Male infertility - Symptoms and causes
Written by specialized authors
Summary
Male infertility: the causes of male infertility
Diagnosis of male infertility: a male check-up
Tests indicated after clinical examination
Men are involved in 60% of the couple's infertility cases.
Before talking about male infertility, and before considering any medically assisted procreation, it is necessary to carry out a rigorous diagnostic process.
Male sterility: the causes of male infertility
Theoretically, a man can conceive children throughout his life, since he produces spermatozoa in a continuous flow from puberty onwards.
Main cause: alteration of spermatozoa and testicles
The causes of infertility in men are generally simpler than in women. Infertility is most often the result of an alteration of the sperm cells:
either the testicles produce too few or no sperm at all,
either the testicles function normally, but it is the excretory tract that is affected,
in some rare cases, the semen goes back up into the bladder at the time of ejaculation.
Infertility: hormonal, genetic, infectious and environmental causes.
The causes of sperm alteration can be multiple:
Causes of male infertility
Possible causes and Consequences
1.Anomaly of hormone secretion
Consequences
Sperm production can be affected: the testicle is not stimulated and no longer produces sperm.
2. Acute infection for example or chronic infection
Consequence
-Damage to the testicular tissue itself.
-Sometimes the testicles function normally, but it is the ducts that are damaged.
3.Genetic abnormalities (rare)
Consequence
In some cases, such as cases of cystic fibrosis :
-the excretory pathways do not exist,
-there are abnormalities in the production of spermatozoa.
These cases must be screened before any infertility treatment to avoid giving birth to a child with cystic fibrosis.
4.Environmental Causes
Consequences
-In many cases, no anatomical, genetic or hormonal causes are found.
-In industrialized countries there is a decrease in sperm production.
-Among the causes cited for the decrease in sperm production, the presence of toxic substances, polluting agents, could be responsible for certain sterility.
Diagnosis
Many infertile couples have more than one cause of infertility, so it is likely that both of you will need to see a doctor. Several tests may be necessary to determine the cause of the infertility. In some cases, the cause is never identified.
Infertility tests can be expensive and may not be covered by insurance. Find out in advance what your health insurance plan covers.
The diagnosis of male infertility problems usually involves
A general physical examination and medical history. This includes examining your genitals and asking questions about hereditary diseases, chronic health problems, illnesses, injuries or surgery that could affect fertility. Your doctor may also ask you questions about your sexual habits and your sexual development during puberty.
Semen analysis. Semen samples can be obtained in different ways. You can provide a sample by masturbating and ejaculating into a special container at the doctor's office. Because of their religious or cultural beliefs, some men prefer another method of semen collection. In this case, sperm can be collected using a special condom during sex.
Your sperm is then sent to a laboratory to measure the number of sperm present and to look for any abnormalities in the shape (morphology) and movement (motility) of the sperm. The laboratory will also check your sperm for signs of problems such as infections.
Often, the number of sperm cells varies considerably from sample to sample. In most cases, several sperm tests are carried out over a period of time to ensure accurate results. If your semen analysis is normal, your doctor will probably recommend that you have your female partner tested thoroughly before proceeding with further male infertility tests.
Your doctor may recommend additional tests to help identify the cause of your infertility. These may include the following tests
Ultrasound scan of the scrotum. This test uses high frequency sound waves to produce images inside your body. A scrotal ultrasound can help your doctor determine if there is varicocele or other problems in the testicles and supporting structures.
Hormone testing. Hormones produced by the pituitary gland, hypothalamus and testicles play a key role in sexual development and sperm production. Abnormalities in other hormonal or organic systems can also contribute to infertility. A blood test measures the level of testosterone and other hormones.
Urine analysis after ejaculation. The presence of semen in the urine may indicate that sperm are moving backwards into the bladder instead of out of the penis during ejaculation (retrograde ejaculation).
Genetic testing. When the concentration of semen is extremely low, there may be a genetic cause. A blood test can reveal if there are subtle changes in the Y chromosome - signs of a genetic abnormality. A genetic test can be ordered to diagnose various congenital or hereditary syndromes.
Testicular biopsy. This test involves taking samples from the testicle using a needle. If the testicular biopsy results show that sperm production is normal, your problem is probably due to a blockage or other problem with sperm transport.
Specialised tests of sperm function. A number of tests can be used to check whether your sperm survive well after ejaculation, whether they can penetrate an egg and whether there is a problem with attachment to the egg. In general, these tests are rarely performed and do not significantly change treatment recommendations.
Transrectal ultrasound. A small, lubricated wand is inserted into your rectum. It allows your doctor to examine your prostate and look for blockages in the tubes that carry semen (ejaculatory ducts and seminal vesicles).
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