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Yes, I\u2019m talking to you men, I guess it\u2019s in our culture, but every time a couple have difficulty having kids, it\u2019s almost always blamed on the woman.<\/p>\nYes, I\u2019m talking to you men, I guess it\u2019s in our culture, but every time a couple have difficulty having kids, it\u2019s almost always blamed on the woman.<\/p>\n
I don\u2019t know if there are figures for Dominica, but in the U.S., 10% to 15% of couples are classified as infertile, meaning they\u2019ve been trying to get pregnant with frequent, unprotected sex for at least one year with no success. Take note that I said one year \u2013 this is the definition. Many of you try for two months, and conclude somebody is infertile when you come up empty, then, of course, you run to the doctor.<\/p>\n
Half of cases result from MALE INFERTILITY, the causes which are many (see later). Even if the male has the difficulty, though, the female partner may also have fertility issues, so both may need treatment for a pregnancy to occur. But don\u2019t despair; help is out there, guys.<\/p>\n
SYMPTOMS OF MALE INFERTILITY<\/strong><\/p>\n The main thing is the inability for couples to get pregnant. There may be no obvious signs or symptoms. But if male infertility is caused by a hormonal problem, you may have things such as reduced hair growth on the face or body, or a low sex drive.<\/p>\n CAUSES<\/strong><\/p>\n Male fertility is a complex process that involves many factors, including an axis between brain and genitals involving hormones. To get his partner pregnant, a man must be able to deliver healthy sperm into the vagina that are able to reach, penetrate and fertilize a woman\u2019s egg. Take it easy now, guys, no need to get excited? And you women, too.<\/p>\n \u2022\u00a0\u00a0 \u00a0Sperm must have the proper shape and be able to move toward the egg for fertilization to occur. Abnormal sperm shape and structure may cause impaired mobility; sperm may not be able to reach or penetrate the egg.<\/p>\n \u2022\u00a0\u00a0 \u00a0There has to be enough sperm in the semen to make pregnancy possible. Sperm is what you can\u2019t see, semen is what it is transported in. Normal sperm concentration is greater than or equal to 20 million sperm per milliliter of semen. 10 million or fewer sperm per milliliter of semen indicates low sperm concentration (sub-fertility). Very rarely, a man is able to produce no sperm at all.<\/p>\n Generally, causes of male infertility include impaired semen production or function, impaired sperm delivery, lifestyle, and environmental exposure. Following are among the problems that can cause problems with sperm.<\/p>\n \u2022\u00a0\u00a0 \u00a0Varicococle. This is a swollen vein in the scrotum that may prevent normal cooling of the testicle, causing reduced sperm count and motility.<\/p>\n \u2022\u00a0\u00a0 \u00a0Undescended testicle. This is when one or both of your testicles (balls) fail to descend from the abdomen into the scrotum during fetal development. Because they are exposed to the higher internal body temperature, compared with that in the scrotum, sperm production may be decreased.<\/p>\n \u2022\u00a0\u00a0 \u00a0Testosterone deficiency (male hypogonadisur). Infertility can result from disorders of the balls (testicles) themselves, or an abnormality affecting the glands in the brain that produce hormones that control the testicles (the hypothalamus or pituitary glands).<\/p>\n \u2022\u00a0\u00a0 \u00a0Chromosome defect. Inherited disorders of the testes can cause abnormal development of the testicles.<\/p>\n \u2022\u00a0\u00a0 \u00a0Infections. Infections may temporarily affect how your sperm moves. STI\u2019s such as Chlamydia and Gonorrhea, are often associated with male infertility. These infections can cause scaring and obstruct sperm passage. If mumps occurs after puberty, testicular inflammation can impair sperm production. Prostatitis, urethritis or epididymitis also can affect sperm motility.<\/p>\n \u2022\u00a0\u00a0 \u00a0Hormonal disorders. These conditions affect the release of hormones needed for sexual development or sperm production. Anything affecting the delivery of sperm from the penis into the vagina can cause infertility. Examples of problems that can interfere with sperm delivery follow.<\/p>\n \u2022\u00a0\u00a0 \u00a0Sexual issues. Erectile dysfunction (ED), premature ejaculation (a form of ED), painful intercourse (dyspareunia) or psychological or relationship problems can contribute to infertility.<\/p>\n \u2022\u00a0\u00a0 \u00a0Blockage of epididymis or vas deferens. Some men are born with blockage of the part of the testicle that stores sperm (epididymis) or have a blockage of the tube that carries sperm (vas deferens) from the testicle out of the penis.<\/p>\n \u2022\u00a0\u00a0 \u00a0Retrograde ejaculation. This occurs when semen enters the bladder during orgasm (cum) rather than going out through the penis. Conditions causing this include diabetes, bladder, prostate or urethral surgery, and the use of certain medications.<\/p>\n \u2022\u00a0\u00a0 \u00a0No semen (ejaculate). This can occur in men with spinal cord injuries or diseases. This fluid carries the sperm from the penis into the vagina.<\/p>\n \u2022\u00a0\u00a0 \u00a0Misplaced urinary opening (hypospadias). A birth defect can cause the urethra to be abnormally located on the underside of the penis. If not surgically corrected, hypospadias can prevent sperm from reaching the woman\u2019s cervix.<\/p>\n \u2022\u00a0\u00a0 \u00a0Anti-sperm antibodies. Antibodies that target sperm or weaken or disable them usually occur after surgical blockage of part of the vas deferens for male sterilization (vasectomy). These antibodies may cause infertility.<\/p>\n \u2022\u00a0\u00a0 \u00a0Cystic fibrosis. These men often have a missing or blocked vas deferens. These include the following:<\/p>\n Alcohol and drugs:<\/strong> Alcohol and illicit drugs, anabolic steroids, cocaine, and marijuana may temporarily reduce sperm number and quality, Malnutrition:<\/strong> Deficiencies in Vitamin C, Selenium, Zinc and Folate may contribute to infertility. ENVIRONMENTAL EXPOSURE<\/strong><\/p>\n Heat, toxins and chemicals can reduce sperm production or function. Some causes include:<\/p>\n Pesticides and other chemicals:<\/strong> Herbicides and insecticides may cause female hormone-like effects in the male body and may be associated with reduced sperm production and cancer of the testicles. Lead exposure may cause infertility; beware painters. OTHER RISK FACTORS<\/strong><\/p>\n Some of the risk factors have been mentioned under \u201ccauses.\u201d Others include:<\/p>\n \u2022\u00a0\u00a0 \u00a0Age. Men older than 35 may have a gradual decline in fertility.<\/p>\n \u2022\u00a0\u00a0 \u00a0Celiac disease. This is a digestive disorder caused by a sensitivity to gluten. If untreated, it can lead to male infertility. Fertility may improve after adopting a gluten-free diet.<\/p>\n TESTING AND DIAGNOSIS<\/strong><\/p>\n Without going into a great deal of detail, I\u2019ll just say that we make the diagnosis by:<\/p>\n \u2022\u00a0\u00a0 \u00a0General physical examination and medical history.<\/p>\n \u2022\u00a0\u00a0 \u00a0Semen analysis. Everything about your sperm is analysed on a specimen produced by masturbating or interrupting sex, and getting it to the lab within half an hour.<\/p>\n If your semen analysis is normal, thorough testing of the female partner is recommended before further male infertility tests are recommended on you.<\/p>\n Depending on initial findings, more specialized tests may be recommended to determine male infertility cause.<\/p>\n \u2022\u00a0\u00a0 \u00a0Scrotal ultra sound The relevance or these tests have been alluded to already; the idea being to determine whether there\u2019s sufficient production of sperm or blockage of their passage.<\/p>\n TREATMENT<\/strong><\/p>\n Treatment for male infertility will depend on the cause, if one is found. Treatments include:<\/p>\n \u2022\u00a0\u00a0 \u00a0Surgery, such as for varicoceles, or an obstructed vas deferens.<\/p>\n \u2022\u00a0\u00a0 \u00a0Treatment for sexual problems. We\u2019re talking about ED in all its varieties. Counseling or medication are two of the approaches.<\/p>\n \u2022\u00a0\u00a0 \u00a0Hormone issues. Treatment with hormones or medications that change hormones levels may be recommended.<\/p>\n \u2022\u00a0\u00a0 \u00a0Assisted reproductive technology (ART). For a variety of structural problems mentioned before, sperm can be taken from the testicles or recovered from the bladder and injected into an egg. The most effective ART is in vitro fertilization (IVF). You must have heard or read enough about this already.<\/p>\n Sometimes, problems of male infertility can\u2019t be treated, and it\u2019s just impossible for a man to father a child. Doctor may in this case recommend to you and your partner that you consider either using sperm form a donor or adopting a child, depending on how bad you want one.<\/p>\n See you next week.<\/p>\n Dr. Victor Emanuel has been an educator of medical professionals in training, and the public, for over 20 years in Dominica. The contents of his articles are based on facts and research conducted, and not of his opinion.<\/strong><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"Yes, I\u2019m talking to you men, I guess it\u2019s in our culture, but every time a couple have difficulty having kids, it\u2019s almost always blamed on the woman. I don\u2019t know if there are figures for Dominica, but in the…","protected":false},"author":15,"featured_media":17122,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_cbd_carousel_blocks":"[]","footnotes":""},"categories":[49],"tags":[],"class_list":["post-19143","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-talk"],"acf":[],"yoast_head":"\n
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\nIMPAIRED PRODUCTION OR FUNCTION OF SPERM<\/strong><\/p>\n
\n
\nIMPAIRED DELIVERY OF SPERM<\/strong><\/p>\n
\n
\nGENERAL HEALTH AND LIFESTYLE<\/strong><\/p>\n
\n
\nTobacco smoking:<\/strong> Smokers may have a lower sperm count than non-smokers. This may even apply to secondhand smokers.
\n
\nEmotional stress:<\/strong> This will affect your hormones. The rest needs no more discussion.<\/p>\n
\n
\nObesity:<\/strong> This can cause hormone changes that reduce male fertility. If you\u2019re overweight and can\u2019t have kids, guys, lose the weight!<\/p>\n
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\nOverheating the testicles:<\/strong> Sitting for long periods (truck and bus drivers) or wearing tight clothing may increase your scrotal temperature and reduce sperm production. Frequent use of saunas or hot tubs may have the same adverse effect or sperm production and sperm count.
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\nCancer and its treatment:<\/strong> Radiation and chemotherapy treatment for cancer can impair sperm production. The closer the radiation treatment to the testicles, the higher the infertility risk.<\/p>\n
\n\u2022\u00a0\u00a0 \u00a0Hormone testing
\n\u2022\u00a0\u00a0 \u00a0Genetic tests
\n\u2022\u00a0\u00a0 \u00a0Testicular biopsy
\n\u2022\u00a0\u00a0 \u00a0Anti-sperm antibody tests
\n\u2022\u00a0\u00a0 \u00a0Vasography<\/p>\n