Causes, signs of infertility in men treatment

Today one of the urgent problems of medicine and society is male infertility. It happened at the same frequency that women and leads to personal tragedy the men and the breakup of the family. The diagnosis "infertility" is a place, in that case, if a couple wants to conceive, do not use any form of contraception, but after 12 months of unsuccessful attempts. In this situation, a woman and a man, is to be investigated, the purpose is to identify the causes and fix them.

The mechanism of development and classification of infertility

Reasons

Causes of infertility in men can often pathological processes, cause a violation production of sex hormones, changes in the composition, the characteristics of the semen of the lack of ways out of the flow.

  1. Violation of the nervous system. Spermatogenesis is regulated by complex physiological processes, of which 4 structures: the cerebral cortex of the brain, the hypothalamus-pituitary and male reproductive system – testicles and other glands of internal secretion. The first stress-sensitive central nervous system: severe trauma interferes with the hypothalamus, it reduces the production of several hormones, which leads to the reduction or complete absence of sperm in the ejaculate (oligo - and azoospermia, respectively). Psychoemotional stress causes an imbalance of the autonomic nervous system. It can also cause infertility in men, although a satisfactory condition of the testes. Damage to the ilio-inguinal nerve (eg. during the operation, a hernia, or after surgery, because scar tissue of genitalia) often causes degeneration and even atrophy of the testes.
  2. Genetic and congenital factors. The frequency of congenital malformations of the testicles, today is about 4-5 %, meaning they are the place, almost every twentieth man. Is cryptorchidism (undescended testicle into the scrotum), monorchism (1 egg), Anorchia (congenital absence of the scrotum and both testicles), dysgenesis (impaired development) gonads and other violations.
  3. Infection.
  4. Intoxication. Environmental -, chemical -, accidents at work in connection with increasing industrialization cause infertility in men more often. Intoxication can act directly on testicular tissue, or nervous system Generally, with the consequences described in paragraph 1.
  5. Diagnosis
  6. Food additives, pharmaceuticals, industrial compounds, pesticides – exposure to these factors a person is exposed to every day, and many of them are mutagens and damage to the germinal epithelium of the testicle. Also quite dangerous in this regard, the exhaust gas of vehicles and anoxia, especially in the background of stress and fatigue. Has a negative effect on the tissues of the testes, which produce sperm, some antibiotics and sulfonamides, nitrofurans, as well as estrogen and cytostatics. Chronic poisoning by nicotine and alcohol causes significant changes in the ejaculate in the form of reduced mobility and the emergence of pathological forms of sperm.
  7. The supply deficit. Food factor is also very important that the correct sperm. Pathological changes in the tissues of testes may lead not only to absolute fasting, but fasting is partial, and inadequate nutrition. Especially important is a balanced diet for children and young people. You should know that degenerative changes occur not only in the tissues of the testes, but also the hypothalamic-pituitary system.
  8. Ionizing radiation. Irradiation can be a direct cause-factor infertility (the cell death of embryonic epithelium), and have a mutagenic effect (leads to abnormalities in the process of sperm production in the offspring of irradiated male).
  9. Pathology of endocrine glands and other organs. One of the manifestations of some diseases is a malfunction of the testes. However, if the disease is not difficult, these disorders often go undiagnosed, because it is not expressed, and in the case of severe course of the underlying disease, the issue of fertility goes to the second and most important goal, the patient is to eliminate the underlying disease under the supervision of a doctor. After the recovery of spermatogenesis usually recovers.
  10. Overheating. The optimum temperature of part of the production of semen – 2-3 °C lower than the temperature of the whole body. Overheating damage of testicular tissue and leads to their degeneration. Even a short rise, the overall body temperature to febrile values (39 °C and above) disturbs the process of formation of sperm, and it only gets better after 2-3 months of recovery. It is important here, because the total (infectious disease, work in hot shops) and local (hernia testis, varicocele) hyperthermia.
  11. Hypothermia. Effects on the testis low temperature also causes damage to the cells that produce sperm. However, cases of infertility, it is for this reason quite rare, due to the violation of sperm requires a testicle to the scrotum was exposed to temperatures below -10 °C during at least an hour.
  12. Disorders of blood circulation. Spermatogenic epithelium is very sensitive to even short-term ischemia, so the disease violate blood flow in the testis (in particular, a hernia or hydrocele) may cause infertility. Also, it promotes stagnation of blood in sex organs (for example, a varicocele (varicose veins of the testicle), abnormalities in the structure of the venous plexus region of genitourinary organs other diseases).
  13. Infertility
  14. Traumatic injuries of the genital tract. Depending on the nature and force of the injury, it can cause bleeding, inflammation, necrosis of the affected tissue destruction (blockage of the lumen) the seminal tract, compression and/or blood vessels that carry blood to testis, hematoma and other pathological changes. As a result of their be reversible or permanent pathological changes in the tissues of the testes or seminal tract.
  15. Autoimmune processes in the area of the reproductive system. Spermatogenic epithelium work properly, due to the presence between the blood and contents of the seminiferous tubules of the so-called haemato-testicular barrier, which bypasses some of the cells and does not give to others. As a result of overheating, hypothermia, infectious diseases, disorders of blood circulation, the permeability of the barrier increases, and some semen can enter the bloodstream. They are known antigens, so the body reacts by the formation of antibodies cells of the seminiferous tubules, which produce sperm. To develop autoimmune infertility.

There are 5 forms of male infertility:

  • secretory;
  • the excretory;
  • auto-immune diseases;
  • combined;
  • relatives.

Secretory infertility

It is usually associated with reduced testicular function — hypogonadism. There are 2 types of this condition: primary and secondary.

Primary hypogonadism the pathological process is localized directly in the tissues of the testicle. It can also be congenital malformations or cryptorchidism, and injury-traumatic or infectious nature. This form of the disease is associated with increased secretion of gonadotropins in the blood, their concentration is increased.

Secondary hypogonadism occurs when there is damage to the pituitary, hypothalamus, endocrine organs. It develops tumors, neuroinfections, traumas of the brain and is a sharp production of gonadotropins, leading to dysfunction of the testes. Loss of the prostate, seminal glands and other endocrine glands is also developing testicular failure. Content of gonadotropins could increase, decrease, or stay the normal values.

Excretory infertility

Is the result of diseases or malformations of the accessory genital glands of the urethra blockage of the lumen of the vas deferens, and aspermatism. Exclaim either lose its properties (because of the lack of sperm or change their structure and properties) or is a normal configuration, but can get to the female genital organs.

Aspermatism is called the mode, which is characterized by a lack of ejaculation during intercourse. It occurs as a result of violations of its functions of the nervous system (both Central and peripheral) and is also considered a form of excretory infertility in men.

Infertility in men

Immune infertility

Can occur, when immunological conflict between a man and a woman, emerging in response to receipt of sperm, which is the antigen, a woman's vagina. This so-called ISO-immune forms of infertility. The risk of such a conflict can be raised in disorders of the immune system, incompatibility of blood groups and other factors.

Autoimmune disease in the form of infertility occurs when a violation of the permeability of the hemato-testicular barrier. The causes of this condition have been described above.

Combined infertility

Combined hormonal disorders and excretory components.

The relative infertility

Such a diagnosis is present, if, after a complete study of the men and women of the pathological changes, none of them have been identified. The term must be applied with caution, because it does not recognize the pathology does not mean that it is not – perhaps this is due to the imperfection of the research.

Signs of infertility in men

The leading symptoms of infertility in men is not pregnant on a regular basis (2 times a week) sexual intercourse for 12 months, provided that the contraception is not used, the woman completely revised and pathology it is not revealed.

The number of diagnostic procedures includes:

  • history
  • General research;
  • the study of sperm;
  • diagnosis of excretory functions in the testes and other glands;
  • a biopsy of the testes;
  • genitography.

Principles of treatment of infertility in men

Tactics of treatment depends on what causes lead to infertility.

Excretory infertility due to inflammatory processes in the genital organs, apply the conservative treatment.

Occlusion (blockage of the lumen) of the vas deferens is usually removed surgically.

The effectiveness of treatment is determined by a review of the ejaculate and other diagnostic methods.

General operating

The patient should:

  • quit Smoking;
  • give up alcohol;
  • to stop taking certain medications;
  • leave the effects of harmful occupational factors, to change working conditions;
  • avoid emotional stress, fatigue;
  • lead an active lifestyle;
  • regularly and fully fed.

It is also very important to respect the sexual life. Frequent sex reduces the ability of sperm to fertilize, because the number of Mature sperm in it decreases, and the young form more. The result of uncommon sexual acts, the growing number of old sperm. The optimal duration of abstinence of 3-5 days. It should take into account the day of ovulation of the female partner, because in this period, planning of the event. After intercourse the woman should remain in a horizontal position for another 30-40 minutes.

Vitamin

Common medical event

The patient can be determined:

  • vitamin therapy;
  • preparations, phosphorus, glutamic acid;
  • tincture Chinese Magnolia vine, Siberian ginseng;
  • sedatives;
  • medications;
  • biostimulants;
  • top experts – a neurologist, psychotherapist.

Treatment of secretory infertility

  • Primary hypogonadism – androgen drug.
  • In secondary hypogonadism, gonadotropins, progestins, or drugs that stimulate their secretion.

Treatment of excretory infertility

Depending on which disease it caused.

  • When hypospadias and epispadias surgery. Completely disagree with the patient for surgery – artificial insemination (fertilization).
  • Chronic inflammatory diseases of the genital organs – medications, depending on the causative agent (antibiotics, sulfonamides and others). Because these drugs can suppress the sperm, to apply them in parallel medications, warning of the adverse effects on the liver and testicles.

Surgery

A direct indication it is obstructive azoospermia, as confirmed by biopsy preservation of sperm. The goal of surgery is to restore the patency of the seed excretory systems.

Treatment of immune infertility

Couples were encouraged to continue having sex with a condom and only during the period of ovulation do not take precautions. A woman's body decreases the amount of antigen of male sperm and the chance of fertilization increases. Parallel to this, a man or a woman (depending on the violations) are prescribed antihistamines. Also, in order to achieve the anti-allergic effect can be used for glucocorticoids.

Treatment

In the chronic inflammatory process in the male body, it can be recommended intake of Immunostimulants.

The choice of method for the treatment of immune infertility artificial insemination. Women in the cervical canal or the cavity of this body is injected semen just received from her husband.

Prevention

To prevent the development of infertility, a man should be attentive to their health, timely treatment of diseases that affect reproductive function, and prevent their development. Also it is necessary to observe the regime of work and rest, sexual activity, rational feeding, not free, not to take uncontrollably drugs, to refuse, or at least limit alcohol consumption and Smoking.