Male infertility
Male Infertility
Male Infertility is a syndrome encompassing a wide variety of disorders. In more than half of infertile men, the cause of their infertility is unknown and could be congenital or acquired. Recognition of a male factor influence in an infertile partnership is often delayed because women have traditionally been the primary focus of the infertility evaluation and have ready access to gynecological care; men are much more reluctant to seek advice. Men are also more apt to confuse fertility with sexual potency (the ability to have an erection), ejaculation and ability to perform sexually, and they assume that if they produce seminal fluid at orgasm then they also produce sperm.
Causes of fertility problems in men include sperm disorders, obstructive problems (blockages in sperm-carrying tubes), testicular injury and disease, varicocele, genetic disorders, hormonal problems, general medical disorders that reduce fertility, drugs that reduce fertility, and environmental toxins and radiation.
PRE-TESTICULAR CAUSES OF INFERTILITY:
- Hypothalamic disease
- Isolated gonadotropin deficiency (Kallmann's syndrome)
- Isolated LH deficiency ("Fertile eunuch")
- Isolated FSH deficiency
- Congenital hypogonadrotropic syndromes
- Pituitary disease
- Pituitary insufficiency (tumors, infiltrative processes, operation, radiation)
- Hyperprolactinemia
- Hemochromatosis
- Exogenous hormones (estrogen-androgen excess, glucocorticoid excess, hyper and hypothyroidism).
TESTICULAR CAUSES OF INFERTILITY:
- Chromosomal abnormalities (Klinefelter's syndrome, XX disorder (sex reversal syndrome), XYY syndrome)
- Noonan's syndrome (male Turner's syndrome)
- Myotonic dystrophy
- Bilateral anorchia (vanishing testes syndrome)
- Sertoli-cell-only syndrome (germinal cell aplasia)
- Gonadotoxins (drugs, radiation)
- Orchitis
- Trauma
- Systemic disease (renal failure, hepatic disease, sickle cell disease)
- Defective androgen synthesis or action
- Cryptorchidism
- Varicocele
Semen Analysis
Semen Analysis is a test that assesses the formation and maturity of sperm as well as how the sperm interact with the seminal fluid. A fresh semen sample (no more than a half hour old) is collected and then analyzed in a laboratory for a variety of different factors. In order for sperm to be able to fertilize an egg, it is necessary for seminal fluid to be of the correct consistency as well as for sperm to have maximum motility and ideal morphology. If any of these factors are revealed to be less than perfect in a semen analysis, male fertility may be compromised. Male infertility testing is an important part of making an accurate infertility diagnosis.
