Category Archives: Male Infertility

Assisted Reproductive Techniques

In-vitro Fertilization In-vitro fertilization (IVF) is recommended for people who suffer from tubal illness and female infertility that does not have any certain reason. It is also used by men who suffer from male infertility. This method is applied for the fertilization of human ova that is concentrated of 20,000 to 100,000 motile sperm. IVF […]

10 Ways to Increase Sperm Count

There are a lot of reasons for male infertility. The main are: infected semen, tight underpants, taking a very hot bath, smoking, excessive alcohol intake, zinc deficiency and many others. Very frequent semen ejaculation also lead to lowered sperm count and man may become effectively infertile.

Against of this there are ways how to increase your sperm count.

  1. First of all you should to refrain from habits like alcohol consumption, smoking etc. when you drink alcohol it affects your liver function, which for its part causes a dramatic rise in estrogen levels.

  2. Have sex & masturbate less often – the more times you ejaculate, the less dense your semen will be.

  3. Also you should to avoid heating of testicles. It will be better for your health to wear loose, cotton boxer shorts and avoid hot saunas and baths.

  4. One more way you should eat more nutritious food. Diet that is high in protein and vegetables and low in fat is good as for your health as for your sperm. You should avoid astringent, spicy and bitter foods and lessen caffeine intake.

  5. You should lessen your stress levels by learning relaxation techniques. Regular practice of yoga and meditation will keep your mind and body healthy.

  6. Also regularly exercise will increase your sperm count. Exercising your PC muscle can help you shoot further than ever before.

  7. Try to lose any excess weight, which leads to cause testosterone/oestrogen imbalances.

  8. Also certain natural supplements promise to increase sperm production.

  9. Frequently uses of massage body with herbal oil will improve your blood circulation.

  10. And at last make love in the early morning or afternoon. As sperm levels are often highest in the mornings.

Initial Evaluation

Such factors as the duration of the couples infertility, successful or unsuccessful treatment, previous pregnancies and difficulty with conception that has already been observed are very important factors of initial evaluation.

1. Sexual Habits
Sexual Habits play a big role in the sexual life of a couple. Too-frequent or too-infrequent intercourse can influence the process of fertilization. One should keep in mind that woman’s menstrual cycle is often ignored. Couples are unaware that the best time for intercourse is midcycle and that intercourse should be repeated every 48 hours, because sperm that is located in cervical mucus and within the cervical crypts keeps its effectiveness about 2 days. During 24-hours the egg is situated in the fallopian tube and it is ready to be fertilized with viable spermatozoa. Lubricants or the frequent masturbation can be applied after the husband’s consent due to an ability to deplete the sperm "reserve."

Some experiments were held on lubricants to see their vitro effects on sperm motility. Such constituencies as K-Y Jelly, Lubifax, Surgilube, Keri Lotion, petroleum jelly, and saliva lead to problems with motility. Raw egg white, vegetable oil, and the Replens douche do not influence vitro motility. Astroglide, a water-soluble, inert vaginal lubricant does not have petroleum constituencies that are toxic to sperm; their high concentration can lead to bad sperm motility.

2. Childhood Illnesses
It was observed that childhood illnesses and disorders influence male infertility. A newborn boy has overall semen quality lower comparing with normal men. The time of orchiopexy was not taken in consideration. 30% of men who have unilateral cryptorchidism and 50% who have bilateral cryptorchidism have sperm densities that are lower than 12-20 million/mL. Most man, who have undescended testis and whose semen parameters are not taken into consideration, can easily make a women pregnant. Testicular trauma or torsion of the testes is also important due to their result in atrophic testes. It was observed that 30% of men, who suffer from testicular torsion, have abnormal results according semen analysis.

Such illness as postpubertal mumps orchitis should be also taken in consideration. Mumps does not influence the testes when they were observed prepubertally. After the age of 11 or 12 unilateral mumps orchitis has been observed within 30% of men who suffer from it and bilateral orchitis is observed within 10%. The testicular damage may have consequences and physical examination should be conducted, since the involved gonads will be proved atrophic. Male, whose bladder neck during childhood has been operatively corrected (Y-V plasty), frequently observe retrograde ejaculation because of the internal sphincter’s ablation. Bladder neck during ureteral reimplantation surgery was widespread at the beginning of 1960s.  Retrograde ejaculation is recommended for patients who have had bladder surgery and whose ejaculate volume is less than 1 cc, severely oligospermic, and alkaline that is lower a norm. When the diagnosis is put properly, large quantities of sperm in the postejaculate urine are observed. Children, who have congenital anomalies since their birth, have problems with the male reproductive system, such as bladder exstrophy/epispadias, abnormalities of ejaculation due to problems with both intromission and ejaculation. Spermatogenesis is conducted without problems; however, the ejaculatory ducts get obstructed or retrograde ejaculationis possible. Herniorrhaphy is important for iatrogenic vasal injury that may occur.

3 Factors Affecting Men Infertility

There are three main reasons for problems with sperm. They are: function, delivery and production. Sperm Abnormality: Sperm can have an unnatural shape and movement that would produce problems for fertilization. Clearly if the sperm have mobility problems they will have difficulty even reaching the egg. Any unnatural shape of the sperm also promotes to […]

Infertility in Men: Overview

About 15% of couples are unable to achieve a pregnancy after one year of unprotected intercourse. As data available prove that in approximately 30% of cases pathology is found in the man alone, and in another 20% both the man and woman are abnormal. Therefore, a male factor is at least partly responsible for couple infertility in conception in roughly 50% of cases.

Chances for an effective cure are becoming worse depending on duration. The longer couple remains subfertile, the more difficult to treat both partners. Because of this reason early evaluation and treatment of the male along with is a comprehensive program for the infertile couple is critical.

There are many causes of male factor infertility and early treatment may help in most of cases. It is recommended to start clinical evaluation after 12 months of unprotected intercourse. But the initial evaluation may take place whenever the patient presents with the chief complaint of infertility.
Effectiveness of the whole treatment process depends on the correct diagnosis of male infertility. Rationale and effective medical and surgical regimens in the treatment of these disorders are defined according to the diagnosis.
Serious medical conditions, even life threatening are the cause of 1% infertility in men.

The use of standard techniques for evaluating medical problems in general, such as complete history, physical examination, and laboratory tests is essential for this purpose. Early treatment of such conditions is vital and can save the life.

Possible Causes of Male Infertility
There are many male factors that can prohibit a couple to become pregnant. This includes the following factors:
a) Conditions:
• diabetic neuropathy
• extreme obesity
• Liver and Kidney disease
b) Testicular causes of infertility
• Chromosomal abnormalities (Klinefelters syndrome, XX disorder (sex reversal syndrome), XYY syndrome)
• Noonans syndrome (male Turners 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
c) Additional factors:
• Certain medicated drugs
• Anabolic steroids
• Diet low in folic acid
• Excessive exercise
• Radiation therapy
• Wearing tight-fitting pants and underwear

Male Fertility

There are millions of couples who decide to start a family. It’s a pity to hear that a large number of these couples will occur with some problems. And some of such couples may face with such problem as male infertility. There are ways and means of improving and increasing male fertility and a lot of it depends on your lifestyle and diet. Male Fertility rates have dropped dramatically over the last 100 years and one of the main factors has been changes in our diets.

Most men end up with male fertility problems because of their diet. Here we will look at diet and lifestyle changes that can be made to increase male fertility. Here are you will find some tips on a diet for increasing male fertility:

  Eat Naturally

Eat “naturally from the earth” get plenty of fresh vegetables, fruits, whole grains, fish, poultry, legumes, nuts, brown rice and seeds. A healthy diet with fruits and vegetables will help in sperm motility and the sperm will be able to find their way to the egg in your partners vagina.

  Water. Drink plenty of water at least 2 -3 liters a day to flush out any toxins in the body.

  Zinc food

Make sure that you eat healthily by consuming foods rich in zinc. As we known zinc increases the production of sperm. You can get it through eating foods like seafood, eggs and whole grain cereal. Also pumpkin seeds are great food for male fertility, as they contain high levels of zinc and essential fatty acids which are vital to healthy functioning of the male reproductive system.

You may know this already, but here are three major causes of male infertility, which should be cut or even better stopped completely. Avoid or cut alcohol consumption, stop smoking  and stop taking recreational drugs. Medical evidence has linked alcohol consumption with defective sperm. Also medical evidence has shown there is a link between smoking and low sperm count. Abstain from taking drugs, using tobacco products and drinking too much alcohol. All these work towards decreasing sperm count and sperm motility.
Moreover, stress plays an important role in reducing male fertility and rather than spending your time sitting in front of the TV and consuming a lot of alcohol, you exercise for regularly for 45 minutes, 5 times a week. This will increase your sexual urge, improve the quality of your sperm and help you to keep fit and healthy on the whole.

Laboratory Tests

1. Routine Laboratory Tests
1.1 Semen Analysis
At first physical examination is conducted and then laboratory testing should be held. For the evaluation of the semen laboratory analysis should be held. The semen analysis does not consider being a test for fertility. Fertility determination should be held for a couple and the initiation of a pregnancy is recommended for the purpose. The best results can be achieved uniting a female factor evaluation with of the male one.
2-3 days are required to take all specimens and to evaluate them of sperm motility and forward progression within 2 hours of collection that is held at the laboratory. Specimen container should be clean, sterility is not required. Some plastics have residual spermatocidal chemicals in their content and may include spermatotoxic contaminating material as one of their constituences. The collection of the semen is held by masturbation, coitus interruptus, or with a special condom avoid of spermatocidal constituences.

"Normal" (average) and "adequate" (potentially fertile) semen quality differ. A mean or average sperm density is important because of semen quality. The results can be achieved without any difficulty. Sexual abstinence is not controlled and does not demand complete ejaculation. The age of such men is more comparing with men who have fertility evaluation.
Men with high-quality spermatozoa have fertility with very low sperm densities.

1.2. Basic Laboratory Tests
One should begin laboratory investigation of testicular function with basic screening tests. The clinical history and physical examination are the factors influencing the tests’ results. The hormones that are recommended to be tested are testosterone (T), luteinizing hormone (LH), and follicle-stimulating hormone (FSH).
Serum T is responsible for Leydig cell function and indicates intratesticular testosterone. The levels of measured circulating LH and FSH are necessary to find out if a patients endocrine dysfunction appears as the result of primary testicular failure or hypothalamic and/or pituitary deficiency.

Other tests are also recommended. The measurement of serum prolactin is recommended for patients with signs and symptoms of a pituitary tumor, patients whose serum testosterone level is low and whose do not have elevated serum LH that does not have any connection with it and for patients consuming psychotropic drugs or centrally acting antihypertensives.

An evaluation of other pituitary hormones (adrenocorticotropic hormone [ACTH], thyroid-stimulating hormone [TSH], and growth hormone [GH]) is required for all patients who have hypogonadotropic hypogonadism (LH and FSH deficiency).

2. Additional Laboratory Tests
Between 10% and 20% of infertile couples were evaluated and it was observed that they suffer from "unexplained" infertility. The female infertility has lower data due to techniques held to find out the effectiveness of evaluation. During the male infertility one should pay attention to sperm number and motility, the determination conducted by routine semen analysis and the definition of function or true sperm quality. That’s why tests are required for the identification of other abnormalities of semen parameters. These tests are leukocyte, tests of sperm function and antisperm antibody identification.

2.1. Quantitation of Leukocytes in Semen
The identification of leukocytes in semen has been conducted with monoclonal antibody technology. Some patients, who suffer from infertility, have a lot of round cells in their semen. One may make a difference between immature germ cells and leukocytes conducted with a standard semen analysis. The cell type should be determined due to pyospermia considered as infection. It was found out that infertile men have higher white blood cell counts in their ejaculates comparing with normal men.

2.2. Antisperm Antibody Testing
There is a connection between antisperm antibodies (ASA) in the semen and lower pregnancy rates. It may be a result of some risk factors, such as previous genital infections, testicular trauma or biopsy, heat-induced testicular damage, or genital tract obstruction. ASA may also be found out after semen analysis with clumping/agglutination, diminished motility, a poor postcoital test, or the availability of the "shaking" phenomenon on sperm-cervical cross-mucus testing.

These antibodies have been detected with various methods, the most accurate analyze is the immunobead test. Its purpose is the utilization of polyacrylamide beads to which rabbit antihuman antibodies have been connected. It makes possible the acute detection of IgA or IgG antibody connected with the head, midpiece, or tail of motile sperm. More than 20%-50% of sperm demonstrating immunobead binding is not important. Tests evaluating antisperm antibodies in the serum or seminal plasma are not as important as sperm-bound antibody analyzes due to the sperm surface antibodies that have an ability to produce the functional deficits that are connected with immunologic infertility.

Reasons of Male Infertility

There are many issues, which can cause impaired sperm count or mobility, or impaired ability of sperm to fertilize the egg. Among the most widespread male infertility reasons are considered to be abnormal sperm production of functioning, impaired delivery of sperm, general lifestyle of a man and his overexposure to some certain chemicals and / or radiation.

Impaired Production or Functioning of Sperm
Quite often men suffer from being not able to conceive because of some problems with the sperm. These problems may be the following:

Impaired shape and movement of sperm. In order for the fertilization to occur, sperm is to be of a proper shape and it is to be able to move rapidly and in an accurate way only in the direction of the egg. Either in case of an abnormal shape and structure (morphology) of sperm, or if the sperm is abnormal in its movement (motility), it may not be able to reach and / or penetrate the egg. Thus the fertilization will not take place.

Low concentration of sperm. The normal concentration of sperm is considered to be either greater of equal to 20million of sperm per one milliliter of semen. Any number, which is fewer than that means low sperm concentration (the term “subfertility” is applied to describe this health condition). It is also possible to have complete failure of the testicles, however, it happens rarely enough, and it affects very few men.
Varicocele . It is a varicose vein, located in the scrotum, that may not let normal cooling of testicles to occur, and it usually leads to the reduction of sperm count and motility

Undescended testicle. This condition takes place, when either one or even both of the testicles do not descend into the scrotum from the abdomen during the fetal development of a boy. Thus, the testicles may be exposed to higher internal body temperature, than is considered to be normal for them; it may cause some problems with the production of sperm.

Testosterone deficiency (male hypogonadism). Some kind of disorder of the very testicles may also become the reason of male infertility. Here the abnormality of the hypothalamus or the pituitary gland, which produce special hormones that control the work of the testicles are also included.

Genetic defects. One of the most widespread men’s genetic defects is considered to be the Klinefelter’s syndrome. It is the condition, when a man has two X chromosomes and one Y chromosome. And it really should be one X chromosome and one Y chromosome. This issue may cause some kind of abnormal development of the testicles, the result of which is low sperm production, or the complete absence of sperm. Moreover, the level of the testosterone (the male hormone) is usually low in these men. 

Infections. If a man suffers from constant sexually transmitted diseases, like Chlamydia, gonorrhea, etc, he is at a great risk of becoming infertile, as different infections may affect sperm motility, they can also cause scarring and block the passage, through which the sperm moves. In case if a teenage boy got mumps, the infection, which usually affects little children it may cause the inflammation of the testicles, which can impair the production of sperm. Different kinds of the inflammations of the prostate (prostatitis), urethra and epididymis may also become the reasons of the sperm’s motility alteration.

Physical Examination

Physical examination should include a complete evaluation of physical state of infertile man. Any factor can be responsible for abnormalities in sperm production. Thus, the physical examination should be complete and careful, especially it concerns the genitalia area.

1. Body Habitus
Presence of some signs of inadequately virilization (androgen-deficiency) such as decreased body hair, gynecomastia, eunuchoid proportions, etc., hints on the delayed maturation due to an endocrine abnormality diagnosis.

2. Phallus
Penile curvature or angulation should be assessed for presence of hypospadias. Irregularity can cause an improper placement of the ejaculate within the vaginal vault.

3. Scrotum
The scrotal contents are examined by fingers while the patient is standing. The doctor should pay attention to testicular size and consistency and estimate the volume of the testis either with an orchidometer or by measuring the long and wide diameter of the testes to the nearest millimeter. It has been proved that a decrease in testicular size often indicates impaired spermatogenesis. Normally the length of the testis should be greater than 40 mm and the volume greater than 20 ml.

The doctor should also examine the peritesticular area for epididymal induration, irregularity, cystic changes, the presence of the vas deferens and any nodularity along its course. As a varicocele can cause abnormalities of gonadal function engorgement of the pampiniform plexus should be identified.
The most truthful results are gotten if the patient is examined in a warm room after standing for several minutes.

4. Digital Rectal Examination (DRE)
DRE is used for assessing prostatic size and examination for presence of prostatic and/or seminal vesicular induration, masses, or cysts.

Medical Treatment

Endocrine TherapyExogenous gonadotropin therapy is recommended only for infertile men with hypogonadotropic hypogonadism (secondary hypogonadism). The Leydig cells can be stimulated with LH for the production of high intratesticular testosterone levels and initiation of spermatogenesis. Such medicine as hCG (Pregnyl or Profasi) 2,000 IU taken three times a week is used to stimulate proper production […]