Male infertility is male inability to conceive a child during 12 months of regular tries without using contraception. Contrary to common belief, male infertility occurs as frequently as female infertility and is 35% of total number of infertility cases.
Types of male infertility
1) Obstruction
In this form the normal maturation of spermatozoids in testicles is not broken but there is a barrier on the way of spermatozoids movement from testicles in urethra. This may be caused by inherent absence or narrowing of a portion of seminiferous tubules, commissures left after inflammation, scar left after surgery, cyst, growth in genitalia or in near-by organs. Anatomical defects of penis (phimosis, penile curvature) may also cause obstructive infertility in males.
2) Secretory problem
In this form of infertility testicles cannot produce healthy spermatozoids in counts enough to fertilize ovule. Causes of this problem:
- genetic factors
- hormonal dysregulations
- severe chronic diseases (diabetes)
- past inflammatory diseases of genitalia (orchitis, parotitis, etc) including sexually transmitted diseases
Factors provoking disease:
- protein deprivation
- avitaminosis
- testicles trauma
- occupational hazards (ionizing radiation, high temperatures, contact with various toxins, etc)
3) Immunological problem
This form of infertility develops after tescticles trauma. Normally, testicles tissues are separated from blood stream with a special barrier. When testicles traumas occur, this barrier may get damaged which may put into contact testicles tissues with blood immune cells. Body starts to accept testicles as foreign formation and as a result develops immune reaction with formation of antibodies against testicles tissues. Antibodies may be developed also against apermatozoids. Antisperm antibodies may block spermatogenesis, break sperm motility, prevent spermatozoids from entering cervical canal of uterus, aggravate fertilization, interrupt fission and even contribute to termination of early pregnancy.
Diagnosis
First stage of examination includes accurate history taking (past fertilizations and urological diseases). Must be performed spermogram analysis, detection of immunologic infertility factor.
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