pesticides, herbicides, organic solvents and painting materials might contribute to low gamete counts. 

• Heavy metal exposure. Exposure to lead or other heavy metals also may cause infertility.

• Radiation or X-rays. Exposure to radiation will cut back spermatozoon production, although it'll often eventually come back to normal. With high doses of radiation, sperm production is often for good reduced. 

• Overheating the testicles. Elevated temperatures may impair gamete production and function. Though studies are restricted and are inconclusive, frequent use of saunas or hot tubs may quickly impair your sperm count. Sitting for long periods, sporting tight articles of clothing or functioning on a laptop personal computer for long stretches of your time conjointly may increase the temperature in your pouch and will slightly scale back sperm production. But, the analysis isn't conclusive. 

Health, lifestyle and other causes

Some other causes of male infertility include:

• Drug use. Anabolic steroids taken to stimulate muscle strength and growth will cause the testicles to shrink and gamete production to decrease. Use of cocaine or marijuana might quickly scale back the amount and quality of your sperm as well. 

• Alcohol use. Drinking alcohol will lower androgen levels, cause impotence and reduce spermatozoa production. disease caused by excessive drinking conjointly could result in fertility problems. 

• Tobacco smoking. Men who smoke may have a lower sperm count than do those who don't smoke. Secondhand smoke also may affect male fertility.

• Weight. Obesity will impair fertility in many ways, as well as directly impacting sperm cells themselves likewise by inflicting internal secretion changes that scale back male fertility. 

Risk factors Male infertility

Risk factors linked to male infertility include:

• Smoking tobacco

• Using alcohol

• Using certain illicit drugs

• Being overweight

• Having certain past or present infections

• Being exposed to toxins

• Overheating the testicles

• Having experienced trauma to the testicles

• Having a prior vasectomy or major abdominal or pelvic surgery

• Having a history of undescended testicles

• Being born with a fertility disorder or having a blood relative with a fertility disorder

• Having certain medical conditions, including tumors and chronic illnesses, such as sickle cell disease

• Taking certain medications or undergoing medical treatments, such as surgery or radiation used for treating cancer

Complications Male Infertility

Complications of male infertility can include:

• Stress and relationship difficulties related to the inability to have a child

• Expensive and involved reproductive techniques

• Increased risk of testicular cancer, melanoma, colon cancer and prostate cancer

Prevention Male Infertility

If your physiological condition is full of manners comparable to smoking and dealing around bound chemicals, you would possibly be able to cut back your risk. talk over with your tending supplier concerning different risk factors and what you'll do about them. If you’re reaching to bear cancer treatment, talk to your healthcare provider about spermatozoan banking.Male infertility isn't invariably preventable. However, you can try and avoid some celebrated causes of male infertility. For example:

• Don't smoke.

• Limit or abstain from alcohol.

• Steer clear of illicit drugs.

• Maintain a healthy weight.

• Don't get a vasectomy.

• Avoid things that lead to prolonged heat for the testicles.

• Reduce stress.

• Avoid exposure to pesticides, heavy metals and other toxins.

Diagnosis Male infertility

Diagnosis begins with a whole physical examination to see your general state of health and identify any physical issues that will impact your fertility. Your attention supplier can also interview each you and your partner regarding your sexual habits. If the physical examination and history don’t indicate any reason for your inability to conceive, following step is also to conduct testing to spot the explanation for infertility.Many unfertilized couples have over one cause of infertility, so it' seemingly you may both have to be compelled to see a doctor. It'd take a variety of tests to determine the cause of infertility. In some cases, a cause is rarely identified. physiological condition tests are high-ticket and won't be lined by insurance — verify what your medical set up covers previous time.

Diagnosing male infertility problems usually involves:

• General physical examination and medical history. This includes examining your reproductive organ and raising questions about any inheritable  conditions, chronic health problems, illnesses, injuries or surgeries that would have an effect on fertility. Your doctor may also ask about your sexual habits and about your sexual development throughout puberty. 

• Semen analysis. Semen samples are often obtained in a very few totally different ways. you'll be able to offer a sample by masturbating and ejaculating into a special instrumentation at the doctor' office. thanks to non secular or cultural beliefs, some men like an alternate technique of humor collection. In such cases, semen can be collected by employing a special rubber throughout intercourse. Your semen is then sent to a research laboratory oratory to live the amount of spermatozoon gift and appearance for any abnormalities within the form (morphology) and movement (motility) of the sperm. The lab also will check your semen for signs of issues such as infections. Usually spermatozoon counts fluctuate considerably from one specimen to the next. In most cases, many humor analysis tests are done over an amount of your time to confirm correct results. If your sperm analysis is normal, your doctor can doubtless advocate thorough testing of your feminine partner before conducting any further male sterility tests. 

Your doctor might recommend additional tests to help identify the cause of your infertility. These can include:

• Scrotal ultrasound. This check uses high-frequency sound waves to supply pictures within your body. A pouch ultrasound will facilitate your doctor see if there's a distension or different issues within the testicles and supporting structures. 

• Transrectal ultrasound. A small, greased wand is inserted into your rectum. It permits your doctor to see your prostate and appearance for blockages of the tubes that carry semen. 

• Hormone testing. Hormones created by the pituitary gland, neural structure and testicles play a key role in sexual development and gamete production. Abnormalities in different secretion or organ systems may also contribute to infertility. A biopsy measures the amount of androgen and other hormones. 

• Post-ejaculation urinalysis. Sperm in your piddle will indicate your spermatozoan are traveling backward into the bladder rather than out your member throughout ejaculation (retrograde ejaculation). 

• Genetic tests. When sperm cell concentration is very low, there may be a genetic cause. A biopsy will reveal whether or not there are refined changes within the Y chromosome — signs of a genetic abnormality. Genetic testing might be ordered to diagnose varied non inheritable  or genetic syndromes. 

• Testicular biopsy. This takes a look at removing samples from the ball with a needle. If the results of the male reproductive gland diagnostic assay show that gamete production is traditional your downside is probably going to be caused by a blockage or another problem with sperm transport. 

• Specialized sperm function tests. A number of tests will be accustomed to checking how well your spermatozoan survives when ejaculation, how well they will penetrate an egg, and whether or not there' any downside attaching to the egg. These tests aren't often used and typically don't considerably modify recommendations for treatment. 

Treatment Male infertility

If your physiological condition is caused by some side of your lifestyle, your doctor can support you to vary your behavior. If medication for a medical condition may be tributary to your infertility, they'll conjointly notice different treatments. Your doctor may visit secretion treatment or different medications to treat your infertility. Surgical procedures can be performed to repair dilatation or obstructions of the system tract if these are the explanation for your infertility. If treatment of your infertility is unsuccessful, power-assisted procreative technologies (ART) may assist you and your partner conceive.Often, an exact explanation for physiological condition can't be found. Notwithstanding a certain cause isn't clear, your doctor may be able to suggest treatments or procedures which will result in conception. In cases of infertility, it's advised that the feminine partner even be checked. There may be specific treatments recommended for your partner. Or, you'll learn that continuing with power-assisted procreative techniques is acceptable in your situation.

Treatments for male infertility include:

• Surgery. For example, a distention will often be surgically corrected or a choked duct repaired. previous vasectomies are reversed. In cases where no gametes are given within the ejaculate, sperm can often be retrieved directly from the testicles or duct mistreatment sperm retrieval techniques. 

• Treating infections. Antibiotic treatment might cure an infection of the reproductive tract, but doesn't always restore fertility.

• Treatments for sexual intercourse problems. Medication or guidance will facilitate improved fertility in conditions akin to dysfunction or premature ejaculation. 

• Hormone treatments and medications. Your doctor would possibly advocate endocrine replacement or medications in cases wherever sterility is caused by high or low levels of sure hormones or issues with the manner the body uses hormones. 

• Assisted reproductive technology (ART). ART treatments involve getting gamete through traditional ejaculation, surgical extraction or from donor individuals, betting on your specific case and wishes. The sperm are then inserted into the feminine reproductive organ tract, or accustomed to perform in vitro fertilization or intracytoplasmic sperm injection. 

When treatment doesn't work

In rare cases, male fertility issues will't be treated, and it's not possible for a person to father a child. Your doctor may counsel that you simply and your partner think about using spermatozoan from a donor or adopting a child. Our caring team of salad dressing Clinic specialists can assist you along with your health concerns. Visit salad dressing Clinic Men' Health to start. Get the method started

Lifestyle and home remedies

There are a few steps you can take at home to increase your chances of achieving pregnancy:

• Increase frequency of sex. Having sexual issues on a daily basis or each different day starting a minimum of 5 days before biological process will increase your possibilities of obtaining your partner pregnant. 

• Have sex when fertilization is possible. A woman is probably going to become pregnant through an organic process — that happens within the middle of the emission cycle, between periods. This may make sure that sperm, which may live many days, are a gift once conception is possible. 

• Avoid the use of lubricants. Products adore Astroglide or K-Y jelly, lotions, and secretion would possibly impair spermatozoan movement and function. raise your doctor concerning sperm-safe lubricants. 

• Live a healthy lifestyle. Eat a variety of healthy foods, maintain a healthy weight, get enough sleep, and exercise regularly.

• Avoid things that damage your overall health. Stop or reduce your use of alcohol, quit smoking, and don't use illicit drugs.

Alternative medicine

Evidence is restricted on whether or not — or what quantity — herbs or supplements may facilitate increased male fertility. None of those supplements treat a selected underlying reason behind infertility, cherish a spermatozoon duct defect or body disorder. Supplements with studies showing potential advantages for rising sperm count or quality include:

• Coenzyme Q10

• Folic acid and zinc combination

• L-carnitine

• Selenium

• Vitamin C

• Vitamin E

Talk together with your doctor before taking dietary supplements for male infertility. There's no clear proof that they work, and a few supplements could cause facet effects or act adversely with medications you take.

Coping and support

Coping with a physiological state will be difficult. It's a difficulty of the unknown — you will't predict however long it'll last or what the result will be. physiological state isn't essentially resolved with laborious work. The emotional burden on a handful is considerable, and plans for brick can help.

Planning for emotional turmoil

• Set limits. Decide earlier what percentage and what reasonable procedures are showing emotion and financially acceptable for you and your partner and verify a final limit. Fertility treatments are often pricey and infrequently aren't lined by insurance. 

• Consider other options. Determine alternatives — adoption or donor spermatozoan or egg — as early as attainable within the fertility process. This may scale back anxiety throughout treatments and feelings of despair if conception doesn't occur. 

• Talk about your feelings. Locate support groups or counseling services for help before and after treatment to help endure the process and ease the grief if treatment fails.

Managing emotional stress during treatment

• Practice stress-reduction techniques. Examples include yoga, meditation and massage therapy.

• Consider going to counseling. Counseling such as cognitive behavioral therapy, which uses methods that include relaxation training and stress management, might help relieve stress.

• Express yourself. Reach out to others rather than holding in feelings of guilt or anger.

• Stay in touch with loved ones. Talking to your partner, family and friends can be helpful.

Preparing for your appointment

If you have got ne'er been evaluated by a doctor, you could possibly begin by seeing your family doctor. If, however, you have a noted condition leading to sterility or have any abnormalities on your testing by your medical care doctor, then you will be referred to a specialist. Here's some data to assist you prepare for your appointment, and what to expect from your doctor.

What you can do

• Be aware of any pre-appointment restrictions. At the time you create the appointment, make certain to raise it if there's something you would like to try and do in advance. If an ejaculate analysis is scheduled, you may have to refrain from ejaculating for a minimum of 2 to 5 days before the collection. 

• Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.

• Write down key personal information, including any major stresses or recent life changes.

• Find out whether you have a family history of fertility problems. Having a male blood relative, corresponding to your brother or father, with fertility issues or different procreative problems would possibly provide clues to the explanation for fertility problems. 

• Find out from your parents if you had undescended testicles or other issues at birth or in early childhood.

• Make a list of all medications, vitamins and supplements that you're taking. This includes prior use of muscle-building substances and any use of alcohol, tobacco, marijuana or other recreational drugs.

• Take your partner along. Your partner may additionally  want tests to ascertain for any fertility issues that might be preventing pregnancy. It's also sensible to own your partner to assist keep track of any directions your doctor offers you or to raise queries you'll not assume of. 

• Write down questions to ask your doctor.

Questions to ask your doctor

Examples of questions to ask include:

• What do you suspect might be interfering with my ability to father a child?

• Other than the most likely cause, what are other possible reasons my partner and I haven't been able to conceive a child?

• What kinds of tests do I need?

• Will my partner also need tests?

• What's the best treatment for my condition?

• What are the alternatives to the primary approach that you're suggesting?

• Are there any restrictions that I need to follow?

• Should I see a specialist?

• Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?

Don't hesitate to ask additional questions at any time during your appointment.

What to expect from your doctor

Be ready to answer questions your doctor is likely to ask, including:

• At what age did you start puberty?

• Have you had any sexual problems in this relationship, including difficulty maintaining an erection, ejaculating too soon or not being able to ejaculate?

• Have you ever fathered a child?

• Have you had a vasectomy or other abdominal, pelvic or scrotal surgery?

• Do you use illicit drugs, such as marijuana, cocaine or anabolic steroids?

• Have you been exposed to toxins such as chemicals, pesticides, radiation or lead, especially on a regular basis?

• Are you currently taking any medications, including dietary supplements?

• Do you have a history of undescended testicles?

General summary

1. Male infertility is a condition that affects about 15% of couples who are trying to conceive It can be caused from a number of different factors including low sperm count abnormal sperm shape and motility or presence of antisperm antibodies in the female reproductive tract However according to an article published in "Fertility and Sterility" in 2010 male factors contribute to more than half of all cases of infertility.

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