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General Practice 2023

Male infertility: 6 main causes and what to do

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Male infertility: 6 main causes and what to do
Male infertility: 6 main causes and what to do
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Male infertility corresponds to the man's inability to produce sperm in sufficient quantity and/or that are viable, that is, capable of fertilizing the egg and resulting in pregnancy. Many times a man's reproductive capacity can be influenced by lifestyle habits such as smoking, drinking alcohol frequently, being overweight or using illicit drugs, for example, reducing the production and quality of sperm.

In addition to being related to life habits, infertility in men can also be due to changes in the reproductive system, infections, hormonal or genetic changes, or be a consequence of varicocele, which is a type of varicose vein that arises in the testes and directly interferes with the production of sperm.

It is important that the cause of infertility is identified so that the urologist can indicate the most appropriate treatment, which can be with changes in habits, the use of medications, hormones or surgery.

The main causes of male infertility are:

1. Life habits

Some habits and lifestyle can decrease a man's reproductive capacity, such as smoking, drinking and being overweight, for example, because it can lead to metabolic and hormonal changes, which can decrease the ability to produce sperm. In addition, men who are frequently under stress can also experience hormonal dysregulation, which can interfere with reproductive capacity.

The use of injectable drugs, such as anabolics to gain muscle mass, for example, can also lead to infertility, as they can shrink the testes and, consequently, decrease sperm production.

What to do: In these situations, it is important to identify which factor may be related to infertility. In the case of smoking and alcoholic beverages, it is recommended to stop using, while in the case of obesity, it is recommended to change eating habits and practice physical activity, for example.

In the case of infertility related to the use of injectable drugs, it is important that the drug is stopped and the treatment is recommended by the doctor, especially if there is any other associated alteration.

2. Varicocele

Varicocele is the most frequent cause of infertility in men and corresponds to the dilatation of testicular veins, which promotes blood accumulation and increased local temperature, directly interfering with sperm production. This situation is more common to happen in the left testicle, but it can also happen only in the right or reach both testicles at the same time.Learn more about varicocele

What to do: When the doctor checks for dilated veins indicative of varicocele, the recommendation is that surgery be performed to solve the problem. The surgery is simple and the man is discharged on the same day or the day after the procedure, and can resume normal activities after about 1 week.

3. Reproductive tract infections

Some infections in the male reproductive system can reach the testes and result in alterations in the semen production process and in the quality of the sperm produced, being more common as a consequence of infection by the virus responsible for mumps.

In addition to infertility as a result of mumps, urinary infections that have not been identified or treated correctly can also reach the testicle and compromise sperm production.

What to do: It is important that the cause of the infection is identified so that the most appropriate drug is indicated to treat the infection, which may be antifungal, antiviral or antibiotic.It is important that the partner of the man with the infection also undergoes the treatment, even if they do not have symptoms, to avoid the recurrence of the infection.

4. Ejaculation problems

Some situations related to ejaculation, such as retrograde ejaculation or absence of ejaculation, can also be the cause of infertility, since the man cannot release semen at the time of orgasm or produces little or no semen.

What to do: In these cases, the treatment must be indicated by the urologist and consists of the use of drugs that favor the semen exit, such as ephedrine or phenylpropanolamine. However, when drug treatment does not work, sperm collection and artificial insemination may be necessary. Understand how ejaculation changes are treated.

5. Hormonal changes

Hormonal changes, especially with regard to the amount of circulating testosterone, can also cause infertility.In addition, the high production of prolactin, changes in the thyroid, use of anabolic steroids, presence of a tumor in the pituitary and radiotherapy can also interfere with the reproductive capacity of men.

What to do: In these cases, the treatment for infertility is recommended by the doctor according to the identified hormonal alteration and aims to regulate the amount of hormones and, thus,, favor the normal production of sperm.

6. Genetic problems

Genetic problems mean that a man naturally does not have sperm in his semen or produces sperm in a very small amount, causing the woman's egg to be fertilized.

How to treat: When infertility is due to genetic alterations, the couple's option to get pregnant is through assisted reproduction techniques, in which sperm are removed directly from the testicles with the help of a needle, and then they are placed in the woman's uterus for fertilization to occur.Another alternative is to do so-called in vitro fertilization, in which the man's sperm are joined to the woman's egg in the laboratory, forming an embryo that is then placed in the woman's uterus.

How the diagnosis is made

The main test performed to evaluate and diagnose male infertility is the spermogram, which must be recommended by the urologist, and which aims to assess the quantity and quality of sperm produced. This test is done from the laboratory analysis of a semen sample that must be collected on the same day in the laboratory after masturbation. Understand how the spermogram is done.

In addition to the spermogram, the doctor may request other tests to be carried out in order to identify the cause of infertility. Thus, the measurement of testosterone, thyroid hormones and prolactin, urinalysis, both type 1 urinalysis and microbiological examination of urine, pelvic ultrasound to evaluate the male reproductive system and physical examination may be indicated. which is especially important for the diagnosis of varicocele.

Learn about other tests that assess fertility.

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