What is Couple-Infertility?
We talk about Couple-Infertility, when a sexually active man and woman fail to procreate after 12-24 months of reproductive purposes. According to statistics, a healthy couple of about 25-30 years with a regular sex life has one in four chances of getting conceived every year.
In contrast, according to an estimate by the World Health Organization (WHO), around 10-20% of couples in industrialized countries suffer from fertility problems. In the past "the faults" were attributed mainly to women. Female infertility accounts for one third of infertility cases, male for another third, combined infertility for 15% and the rest remains "unexplained".
These reproductive alterations of the male in a high percentage of cases can arise in the pediatric or pubertal age. In fact the statistics tell us that around the age of 15-20 a boy of two is at risk of infertility.
There are various factors that can affect the fertility of the male in a negative sense.
The bad daily habits and the low quality of life style (smoking, alcohol and drug use, inactivity, stress, obesity) are important risk factors for reducing the fertilizing capacity of the sperm. They also involve impairment of fertility specific andrological pathological situations such as varicocele, the undescended and abdominal testicle as well as infections that can affect the prostate (prostatitis) or the testicles (orchitis).
From this point of view, mumps, if are contracted in the post-puberal period, can "descend" as they are commonly known to the testicles and damage them irreversibly.
There are also important pathological conditions such as hypogonadism, in which qualitative and quantitative alterations of spermatozoa are accompanied by low testicular volume and low levels of circulating testosterone. Not to forget then that the chronic use of some medicines, above all psychotropic drugs, can compromise the fertility of the man, either through a direct damage on the spermatozoa, or through a phenomenon called retrograde ejaculation, for which the sperm no longer comes out from the outside , but it goes into the bladder with consequent impossibility to procreate.
How is Male Infertility diagnosed?
The history of the patient must be examined with particular reference to the habits of life and pubertal age and of development, it is also necessary to perform a specific in-depth medical examination to evaluate the external genitals and the prostate. Laboratory tests usually include the execution of at least two seminal fluid tests at a distance of 15-20 days from each other, a complete blood test, cultural analysis of urine and hormonal tests.
The seminal fluid test is the pivotal examination in this area, as it provides us with precise information on possible quantitative and qualitative alterations of the spermatozoa. It is often useful to also perform an ultrasound of the entire urogenital system to highlight congenital or acquired pathologies of these structures that can influence human fertility.
How is Male Infertility treated?
Once a diagnosis has been made with the above tests, we move on to the therapeutic phase. It can range from the removal of a varicocele (varicose veins around the testicle that can damage it) if present, to drug therapies in the case of prostatitis, urogenital infection or hypogonadism.
If a picture of azoospermia emerges from the seminal fluid tests (absolute lack of spermatozoa in the ejaculate), through particular percutaneous techniques (TEFNA), or surgical and microsurgical procedures, called TESE and Micro-TESE, the testicles can be accessed directly to take the sperm.
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