Menstuff® has compiled the following information regarding
infertility. See also Impotency. Take this Fertility
Quiz 
.
Fertility Myths Dispelled, Debunked, and
Discarded
How Does a Man Find Out If He's
Infertile?
Male Infertility and Testicular
Cancer
Testicular Cancer and
Infertility Linked?
Surgery Lite: When You're TTC
How Does a Man Find Out If He's Infertile?
When evaluating a man for male factor infertility, semen analysis is done to look for problems with his sperm. These problems may include a low total sperm count. You may also hear terms such as morphology (the shape or size of sperm), motility (the movement of sperm) and agglutination (the clumping of sperm).
A very common cause of decreased sperm production is a varicocele. This is a condition in which a varicose vein develops in the scrotum. Varicoceles are found in 15% of all men but in up to 40% of men being evaluated for infertility.
Just like varicose veins in the legs, varicose veins in the scrotum prevent blood from flowing properly, and they increase the temperature of the testicles. This can affect both the quality and production of sperm. A left varicocele is more common than a right one, but the condition may occur on either side. Some varicoceles cause pain and/or decrease in the size of the testicle, but most cause no symptoms. Sometimes a varicocele can be felt either by the man himself or his doctor. It typically will feel like a bag of spaghetti when the scrotum is felt from underneath while the man is in a standing position.
Some Common Tests Top
Tests used to diagnose varicocele include ultrasound imaging of the scrotum and the use of a Doppler stethoscope, which allows the doctor to hear the blood moving through the scrotum. Varicoceles can be corrected surgically, restoring fertility.
When testing semen, doctors often will look for the presence of infections that can contribute to infertility. Sexually transmitted diseases like chlamydia and gonorrhea are two common examples of infections that can cause infertility. Fortunately, they can often be treated and fertility can be restored.
If semen analysis shows nothing significant, there are other tests that can be done to look for problems such as imbalances of male hormones or defects of the outer covering of sperm. Tests can also check the biochemical content of semen, the sperm's ability to penetrate and survive in the mucus of the woman's cervix, and the presence of antibodies that bind to sperm and destroy them. This last one is called an antisperm antibody test.
Physical problems of the testes (the sperm-producing glands) or male reproductive tract can also contribute to infertility in men. Some men have a condition called oligospermia, which means the sperm count is too low to achieve pregnancy. Others have something called azoospermia, which means their sperm count is zero. That doesn't necessarily mean no sperm is being produced, just that the sperm is not capable of getting out of the testes.
Other factors that can affect the quality of your sperm and how much of it you produce include exposure to chemotherapy, radiation, pesticides, and lead. Sometimes something less obvious may be the cause, such as taking hot saunas or baths or riding a bike for long periods of time, both of which can raise the temperature of the scrotum and affect sperm quality. Prostate disease, injury to the testicles, and some medications like those used to treat high blood pressure may also be factors.
Getting Pregnant When Male Factor Infertility Is Involved Top
If a blockage is causing azoospermia in the man, surgery often can correct it. If no blockage is found, most likely there is a sperm production problem. While some men have little or no sperm in their semen, the good news is that new technology now enables doctors to locate sperm between the cells of the testicles. Success rates for pregnancy are reported to be as high as 50% for men with non-obstructive azoospermia.
One of the most common treatments for male infertility and low sperm count is intracytoplasmic sperm injection (ICSI). This is a laboratory procedure in which sperm and eggs are retrieved from both partners and then a single sperm is injected into an egg. The fertilized egg is then implanted into the woman's uterus.
Success rates are generally good -- as high as 65% in some clinics -- but factors such as poor sperm quality, poor egg quality, and older age of the mother can lessen the chance of success.
Another new technique for men who are not manufacturing sperm and
have zero sperm counts is Round Spermatid Nucleus Injection (ROSNI ).
It involves removing immature cells from the testicle and separating
out the nucleus, which contains all the genetic material. The nucleus
alone is then injected into an egg. This technique is still
experimental and has not yet resulted in a live birth, but
researchers say it may one day offer hope for men who otherwise
couldn't have a biological child of their own.
Source: my.webmd.com/content/article/44/1819_50271
Male Infertility and
Testicular Cancer
Intrigued? Keep reading for more from the blog by WebMD's men's health expert, Sheldon Marks, MD.
Male Infertility and Testicular Cancer
You'd think that missing the diagnosis of a testicular cancer in a young, healthy male would scare the living daylights out of any doctor. But there exists in today's modern medicine a situation that continues to baffle me,where some bright doctors ignore the facts. Study after study has proven what urologists have known for years: that a significant number of men seeking evaluation for male infertility have a testicular cancer as the cause of their infertility!
Young men with fertility problems (poor or zero sperm counts) usually go to a fertility center. Almost always this is an OB/GYN that specializes in female reproductive issues or an OB/GYN that has done additional training after residency in female reproduction and is called a reproductive endocrinologist (RE). Because so many advances have been made in assisted reproductive techniques for the female, the cause of the husband's infertility is considered irrelevant. Sperm can be retrieved blindly and used to create a baby through the magic of ICSI with IVF. This technique is an amazing advance in helping infertile couples create a baby of their own. However, in the doctor's zeal to move ahead with the "baby making," the cause of the male's infertility is often of little concern . They can get sperm, so what difference does it make whatever the cause?
This is where the facts should help define "standard of care." There are two reasons why a urologist with special interest or training in male fertility should be an integral part of the fertility medical team.
There is a real risk that some of these men have a testicular cancer as the cause of their infertility. Without a urologic exam and appropriate studies, he may be able to father a child through IVF, while the undiagnosed cancer continues to grow until it becomes much larger or shows signs of being advanced (as with Lance Armstrong). This is obviously not good for the man, or his new family. Missing an opportunity for an early diagnosis may mean chemotherapy, radical surgery and increased chances for death.
Sometimes the urologist is able to diagnose and correct the cause of infertility, such as a varicocele, ejaculatory duct obstruction, or blockage of the vas. This could allow some couples to conceive naturally or without the risks and expense of ICSI with IVF.
So what can be done? First and foremost, couples need to be
informed about the causes and treatment options of infertility in the
male and female. Second, urologists need to be more involved in their
community when it comes to fertility issues. Urologists should also
work with the female fertility experts, reminding them of the
importance of being included whenever there are male fertility
questions. Lastly, doctors that prefer to ignore the potential risks
to their infertile male patients need to refer these patients to
urologists. This is not rocket science. It is good patient care. If
the doctors themselves won't initiate it, then informed patients must
demand it!
Source: blogs.webmd.com/mens-health-office/2006/01/male-infertility-and-testicular-cancer.html
Fertility Myths
Dispelled, Debunked, and Discarded
 |
|
 |
