Nowadays having a child is imperative!
Children at all costs, with great
expenditure of energy and money! Have you thought, instead, that some
unfortunate child is looking for you?
The causes of a missed pregnancy are often to be found in men or women (33% and
33%) or in couples. In fact, if partners are often changed and if the
relationship is properly conducted, it is possible to become pregnant; this may
depend on whether the semen is more fertile, or, conversely, the woman is more
receptive.
The proof is the fact that both spouses must undergo a series of
tests. Meanwhile, what tests does the doctor prescribes, considering that out of 10
couples, 4 couples will have difficulty in procreation?
Before prescribing the investigation aimed at her, let's see what investigations
are indicated in the search for male infertility.
First of all, the examination of the seminal fluid is required.
The semen analysis, also known as a sperm count test, analyzes the
health and viability of a man's sperm. is the main laboratory survey to which a man
is subjected in this phase.
The seminal exam provides:
- quantitative values (number of sperm)
- qualitative values of the liquid (sperm vitality)
It must be repeated, especially if it's a negative test, after two or three months, or after a cure
by
hormones (eg gonadotropin hormone).
The seminal fluid necessary for these tests must be taken in a sterile manner,
with hands and genitals washed in sterile containers, e.g. for
urinoculture, which must be opened and closed immediately.
We'll have the follow clinical pictures::
- Aspermia: if there is no seminal fluid.
- Hypospermia: if the volume is less than 2 ml.
- Hyperspermia: if the volume is more than 6 ml.
- Azoospermia: if there are no sperm in the seminal fluid.
- Oligospermia: if the number of spermatozoa is less than 20,000,000 per ml.
- Astenozoospermia: if the motility is less than 50% of the total number.
- Teratozoospermia: when spermatozoa but formed exceed 50%
The causes of male infertility can be identified:
- Inability or decreased ability to produce normal spermatozoa.
- Inability to bring the seed produced outside
- In the varicocele.
- In surgical trauma.
- In the formation of anti-sperm antibodies.
It is a varicose dilation of the veins of the scrotum, which can interfere with
the production of sperm because it raises the temperature of the testis. The
patient feels a discomfort to the scrotum: like a weight, especially to the left
while the doctor feels the vein dilated by touch. The spermiogram is
investigated because it is not said that the presence of varicocele always
causes changes in the number of spermatozoa, therefore the Eco-Doppler, an
examination that, by observing the circulation in the blood vessels, allows to
evaluate the extent of the disorder. The varicocele is treated with surgery.
This is a very simple operation, which requires only one day of hospitalization
and consists in the removal of the dilated vein by cutting at the groin. The
intervention, however, should be performed as soon as the disturbance is noticed:
the varicocele, in fact, affects fertility very gradually, so the first action
is taken and the risks for fertility are less.
It is the missed or incomplete descent of one or both testicles of the scrotum.
It is a congenital defect, all the more serious for fertility purposes if it
involves both testicles (bilateral cryptorchidism).
Cryptorchidism is detected with the visit of the genital organs. The only
effective intervention is the orchiopexy, which consists in the repositioning of
the testis in its seat, which causes a recovery of the. Until recently, it was
considered impossible to improve the functionality of the testicle out of place
in the adult: the doctors thought that the operation should be performed within
5 years, otherwise the ability to produce spermatozoa would have been
compromised. On the contrary, recent research has shown that there is no certain
correlation between the age at which the intervention is performed and the
results obtained.
Untreated inflammatory forms, if they become chronic, can cause infertility and
sometimes even sterility. Infections caused by venereal diseases (such as
gonorrhea and syphilis) or other sexually transmitted diseases (Chlamydia) can,
in fact, determine the obstruction of the canal (the vas deferens) that goes
from the testicle to the seminal vesicle. In this case, the absence of
spermatozoa in the ejaculated liquid depends on a mechanical obstacle that
prevents their passage from the testis through the vas deferens.
How to check: the most suitable test to check for infections and Stamey's test.
This method is divided into three phases. First, a urine culture is performed,
i.e. the search for bacteria in the urine. Then we proceed with the prostatic
massage (done by inserting a finger into the rectum to push and stimulate the
prostate to secrete prostatic fluid, an important constituent of the seminal)
and with the culture (search for bacteria) of the prostatic fluid emitted from
the penis. Finally, the patient urinates again (to carry out a sort of washing
of the urethra in which the prostatic liquid has converged) and a second urine
culture is performed. Once the germ responsible for the infection has been
identified, a treatment based on specific antibiotic drugs must be started
immediately.
Sperm production may not normally occur if the hypophysis (it is the gland at the base of the brain that processes numerous hormones and supervises the functioning of other glands) does not secret hormones in sufficient quantities. This hormonal deficit is called hypogonadotropic hypogonadism and is caused by the insufficient production of gonadotropins FSH (follicle-stimulating hormone that stimulates sperm production in humans) by the hypophysis. Genetic abnormalities. In recent years, thanks to studies and research on genes (the particles of chromosomes carrying hereditary characters), constitutional anomalies have been discovered that can determine the total absence of spermatozoa (azoospermia) or the production of an insufficient number of spermatozoa at conception (oligozoospermia). In particular, the connection between the secondary incapacity and the lack of some genes located on the Y chromosome (it is part of the XY pair, which indicates the two sex chromosomes of the male cell) has been ascertained. How to check: the anomalies are diagnosed with a blood test aimed at finding genes located on the Y chromosome. When the number of spermatozoa is very small, a particular in vitro fertilization procedure can be used. This is the technique with microinjection, which allows to inject, with a glass micropipette, a single spermatozoon inside the egg cell.
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