Causes of infertility in men - varicocele, mumps, cryptorchidism, other factors. Medical blog

The failure of attempts to conceive a child in about 30 percent of cases is associated with male infertility. It is most often caused by a decrease in the quality of sperm, which manifests itself in a violation of the structure, motility and quantity of sperm contained in it. Such violations occur due to bad habits, previous infections, diseases, injuries.

Nowadays, the treatment of male infertility by an andrologist is quite effective in most cases.

What happens in the body of a healthy man

Conception of a child, as is known, occurs a certain time after the fusion of the sperm and the egg - the male and female reproductive cells. Therefore, a man's ability to conceive is determined mainly by the condition and number of his sperm.

The formation of sperm in a man's body occurs continuously. The full cycle of their development lasts about 70 days. In the testicles of a healthy adult man, up to several tens of millions of germ cells mature daily, capable of giving rise to a new life.

After maturation, sperm from the testicles move along the vas deferens and ejaculatory ducts to the prostate (prostate gland), near which each duct expands, forming a seminal vesicle. In the ducts and seminal vesicles, sperm mix with the secretion of the prostate gland and seminal vesicles - seminal fluid, forming sperm. At the moment of orgasm, with a strong contraction of the seminal vesicles, prostate gland and walls of the vas deferens, sperm is ejected from the male genital tract through the urethra - ejaculation occurs.

Male infertility can manifest itself in the following:

• insufficient production of sperm;
• irregular shape of sperm and, as a result, their low mobility;
• obstruction of the vas deferens, preventing the release of sperm at the moment of ejaculation.

Possible causes of infertility in men

Testosterone deficiency

Impaired production of sex hormones can cause infertility in men suffering from endocrine diseases or genetic disorders. In this case, impotence, weak facial and body hair, high voice, obesity, excessively tall stature, etc. are often observed.

Varicocele

It is considered one of the possible causes of male infertility and is a condition in which there is a pathological expansion of the veins of the spermatic cord - varicocele. In this case, sperm analysis can detect:

• decreased sperm motility (asthenospermia);
• absence or sharp decrease in the number of sperm in the seminal fluid;
• absence of sperm shape (teratospermia).

According to research, men with varicocele are approximately twice as likely to have difficulty conceiving a child. It is assumed that the reasons for this are related to this condition - a violation of the thermoregulation process of the testicles (stagnation of blood around the testicles leads to their overheating).

Sperm formation, as is known, occurs most actively at a temperature of 2-3? C below the normal temperature of the human body (for this reason, the testicles are located in the scrotum, where the temperature is lower).

Epidemic parotitis (mumps)

Inflammation of the testicles in epidemic parotitis (mumps) can cause male infertility, but only if both testicles are affected at once, and this happens in very rare cases. Inflammation of one testicle has virtually no effect on the reproductive function of a man.

Cryptorchidism

Failure of the testicles to descend into the scrotum - cryptorchidism - is also one of the factors that can lead to infertility. In cryptorchidism, sperm production in the testicles is disrupted. A spermogram shows a decrease in the number or even a complete absence of sperm in the semen. Fortunately, this happens quite rarely, because:

• most often only one of the testicles does not descend into the scrotum, and the second, descended one, produces a sufficient number of healthy sperm;
• usually cryptorchidism is detected in boys at an early age, as a result of which it is successfully treated with conservative or surgical methods.

Inflammatory diseases

Chronic inflammatory diseases of the male urogenital system (prostatitis, posterior urethritis, vesiculitis, orchitis, etc.) lead to blockage of the vas deferens, changes in the composition of the ejaculate and, as a result, a decrease in reproductive capacity.

The most common cause of infertility in men are various sexually transmitted infections (gonorrhea, syphilis, mycoplasmosis, chlamydia, ureaplasmosis, trichomoniasis). In advanced cases, they can cause blockage of the vas deferens and reduce sperm motility. Of particular danger in this regard is the possibility of a latent (asymptomatic) course of such diseases, in which infertility may be their only manifestation.

Testicular Injuries

Past injuries can cause various disorders in the reproductive system, including the inability to have children.

Gurogenital System Malformations

Infertility can also be caused by some congenital anomalies, such as the absence or underdevelopment of the seminal vesicles and vas deferens. However, such pathologies are rare.

Side effects of drugs

Some drugs can negatively affect sperm production. These include anabolic steroids (used by bodybuilders), chemotherapeutic drugs (spironolactone, cimetidine).

Drugs such as phenytoin reduce the level of follicle-stimulating hormone in the blood, and nitrofurantoin and sulfasalazine reduce sperm motility.

Impotence

Insufficiency or absence of erection is, for obvious reasons, a serious obstacle to conception, however, a man in such a situation can very well become a father, provided that his sperm is healthy.

Sports

The most risky sports in this regard are equestrian and cycling. Frequent and intense exercise can affect a man's ability to become a father.

Obesity

Excess weight also has a negative impact on the ability to conceive. This is due to an imbalance of sex hormones in the male body (the female sex hormone estrogen is produced in adipose tissue), which affects the qualitative and quantitative composition of sperm.

External factors

• Exposure to pesticides, industrial poisons, ionizing radiation.
• Smoking, alcoholism and drug addiction.
• Food products based on soy, which contains a large number of plant analogues of female sex hormones.
• Prolonged exposure to high or low temperatures on testicular tissue.

How is infertility diagnosed

To make an accurate diagnosis, the doctor may prescribe the following examinations:

• Urological examination and study of the anamnesis (medical history).
• Spermogram is one of the most informative methods of examining men with infertility problems. Allows you to evaluate the qualitative and quantitative composition of sperm.
• Testicular tissue biopsy is a diagnostic surgical intervention in which a fragment of testicular tissue is taken for further microscopic examination. It is usually prescribed for azoospermia (absence of sperm in the ejaculate).
• Tests for infections are carried out when any deviations from the norm are detected in the sperm analysis, since infectious diseases are one of the most common causes of male infertility.
• A test for the detection of antisperm antibodies is prescribed for changes in the spermogram (sperm sticking together, impaired motility), as well as for unexplained infertility.
• Determination of the level of sex hormones: FSH (follicle-stimulating hormone), testosterone and, in some cases, luteinizing hormone (LH).

How to convince a man of the need to see a doctor

Often the problem of conceiving a child is easily solved, provided that the man and woman consult a reproductive specialist in a timely manner. However, many representatives of the stronger sex are in no hurry to undergo examination and begin treatment. Why?

According to psychologists, a man's persistent reluctance to communicate with people in white coats is primarily due to fear. A man experiences fear not only of unpleasant diagnostic procedures and treatment, the success of which is difficult to guarantee, but also fear for his "masculinity". Consciously or unconsciously, many representatives of the stronger sex associate this concept, first of all, with "order" in the sexual sphere. Any problems of this nature can seriously damage a man's self-esteem.

What a woman can do

You can't blame or accuse a man. Explain to him how important it is for your family that he be examined and, if necessary, treated.

Try not to "hit him where it hurts" and not to lower his self-esteem. On the contrary, support him and strengthen his belief that his problems will in no way affect his masculinity and that for you he is still "the smartest", "the strongest" and "the most handsome".

Convince him that no matter what happens to him, you will not change your attitude towards him, but together with him you will look for a solution to your common problem.

Explain that difficulties with conception are not always caused by serious illnesses. More often, we are talking about minor disorders that are easily treated.