2023-10-16 21:15:00
Often, in couples who are unable to conceive children, the woman is the first to be examined: many people know regarding female infertility. But sometimes the reason may be hidden in a man’s health. Let’s understand this phenomenon and dispel myths together with urologist Artem Loktev.
1. What is infertility and how does it happen in men?
Infertility is the inability to conceive a child within 12 months with regular, unprotected sex. In cases of couples in which the woman is over 35 years old, the period is already reduced to 6 months.
Interesting fact: even following 12 months, 50% of healthy young couples conceive in an additional 12 months. Therefore, sometimes it is not necessary to rush at a man and a woman in order to actively treat them. The maximum chance of conception is in the first 2 years.
Male infertility can be primary or secondary. Primary cases are those when a man has not yet had children or conceptions. Secondary – when conception has already occurred before, but at the moment it is not happening.
70–80% of infertility cases are associated with factors that we cannot accurately determine. About 10% are endocrinological factors, that is, changes in hormone levels. Somewhere else 10% is idiopathic infertility, when there are no changes in sperm parameters, but conception still does not occur. And regarding 5% are more rare cases, such as immunological infertility and so on.
2. Who is at risk?
First, there are risk factors such as smoking, alcohol and drug use.
Secondly, the use of anabolic hormones (testosterone, growth hormone), which negatively affects spermatogenesis, affects sperm quality.
Thirdly, some diseases can be called a risk factor: for example, varicose veins of the scrotum or varicocele – varicose veins of the spermatic cord of the testicle. At the same time, this does not mean that all patients with varicocele necessarily have infertility.
3. How is a spermogram taken correctly?
The main method for diagnosing fertility in a man is to perform a spermogram, that is, analysis of the ejaculate. Taking a spermogram presupposes abstinence. It is important that it should not be long – approximately from 2 to 5 days. Now there is evidence that, in principle, one day of abstinence may be enough. It is advisable to limit alcohol, smoking, prolonged exposure to a hot bath, and so on, a week before donating ejaculate.
Фото: Arif biswas / Shutterstock / Fotodom
4. Is it possible to detect infertility without a spermogram?
It is impossible to do without a spermogram. The only way we can externally assess a man’s fertility is to look at his genitals, that is, his scrotum. A urologist examines the genitals: if the testicles are not reduced in size, they have the same density, and the external genitalia are developed correctly, then with a high probability we can say that everything is fine with fertility. To find out everything in more detail, you need to take a spermogram.
If the testicles are small, there are probably some problems with spermatogenesis, that is, sperm synthesis. They are synthesized in the testicles by special cells – Sertoli cells. The problem may be the condition of these cells.
5. In what cases is male infertility not treated?
It also happens that a man has sperm, but there are no sperm in it – this pathology is called “azoospermia”. Therefore, you need to understand whether there are sperm, whether they are formed in the testicles and whether they reach the final stage – the ejaculate.
For this purpose, various hormonal studies are performed. A testicular biopsy may also be performed, where a piece of testicular tissue is assessed for the presence of sperm.
The complete absence of sperm in the ejaculate is not very common, in a few percent of cases, but it does occur. It is in these patients that the likelihood of natural conception is extremely low.
Some types of azoospermia cannot be treated.
6. Can overheating or tight underwear cause infertility?
For sperm quality to actually deteriorate due to overheating, you need to try hard. By the way, in Japan this was used as a method of contraception: men took very hot baths for a long time, which temporarily reduced fertility.
But still, there are no contraindications regarding tight underwear or heating, for example in a sauna. The main thing here is not to overdo it and not to do it on purpose.
7. Is it true that wearing diapers in childhood is a risk of infertility?
This judgment is a myth that has nothing to do with infertility. Rather, you need to pay attention to something else.
Фото: sirtravelalot / Shutterstock / Fotodom
During the fetal development of the child and following his birth, the testicles move from the abdominal region to the scrotum. Sometimes, if this process is disrupted, the testicle remains in the abdominal cavity or inguinal canal. This is called “cryptorchidism”, it is important to detect it in time and consult a urologist.
8. There is an opinion that men have a finite supply of sperm. Is it so?
This is a myth, there is no reserve. Men are fertile for the rest of their lives. Of course, sperm quality deteriorates with age, but there is definitely no sperm reserve that can one day be used up.
9. What methods of preventing infertility exist?
There is no convincing data on prevention, since many factors are related to genetics and cannot be influenced.
At the same time, there are methods for maintaining sperm quality – they are generally associated with a healthy lifestyle in general. But this is not regarding the fact that you must eat shrimp or cottage cheese – these are myths, this is not how it works. A balanced, proper diet, avoiding bad habits, sufficient physical activity, adherence to work and rest, sleep and wakefulness – all this leads to good sperm quality. There is nothing tricky. Everything just needs to be in moderation and balanced.
Cover photo: Yurchanka Siarhei, RealPeopleStudio / Shutterstock / Fotodom
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