Sunday, 6 August 2017

Male Infertility

Infertility affects approximately 1 out of every 6 couples. An infertility diagnosis is given to a couple who are unable to conceive over the course of one year. When the problem lies with the male partner it is referred to as male infertility. Male infertility factors contribute to approximately 30% of all infertility cases, and male infertility alone accounts for approximately one-fifth of all infertility cases.
Causes of Male Infertility

More than 90% of male infertility cases are due to low sperm counts, poor sperm quality, or both. The remaining cases of male infertility can be caused by a range of conditions including anatomical problems, hormonal imbalances, and genetic defects.

Sperm Abnormalities

Sperm abnormalities are a critical factor in male infertility. These abnormalities include:

Low sperm count
Poor sperm motility (movement)
Abnormal sperm shape
Risk Factors

Risk factors for male infertility include:

Varicocele, an enlarged varicose vein in the spermatic cord that connects to the testicle
Aging, which can reduce sperm counts and motility and decrease the genetic quality of sperm
Sexually transmitted diseases, which can cause scarring in the male reproductive system or impair sperm function
Lifestyle factors such as smoking and substance abuse
Long-term or intensive exposure to certain types of chemicals, toxins, or medications
Diagnosis

Sperm abnormalities can be caused by a range of factors, including congenital birth defects, disease, chemical exposure, and lifestyle habits. (See Risk Factors section.) In many cases, the causes of sperm abnormalities are unknown.

Sperm abnormalities are categorized by whether they affect sperm count, sperm movement, or sperm shape. They include:

Low Sperm Count (Oligospermia). A sperm count of less than 20 million/mL is considered low sperm. Azoospermia refers to the complete absence of sperm cells in the ejaculate. Partial obstruction anywhere in the long passages through which sperm pass can reduce sperm counts. Sperm count varies widely over time, and temporary low counts are common. A single test that reports a low count may not be a representative result.
Poor Sperm Motility (Asthenospermia). Sperm motility is the sperm's ability to move. If movement is slow or not in a straight line, the sperm have difficulty invading the cervical mucus or penetrating the hard outer shell of the egg. If 60% or more of sperm have normal motility, the sperm is at least average in quality. If less than 40% of sperm are able to move in a straight line, the condition is considered abnormal. Sperm that move sluggishly may have genetic or other defects that render them incapable of fertilizing the egg. Poor sperm motility may be associated with DNA fragmentation and may increase the risk for passing on genetic diseases.
Abnormal Sperm Morphology (Teratospermia). Morphology refers to shape and structure. Abnormally shaped sperm cannot fertilize an egg. About 60% of the sperm should be normal in size and shape for adequate fertility. The perfect sperm structure is an oval head and long tail.
Dietary Considerations

Everyone should eat a healthy diet rich in fresh fruits, vegetables, and whole grains. Replace animal fats with monounsaturated oils, such as olive oil. Certain specific nutrients and vitamins have been studied for their effects on male infertility and sperm health. They include antioxidant vitamins (vitamin C, vitamin E) and the dietary supplements L-carnitine and L-acetylcarnitine. To date, there is no conclusive evidence that they are effective.

Other Lifestyle Changes

Other tips for helping fertility include:

Avoid cigarettes and any drugs that may affect sperm count or reduce sexual function.
Overweight men should try to reduce their weight as obesity may be associated with infertility.
Get sufficient rest, and exercise moderately but regularly. (Excessive exercise can impair fertility.)
Stress may contribute to reduced sperm quality. It is not known if stress reduction techniques can improve fertility, but they may help couples endure the difficult processes involved in fertility treatments.
Although studies indicate that tight underwear and pants pose no threat to male fertility, there is no harm in wearing looser clothing.
To prevent overheating of the testes, men should avoid hot baths, showers, and steam rooms.
Avoid use of sexual lubricants (Astroglide, KY-jelly) as they may affect sperm motility.
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