Not so long ago, women were most often blamed for family infertility. Today, existing statistics allow us to assert that in about half of the cases, the impossibility of having children in a couple is due precisely to male infertility. And no matter how the representatives of the strong half of humanity opposed this, the fact remains.
What it is?
The forms of male infertility are quite diverse. All of them can lead to the disintegration of the family, to the great personal tragedy of a man. In almost 99% of cases, the reason for the impossibility of having offspring in the stronger sex lies in a violation of the composition of the sperm. Semen with sperm is a rather sensitive and vulnerable environment; a variety of factors can affect it. A man can suffer inflammation, infection, even slightly injure the scrotum, and his ejaculate will no longer be considered healthy and capable of fertilization.
Men do not like to admit that the reason for their infertility may not lie in her. For such "stubborn" the Ministry of Health has statistics: only in 40% of cases the absence of children in marriage is due to female infertility. In 45%, the reason lies in the male factor, and the remaining 15% include cases of genetic incompatibility of partners and rare forms of infertility.
The probability of conception, it should be noted, is not so great in perfectly healthy men. If both mom and dad are doing well in reproductive health, the probability of conceiving a child on the first attempt is only 11-13%. Depending on the form of infertility in men with deviations in reproductive function, this probability decreases.
Infertility is talked about when a couple cannot conceive a child with regular unprotected sex throughout the year. For couples in which the age of the spouses is over 35 years old, the "critical" period is considered a period of six months. If during this time all attempts were unsuccessful, conception is called into question and an examination is scheduled.
Both women and men need to pass it. Only then can you establish the cause and find a way to eliminate it.
Norm
The main reproductive cell of a man is the sperm. The sperm carries the genetic information of the father. It is concentrated in the head of the sperm. The tail helps the cell move so that it can reach the egg.
Young sperm are born in the testes. This process begins during puberty in boys and continues throughout the life of the stronger sex. From the testicles, young spermatozoa enter the seminal ducts - the tubules, and at the time of ejaculation, mature cells mix with the seminal fluid, with the secretion of the prostate gland and enter the female genital tract.
The seminiferous tubules are very long. Almost motionless sex cells have to pass through them for a long time: about 2-3 months. During this time, they have time to mature. The final stage of maturation of sex cells takes place in the epididymis.
In the ejaculate of a healthy man, there are always live and dead sperm, and mobile and inactive cells. It is important that the ratio of healthy and strong spermatozoa is sufficient for fertilization, because only the most hardy specimens will get to the egg.
It is not enough for cells to develop - they still need to mature, passing through the tubules, and also to gain access to the secretory products of the male body. Male infertility is usually divided into three broad types:
- secretory - associated with secretion disorders at any stage of spermatogenesis;
- obstructive - associated with obstruction of one of the sections of the vas deferens;
- other forms associated with immune, autoimmune processes.
There are also more rare forms of infertility, usually genetic, in which healthy and viable germ cells are not produced at all or are produced, but critically little. But such cases are rare in the practice of a fertility specialist.
Infertility reasons
Secretory infertility
The reasons why men become unable to fertilize are many and varied. In all cases, except for congenital genetic infertility, they, in one way or another, are associated with a harmful effect on the processes of spermatogenesis or the mechanical release of ejaculate.
The secretory form of male infertility is most often associated with a violation of sperm production. The testicles do not produce enough healthy cells. In addition, it is customary to refer to the secretory form all morphological changes in the sex cells of a man, as well as violations of their mobility and vitality. If the sperm is not fast enough, and it has malformations and abnormalities (two heads, two tails, the absence of a tail and other variations of a distorted shape), then spontaneous conception is unlikely.
The most common cause of secretory infertility is varicocele. With varicose veins, the outflow of blood from the scrotum is hampered - "stagnation" occurs, which gradually leads to the suppression of the function of the testicles. Unilateral varicocele often turns into a bilateral form.
If a man is not provided with surgical assistance to eliminate varicose veins, then secretory infertility can become total and neglected.
The tissue that produces young sperm is very susceptible to fluid pressure and pressure. Therefore, infertility often develops against the background of dropsy of the testicle, as well as the existing inguinal hernia. Infertility can be caused by cryptorchidism or undescended testicles into the scrotum.... The risk of negative consequences is great if the boy has not received proper treatment before the age of seven.
Mumps (mumps) carried in childhood by a boy also poses a great danger to his reproductive function in the future. The mumps virus infects the glandular tissue, the salivary and gonads are affected.
The epithelium, which is capable of producing new germ cells, is very sensitive to radioactive radiation. Therefore, infertility and a decrease in reproductive functions are often diagnosed in men who live in areas that are unfavorable from the point of view of a radioactive background, and also work in hazardous industries where there is contact with radioactive substances.
Recently, doctors and scientists are increasingly talking about the effect on the spermatogenic epithelium and electromagnetic radiation, so wearing a cell phone on a belt is not only unfashionable, but also dangerous if a man plans to become a dad.
A special place in the causes of secretory infertility is given to the effect of hot temperatures. The testicles are taken out by nature outside the human body - they are always colder, their temperature is lower than body temperature. With prolonged and frequent exposure to high temperatures, all stages of spermatogenesis are disrupted... Therefore, with complaints about the impossibility of conceiving a child, men who work in hot shops, as well as those who like to steam in the bath, sit with friends in the sauna, increasingly come to the doctor. Even those who like to soak up the hot tub run the risk.
If, after water procedures, do not take a cool shower, normalizing the temperature in the scrotum, a man runs the risk of becoming infertile.
Heated car seats are also dangerous. Of course, it is very convenient, pleasant and comfortable to sit on a warm seat in winter, but we must not forget that the scrotum also heats up, and spermatogenesis is disturbed. Tight underwear, swimming trunks, thongs, as well as tight jeans, tightening the hips and scrotum, lead to impaired blood supply to the testicles and pathological changes in the spermatogenic epithelium.
Secretory infertility can develop against the background of syphilis, tuberculosis, gonorrhea. Often, sexual functions are inhibited by anticancer drugs, antibiotics and hormonal agents. Therefore, after a course of chemotherapy in the treatment of oncology, a man's reproductive abilities are insignificant, or infertility is diagnosed. Professional athletes who use steroid hormones to create beautiful body reliefs also often face the problem of infertility.
Temporary infertility can also develop in men who experience severe stress and anxiety a lot and for a long time. Secretory forms of infertility are found in men who abuse alcohol and nicotine. Even a couple of bottles of beer after work is a serious claim for spermatogenesis abnormalities. Vegetarianism very often leads to infertility - a lack of animal protein in the body provokes a disruption in the production of mobile and active sperm.
Unhealthy diet, especially junk food, can suppress the production of male sex hormones, which will gradually lead not only to obesity, but also to a decrease in fertility. In addition, a large number of concentrates and taste stabilizers, as well as preservatives, cause mutations in spermatozoa, making them unsuitable for conception.
Obstructive infertility
The reasons for this form of pathology lie in a mechanical obstacle to the movement of sperm. Most often, the root cause lies in the blockage of the ducts. This is mainly due to inflammatory processes, which include epididymitis, as well as orchitis and cysts. Chronic prostatitis can also lead to obstruction.
Sometimes the cause of the blockage in the vas deferens is syphilis or tuberculosis, but this is relatively rare. Much more often, injury to the duct area becomes possible after injury to the scrotum in a fight or gym.
Other reasons
Infertility in a man can be primary (from birth) and secondary (acquired), so about 10% of married couples cannot conceive a child, although each of the spouses has children from previous marriages. Old trauma or inflammation can lead not only to the blockages described above, but also to inappropriate male immune responses. In the body of a representative of the stronger sex, antisperm antibodies begin to be produced, which destroy sperm.
Such immune and autoimmune forms of infertility are difficult to treat, it is not always possible to cope with them. But for such men, the chance to become fathers still exists - reproductive assistive technologies such as IVF and ICSI come to their aid.
Symptoms
Male infertility does not have any specific symptoms if it is not associated with inflammation. A man may not realize for a long time that he has any problems with reproductive function, and only a visit to a doctor after a year of planning pregnancy helps to identify the problem.
In some cases, symptoms may appear. A man may notice that the sperm has changed color and contains impurities of pus or blood, and also has an unpleasant odor. A small amount of ejaculate should also alert, as well as increased viscosity, the presence of large mucous clots in the ejaculate.
If the violation of reproductive function is associated with an inflammatory process, the man will complain of pain, fever, pain during urination. With blockage, ejaculation as such may not occur, although the man will experience orgasmic sensations.
In the event that infertility has occurred as a result of chronic, advanced inflammation or infection, there will be practically no symptoms and signs of pathology.
Diagnostics
It is the diagnosis that most often scares men who are faced with the problem of infertility in the family. But there is nothing to be afraid of - most forms of pathology are successfully treated, however, provided that the diagnosis was complete and timely. While a woman is being examined and tested by her gynecologist, it is advisable for a man to visit a urologist-andrologist. The doctor will find out all the features of a man's life: the frequency of sexual intercourse, the place of work, the presence of trauma in the past, inflammatory or infectious diseases, after which he will prescribe general tests of blood, urine, a smear from the urethra for microflora and a spermogram. It is the spermogram that is considered the most complete and detailed examination of a man's fertile abilities.
It is recommended to take a sample of ejaculate after 4-5 days of abstinence and sexual rest. Longer abstinence has a detrimental effect on the characteristics of the semen - it becomes more viscous. Failure to comply with the regimen of sexual rest can make the ejaculate more fluid.
You can take a spermogram in a clinic through masturbation, or at home, collecting sperm by masturbation or interrupted intercourse. In the second option, it is important to deliver the container for biomaterials to the clinic as soon as possible, since after an hour the ejaculate will begin to lose its properties, and the conclusion may be incorrect.
The amount of ejaculate is normally about 3-4 ml, which is roughly equal to the volume of one teaspoon. If the number is less, we will talk about dysfunction of the testicles. If there are less than 20 million sperm in 1 ml of semen, the man will be diagnosed with oligozoospermia. If no spermatozoa are found in the sample, which happens when both seminal canals are blocked at once, then doctors will diagnose "azoospermia".
When at least half of the detected sperm cells are mobile and can not just move, but move straight and with sufficient speed, then this is considered normal. If the number of such motile and rectilinear moving sperm is low, then a diagnosis of asthenozoospermia will be made. In the event that motile sperm cells are not found at all, a diagnosis of necrospermia will be established.
Normally, about half of the sperm should be morphologically healthy. During the MAP test, as part of the spermogram, the patient's cells are compared with the existing standard - all defective cells are rejected. If the head, tail or neck of the sperm does not meet the rigid reference requirements in appearance, the cell is also discarded. For conception, it is necessary that a man's semen contains at least 40% of healthy and full-fledged cells.
If clots are visually detected in the ejaculate, the sperm is heterogeneous, then it is possible that the spermogram will show the presence of agglutination. It reduces the mobility of the germ cells, making conception difficult or impossible. If the spermogram shows an increase in the number of leukocytes, the doctor may suspect an inflammatory process and send the man for an additional examination - ultrasound, as well as undergo tests for sexually transmitted and genital infections. The doctor will do the same if pus is found in semen (pyospermia).
These sperm counts are considered inconsistent, and even the time of day can affect certain characteristics of the study. Therefore, a man should prepare for the fact that he may have to be tested again to check his fertility in dynamics.
Depending on the type of infertility identified, the true cause of the impairment of fertility is established. For full treatment, additional diagnostics may also be required - immunological blood tests, a blood test for a hormonal profile, radiography of the seminiferous tubules with contrast.
Treatment
It is quite possible to cure male infertility.The exception is cases of genetic, congenital infertility. For example, the absence of glandular tissue producing sperm, or malformations of the vas deferens that cannot be corrected. In all other cases, doctors can offer an individualized treatment regimen. According to statistics, it is possible to cure infertility in men in 85-90% of cases.
Treatment directly depends on the true cause of the pathology. If it lies in a varicocele or an inguinal hernia, then a man needs to undergo a surgical operation, after which he may well become a dad, because the cause of infertility will be eliminated. With inflammation, the exact localization and degree are established - at 1 and 2 degrees, treatment can take place at home, more advanced forms require hospitalization. In case of blockage of the seminal ducts, an operation is often prescribed, which completely removes the obstacle to the path of the germ cells.
DFor the treatment of inflammatory processes, antibiotics, anti-inflammatory drugs are used. After the end of the course of treatment, fertility is checked again and a course of therapy supporting spermatogenesis is prescribed.
Regardless of the reason that led to the factor of infertility, all men are prescribed vitamins, drugs to improve spermatogenesis (usually dietary supplements), sedatives designed to bring the psychological state of a man in order. Vitamin complexes for men must necessarily contain zinc, selenium, iron, B vitamins, vitamins A and E, and folic acid. Biologically active additives ("Spermaktiv", "Viardo" and others) contain zinc and selenium, as well as some plant substances that have a positive effect on the production and maturation of sperm.
All men who are treated for infertility are advised to correct their lifestyle, and very often this already has a decisive effect, and pregnancy occurs. Correction involves reducing excessive physical activity to moderate, giving up nicotine and alcohol, proper nutrition, which should be rich in animal proteins and fats.
A man must tidy up his weight: he must lose weight or gain the missing kilograms in order to reach a physiological norm. It is useful to give up working on the night shift, because during the night sleep, the body produces the necessary hormones that are involved in the work of the reproductive system. Working in hazardous production is a reason to find another income with no contact with heavy metal salts, paints and varnishes, nitrates.
Those who like to take a steam bath or sit in a sauna are advised to reduce such activities to a minimum, and it is better to abandon them altogether. All factors of overheating and compression of the scrotum should be excluded. You need to wear loose pants of the "family" type, loose-fitting trousers. Sexual intercourse is recommended on a regular basis: at least twice a week, so that the sperm has time to effectively renew itself.
Couples who intend to treat male infertility need to be patient, as the course of treatment can take quite a long time: from three months to a year. Most men manage to cope with the problem and improve sperm counts in six months. If treatment and adherence to all recommendations during the year does not bring the desired result, then hormonal treatment is prescribed.
In some pathological conditions, for example, with a large dropsy of the testicle or oligozoospermia of 1-2 degrees, a woman is artificially inseminated with her husband's sperm, in which it is injected into the cervix. If spermatogenesis disorders in a man are significant, and treatment, including hormonal treatment, does not give a result, then insemination with donor sperm is recommended for the couple.
The decision to donor insemination is voluntary. Many couples do not agree to this, since the man does not believe that the born child will be his child.
Modern reproductive technologies make it possible to fertilize a woman even with her husband's dead sperm, however, provided that the reproductive cell is not damaged by the structure of the head and there are no violations in the DNA information. In this case, fertilization is carried out in a microscopic way, after taking the egg from the woman. If conception has taken place, the embryo is implanted into the uterine cavity and preserved with the help of hormonal therapy.
Hormone treatment
As already mentioned, doctors try to resort to hormone therapy only when sperm motility is severely impaired, as well as in the absence of effect from other methods of treating infertility. As the main treatment, hormones are prescribed in the case when the very cause of infertility lies in the imbalance of hormones.
Treatment can be carried out with a blocking method. Its essence is quite simple: for several months the patient takes pills that completely block the production of new germ cells at the hormonal level. After a man stops taking medication, the body with double forces begins spermatogenesis and the spermogram indicators usually improve significantly.
Despite the rather impressive results from such blocking treatment, this method is used relatively rarely. Doctors always try to leave room for the intervention of inexplicable "higher" forces, because sometimes a man who simply takes vitamins, after several years of infertility, suddenly becomes a dad.
More often, hormonal treatment is carried out according to a stimulating method. It is based on the introduction of small doses of hormones, which, on the contrary, stimulate the process of sperm production, but do not affect the pituitary gland and hypothalamus. The course of treatment is long: from the beginning it takes from 9 months to one and a half years... All this time, the man will have to conduct a spermogram every three months (this is how long one spermatogenesis cycle lasts) to determine the effectiveness of the treatment provided.
In some cases, doctors do not go for hormone therapy. If they believe that such treatment has no prospects, then they immediately recommend assisted reproductive technologies or other options.
Psychology
It is not for nothing that a man who is being treated for infertility is recommended sedative sedatives. The psychological consequences that can follow the news of the impossibility of conceiving a baby can be devastating. Stress itself contributes to the aggravation of the situation. Added to this is depression, loss of interest in having sex with his wife, and loss of tenderness in relationships with a partner.
However, pills and herbal teas that act as sedatives are far from all. A man needs to be helped to come to an understanding of a simple truth that is obvious to every woman: the biological father is not a father yet, but the one who raised and raised is a real father.
That is why, in the process of treatment, it is desirable that a man and his wife visit a psychologist or psychotherapist, who will help get rid of prejudices and oppressive internal tension, help to look at the situation from different angles.
Very often, a man who accepted the situation, resigned himself to it, stopped being nervous and worried, unexpectedly for everyone, becomes a biological dad. The fact is that stress hormones block the production of sex hormones and have a detrimental effect on testosterone levels. When the stress factor disappears, the man becomes calmer, and after a while sperm counts improve.
The most common example is adoption. When there are no more hopes for treatment and other methods, everything has been tried, the couple decides to adopt the baby. They calm down, focus on raising a child, more often experience positive emotions, and suddenly become pregnant.
Treatment with folk remedies
Alternative medicine has accumulated a myriad of recipes and methods that, according to healers, increase male fertility. It should be noted that all recommendations are based on adherence to a healthy lifestyle, and in this, traditional healers are in full solidarity with their colleagues from the field of official medicine. If a man continues to abuse alcohol, drugs, nicotine, lies on the couch and does not want to lose any of his 200 kg, then no folk and traditional remedies will help.
Traditional medicine should be regarded as an adjunctive therapy in the treatment of male infertility. In no way does it cancel the traditional treatment, which is selected on an individual basis, but can enhance the effect and help a man become a dad.
Also, you should not practice treatment with folk remedies without the agreement of your doctor, since herbs are not at all as harmless as they might seem.
Different types of male infertility require different approaches, and there are no universal recipes. For example, freshly squeezed pumpkin juice is used to increase sperm motility. His man is advised to take a glass on an empty stomach every morning. And to improve the morphology of sperm, honey and bee products are useful, of course, provided that the man is not allergic to them.
Since ancient times, healers have revered St. John's wort for increasing male strength. The dried branches of this herb are burned and fumigated with them in the room in which the man is, once a day. Inhaling this smoke has a positive effect on sperm production. Men living in mountainous regions and in the south have long used fresh quince juice, drinking a tablespoon of it in the evening before going to bed.
Traditional medicine praises the properties of plantain seeds for treating infertility in men. A tablespoon of seeds is brewed in a glass of water, let it brew and take a tablespoon twice a day. The same broth is added to the bath for water treatments. It is important that the temperature of the water in the bath does not exceed 37 degrees.
A real storehouse of phytohormones is sage. A tablespoon of herbal raw materials is brewed in a glass of boiling water, simmered for five minutes in a water bath, after which the resulting broth is divided into three equal parts. Take once a day for a third of a glass. Alternative medicine offers an exquisite recipe from rose petals to especially romantic young ladies. Red and rose petals are rich in vitamin E, so you can make homemade syrup from them and treat your loved one during daily tea drinking in the amount of 2-3 tablespoons.
Instead of tea, a man can be offered a decoction of an adonis or rosehip. Traditional medicine is highly valued for men's health and Adam's root. It can be purchased at pharmacies. Two tablespoons of the root in a thermos of boiling water is insisted for at least a day, after which they offer the man two tablespoons three times a day.
For a long time, infertility in men was treated with leeches. Hirudotherapy allows you to achieve a point effect. For example, a leech installed at a biologically active point improves blood circulation in the pelvic organs, which has a positive effect on any stage of spermatogenesis. Special substances that leeches release into the human body reduce the level of fibrinogen and make the blood thinner. A man will definitely notice a general improvement in well-being, strengthening of immunity, and after a while it is possible that he can become a dad.
Hirudotherapy sessions should be conducted by qualified specialists. Leeches should only be used once. A clinic that provides such services must have all permits and certificates in order. In case of male infertility, leeches are placed on the area around the anus, in the perineum, and the tailbone and sacrum are captured.
Sulfur baths and mud clinics are also useful. At resorts that have such natural resources, the number of sessions and their duration for different types of infertility in men is determined by the doctor.
Homeopathic remedies, which are advertised by manufacturers as very effective for infertility, are usually expensive, but, alas, they do not have proven effectiveness, like Kagocel, for chickenpox. Therefore, you should not pin any special hopes on them.
Reviews
Reviews about the treatment of infertility in the stronger sex are rarely left by men themselves, since this topic is delicate, and men prefer to remain silent about it. But women are very actively discussing various treatment regimens for their spouses, emphasizing that the success of therapy depends on the woman by 80%. It is women who have to control so that the husband does not forget to take the prescribed medication during the long course of treatment, and it is they who take care of proper nutrition and maintaining a healthy lifestyle for men.
Treatment of male infertility is a common, family matter. Much depends on the overall focus on the ultimate goal. In most cases, according to women, it is still possible to cope with the problem, and pregnancy occurs naturally.
The women leave the best reviews about the drugs "Spermaktiv", "SpermaPlant", "Speroton", "Spermastrong". Among the vitamins are "Selenzink", as well as "Duovit" and "Alphabet" marked "For men".
Very few people resort to the help of a psychologist - women usually fail to lure their husbands to such a specialist.
For the reasons for male infertility, see the next video.
