Diagnosis in male infertility
The medical definition of male factor infertility is: a male being unable to make his partner conceive after a year of unprotected intercourse, having abnormal semen characteristics or sperm functionality, or being unable to deliver semen into the vaginal canal.
Male fertility problems may be hard to diagnose. Most frequently, problems with sperm delivery or production are the causes. A thorough history and physical exam are the first steps in the diagnosis.
What occurs under normal conditions?
Conception occurs when a woman's egg mates with a man's sperm. To transport sperm to the female reproductive system during sexual activity, the penis ejaculates sperm produced and stored in the testicles.
Problems that impact the function of the testicles are the most frequent causes of infertility in men. Abnormal hormone levels or obstructions in the male reproductive organs are other possible issues.
Causes of male infertility
It takes a variety of factors to produce mature, healthy sperm that can travel to the vaginal canal. The development of sperm might be hampered by various factors. Also, the sperm may be prevented from reaching the egg due to a number of reasons. Fertility may be impacted even by scrotum temperature.
The main reasons for male infertility are as follows:
- Disorders with the sperm
Problems with sperm might result from genetic characteristics. A poor lifestyle could result in less sperm. Sperm quantity can also become reduced by smoking, drinking alcohol, and using certain drugs. Moreover, low or no sperm production may result from reproductive system damage.
Scrotal varicoceles are enlarged veins. About 16 out of every 100 males have them. They affect 40 out of 100 infertile males. Varicoceles prevent normal blood drainage, which hinders the development of sperm.
- Retrograde Ejaculation
Semen moves backwards in the body during a retrograde ejaculation. Instead of exiting your penis, they enter your bladder. This occurs when your bladder's nerves and muscles fail to contract during an orgasm. Surgery, medicine, or nervous system health issues can all lead to retrograde ejaculation.
- Immune-related infertility
There are situations when a man's body produces antibodies that target his sperm. Sperm movement and function can be hindered by antibodies. It could be challenging for sperm to reach the fallopian tube and penetrate an egg.
The pituitary gland releases hormones that instruct the testicles to produce sperm. Extremely low hormone levels result in poor sperm development.
Sperm can occasionally become blocked in the channels through which they travel. Infections that recur, surgery (such as a vasectomy), oedema, or developmental flaws can all result in obstruction. The testicles' sperm cannot exit the body after ejaculation if there is a barrier.
There are a number of procedures that are conducted to make a male infertility diagnosis.
It's common practice to analyse semen in the lab. These tests show the quantity and efficiency of sperm produced. An example of testing sperm is to check their movement, which is measured as sperm motility.
If the sperm count is abnormal, the test is often run at least twice. One must masturbate into a clean cup to gather semen. The semen sample is then investigated. Tests can be done to see if it helps or hinders conception (fertilisation).
Additional tests to detect male infertility
- Scrotal ultrasound: This test can assist the doctor in determining whether the testicles and supporting structures have a varicocele or other issues.
- Transrectal ultrasound: It enables the physician to examine the prostate and check for obstructions in the channels that transport sperm.
- Post-ejaculation urinalysis: Sperm in urine can be a sign of the sperm moving backwards into the bladder rather than out of the genitals (retrograde ejaculation).
- Testicular biopsy: In this procedure, samples are taken from the testis using a needle. The infertility problem is probably caused by a blockage or another issue with sperm transport if the results demonstrate that sperm production is normal.
- Hormone testing: The generation of sperm depends heavily on hormones. Infertility can be highly impacted by abnormalities in an organ or the hormonal system.
Male factor infertility is characterised by abnormalities in the semen analysis or by insufficient ejaculatory or sexual function. There are many possible causes for it. Though it may be hard to ascertain, it can be diagnosed and tested by various standard steps and procedures.
The DNA of the male is carried by sperm to the egg, and fertility can be impacted by chromosomal changes in their quantity and shape. For instance, there could be gaps in the male Y chromosome, which affects fertility.
If, after a year of trying, the female spouse does not get pregnant, the male partner may be experiencing male infertility. This entails a full year of regular sexual activity without the use of contraception.
Male fertility is diagnosed by first studying the history and conducting a physical examination. Tests are then done if required.