Male Infertility Problems And Solutions Pdf

male infertility problems and solutions pdf

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Oligospermia is a male fertility issue characterized by a low sperm count. Other aspects of the sexual health of men with this condition are typical. This includes the ability to get and maintain an erection, as well as produce ejaculation at orgasm.

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Oligospermia and Fertility: What You Should Know

Request an Appointment. Most people will have the strong desire to conceive a child at some point during their lifetime. Understanding what defines normal fertility is crucial to helping a person, or couple, know when it is time to seek help. As a result, infertility has come to be defined as the inability to conceive within 12 months. We generally recommend seeking the help of a reproductive endocrinologist if conception has not occurred within 12 months.

However, there are various scenarios where one may be advised to seek help earlier. These include:.

History and physical examination — First and foremost, your fertility physician will take a very thorough medical and fertility history. Your doctor may ask you many of the following questions: How long have you been trying to get pregnant?

How often are you having intercourse? Do you have pain with menstrual periods or intercourse? Have you been pregnant before? What happened with your prior pregnancies? Have you had any sexually transmitted infections or abnormal pap smears?

How often do you have menstrual cycles? Do you have any medical problems or prior surgeries? Do you have a family history of medical problems? These and many other questions will help your physician design a specific evaluation and potential treatment for you. In addition to a careful history, a physical evaluation may also be performed.

Transvaginal ultrasound — Ultrasound is an important tool in evaluating the structure of the uterus, tubes, and ovaries. Ultrasound can detect uterine abnormalities such as fibroids and polyps, distal fallopian tube occlusion, and ovarian abnormalities including ovarian cysts. Additionally, transvaginal ultrasound affords the opportunity for your physician to assess the relative number of available eggs. This measurement is called the antral follicle count and may correlate with fertility potential.

Laboratory testing — Depending on the results of the evaluation discussed above, your physician may request specific blood tests. The most common of these tests include measurements of blood levels of certain hormones such as estradiol and FSH, which are related to ovarian function and overall egg numbers; TSH, which assesses thyroid function; and prolactin, a hormone that can affect menstrual function if elevated.

Hysterosalpingogram HSG — This test is essential for evaluating fallopian tubal patency, uterine filling defects such as fibroids and polyps, and scarring of the uterine cavity Asherman syndrome.

Many uterine and tubal abnormalities detected by the HSG can be surgically corrected. Semen analysis — The semen analysis is the main test to evaluate the male partner. There are four parameters analyzed: 1 semen volume — should be at least 1. A smaller amount may suggest a structural or hormonal problem leading to deficient semen production; 2 sperm concentration — normal concentration should be at least 20 million sperm per 1 ml of semen.

Abnormality in any of those regions may indicate abnormal sperm function and compromise the ability of sperm to fertilize the egg. An abnormal semen analysis warrants a further evaluation usually by a reproductive urologist. Your physician will refer you to a reproductive urologist if appropriate. However, in our modern era, women are delaying child birth until their thirties and forties, which has lead to the discovery of the adverse effect of advanced maternal age on egg function.

In fact, female age-related infertility is the most common cause of infertility today. For unknown reasons, as women age, egg numbers decrease at a rapid rate. And as aging occurs, egg quality, or the likelihood of an egg being genetically normal, decreases as well. Hence the ability to conceive a normal pregnancy decreases from when a woman is in her early 30s into her 40s.

A woman is rarely fertile beyond the age of This applies to the ability to conceive with her eggs, but not with donor eggs. Ovulation often can be detected by keeping a menstrual calendar or using an ovulation predictor kit. There are many disorders that may impact the ability for a woman to ovulate normally. The most common disorders impacting ovulation include polycystic ovary syndrome PCOS , hypogonadotropic hypogonadism from signaling problems in the brain , and ovarian insufficiency from problems of the ovary.

If your cycles are infrequent or irregular, your doctor will examine you and perform the appropriate testing to discover which problem you may have and present the appropriate treatment options. Tubal occlusion is a cause of infertility because an ovulated egg is unable to be fertilized by sperm or to reach the endometrial cavity. If both tubes are blocked, then in vitro fertilization IVF is required.

In some cases, simply removing the submucosal fibroid solves infertility. Often, but not always, submucosal fibroids can cause heavy periods, or bleeding between periods. There is more controversy regarding intramural fibroids, where larger ones may have an impact and may necessitate removal. Subserosal fibroids do not affect pregnancy. Your physician will examine you carefully to determine if you have fibroids and if removal is necessary.

Removal of polyps by the minimally invasive procedure hysteroscopy is associated with a doubling of pregnancy rate. In some cases, simply removing the polyp solves infertility. If a semen analysis is found to be abnormal, generally it is first repeated to confirm the abnormality.

Once confirmed, the male partner is referred to a reproductive urologist, especially if the abnormality is severe. In some cases, the reproductive urologist can improve semen function by recommending certain lifestyle changes, by hormonal treatments, or by surgery. In most cases however, sperm function may not improve and therefore any attempts at pregnancy may require additional treatments or procedures performed by our clinic. Intrauterine insemination is a process by which sperm is washed and prepared for placement into the uterine cavity, therefore bypassing the cervix and bringing a higher concentration of motile sperm closer to the tubes and ovulated egg.

At least one open tube is required for IUI, and the sperm abnormality cannot be severe otherwise the sperm will not be able to swim to and fertilize the egg. Intracytoplasmic sperm injection is a process by which semen is washed and prepared for direct injection of one sperm into each egg collected during the IVF process.

In order to perform ICSI, an egg is held via a small suction pipette, while one sperm is injected into that egg using a very fine glass needle. This process bypasses the normal fertilization process, which may be compromised due to poor sperm function. Your doctor will analyze your semen analysis carefully and help you decide if ICSI is an appropriate treatment for you. Endometriosis causes infertility by producing inflammation and scarring, which can result in not only pain but also potentially detrimental effects on egg, sperm or embryo.

Endometriosis can only be confirmed by surgery, usually laparoscopy. If endometriosis is found, it can be surgically removed by various methods, and its removal may lead to a decrease in pain as well as improvement in the ability to conceive naturally.

Your doctor will determine if you are at risk of having endometriosis based on a careful history, physical exam, and ultrasound. Thankfully, even when the cause of infertility is not known, various fertility treatments can overcome the unknown road block that was preventing pregnancy and eventually lead to delivery of a healthy baby.

Understanding the normal reproductive process is essential in knowing when to seek help. Helping our patients develop a deep understanding of their fertility options will make the process smoother. Our goal is to have each and every patient feel as part of our team, a team that is focused on helping them have a healthy baby.

The most commonly prescribed pill to stimulate ovulation generally of one mature egg is clomiphene citrate. This pill generally is taken from menstrual cycle days 3 — 7.

It works in the following way: Clomiphene is an anti-estrogen. It binds in a part of the brain called the hypothalamus, which is essential in stimulating the ovary to grow and release an egg. When clomiphene binds to estrogen receptors in the hypothalamus, it leads to an increase release of an important signaling hormone called GnRH gonadotropin releasing hormone.

This hormone then binds to another area of the brain called the pituitary gland and leads to the release of FSH follicle stimulating hormone , a hormone that directly binds to cells in the ovary, leading to egg growth and maturation. The most commonly prescribed injections that stimulate the ovary are called gonadotropins. These injections are taken nightly, typically for 5 — 10 days, and act directly on the cells of the ovary to stimulate egg development.

Once a follicle containing an egg reaches a mature size, another hormone injection called HCG is often given to mimic the natural LH surge that occurs at the time of ovulation. This leads to the final maturation and release of the egg.

In order to accomplish this, the semen is washed with a solution safe to sperm and eggs, and then centrifuged to separate motile sperm from immotile sperm and other cells. Those motile and viable sperm are then placed in a very small amount of solution, and then very gently and painlessly injected into the uterine cavity using a very thin, soft, and flexible catheter. At least one open tube is required for IUI, and any sperm abnormality cannot be severe, otherwise the sperm will not be able to swim to and fertilize the egg.

The first IVF baby was born in in England. IVF was a major breakthrough because it allowed for successful pregnancies in women that were previous deemed permanently infertile, such as when the fallopian tubes are both markedly damaged.

IVF involves removal of eggs directly from the ovary, fertilization with sperm in the laboratory, followed by transfer of the embryos directly into the uterus, thereby bypassing the tubes. Although tubal disease was the original indication for IVF, many more indications have developed over the years. These include advancing maternal age, severe male factor infertility whereby ICSI can be used to fertilize the egg , and endometriosis, amongst many others. The woman undergoes gonadotropin injections, which stimulate the ovaries to produce many eggs.

Once the follicles fluid filled sacs containing the eggs reach a mature size, an HCG injection is administered which leads to final development and maturation of the eggs. Just before those eggs would otherwise be ovulated, they are retrieved under mild anesthesia in an operating room. This procedure is done by ultrasound guidance when the surgeon utilizes a narrow needle to retrieve eggs from the ovary through the vaginal wall.

This sterile needle is attached to sterile suction tubing and a collecting vial. The sperm can either be mixed with the eggs to allow normal fertilization conventional insemination or by injecting one sperm into each mature egg ICSI. The fertilized eggs, now embryos, are allowed to grow and develop in culture media for typically 3 to 5 days. Then, generally one or two embryos, which have demonstrated appropriate development, are carefully and gently transferred into the uterine cavity.

Embryos transfer is performed in the office under abdominal ultrasound guidance using a small, soft, sterile and flexible catheter. The embryos are placed within the tip of the transfer catheter and then injected within the uterine cavity once the catheter is placed through the cervical canal to the ideal spot within the uterus.

Male Infertility

Request an Appointment. Most people will have the strong desire to conceive a child at some point during their lifetime. Understanding what defines normal fertility is crucial to helping a person, or couple, know when it is time to seek help. As a result, infertility has come to be defined as the inability to conceive within 12 months. We generally recommend seeking the help of a reproductive endocrinologist if conception has not occurred within 12 months.


Male Infertility: Problems and Solutions provides a summary of state of the art ; Digitally watermarked, DRM-free; Included format: PDF.


Infertility

It may be one or a combination of low sperm concentration, poor sperm motility, or abnormal morphology. The rates of infertility in less industrialized nations are markedly higher and infectious diseases are responsible for a greater proportion of infertility. The present literature will help in knowing the trends of male factor infertility in developing nations like India and to find out in future, various factors that may be responsible for male infertility. Infertility is a condition with psychological, economic, medical implications resulting in trauma, stress, particularly in a social set-up like ours, with a strong emphasis on child-bearing. According to the International Committee for Monitoring Assisted Reproductive Technology, World Health Organization WHO , infertility is a disease of reproductive system defined by failure to achieve the clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.

Male infertility refers to a male's inability to cause pregnancy in a fertile female. Factors relating to male infertility include: [7]. One of the most commonly known causes of infertility is Klinefelter syndrome , affecting 1 out of — newborn males [11] Klinefelter syndrome is a chromosomal defect that occurs during gamete formation due to a non-disjunction error during cell division.

Male Infertility: An Overview of the Causes and Treatments

Please understand that our phone lines must be clear for urgent medical care needs. When this changes, we will update this web site. Please know that our vaccine supply is extremely small. Problems with either of these may mean you have infertility.

Low sperm count means that the fluid semen you ejaculate during an orgasm contains fewer sperm than normal. A low sperm count is also called oligospermia ol-ih-go-SPUR-me-uh. A complete absence of sperm is called azoospermia. Your sperm count is considered lower than normal if you have fewer than 15 million sperm per milliliter of semen.

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Male infertility

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