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Probleme de sanatate ale barbatilor | Profecund
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Approximately 40% of the infertility cases are determined by men’s conditions.
Other 20% are caused by both partners, as a couple.

 

Usually, couples believe that fertility is women’s responsibility. Nevertheless, it is important that both women and men are prepared.

Even if the most frequent male problems interfering with fertility are connected to semen, it is as vital to consider the potential issues connected to sexual behavior,

such as erectile or ejaculation dysfunctions, lack of libido due to depression or medicine intake.

90% of male infertility cases are due to insufficient sperm count released, their poor quality and only then, to anatomic issues, hormonal imbalances and birth defects.

 

The most frequent cause of male infertility is connected to semen production in testicles. Low sperm count is produced or sperms produced are faulty or they are both low in quantity and malfunctioning. Sperms with abnormal shapes are unable to penetrate and fertilize the egg. Sperms with low motility, which have trouble moving, cannot reach the egg. Without sufficient number of healthy sperms, chances for fertilization are low.

Approximately two thirds of all infertile men experience semen production issues.


Causes for semen production disorders can include birth defects, infections, testicular traumas, hormonal imbalances, exposure to radiations and certain medicines, torsion (twisted testicles in scrotum), excessive heat, varicocele (varicose veins in the testicles), prostate issues, vasectomy, or unknown causes. Testosterone replacement therapy (oral, injection or topical) significantly diminishes or totally stops semen production.

During a medical checkup, after medical history and physical evaluation, the doctor will request a semen analysis, meaning an analysis of the seminal fluid for sperm evaluation. If the analysis reveals normal results, the existence of hormonal imbalance (testosterone, etc.) or birth defects can be checked.


Blockages or obstacles in the narrow tubes carrying semen from the testicles to the penis can cause a total lack of sperms in the ejaculated seminal fluid. It is the second most frequent cause for male infertility and affects approximately one in every five infertile men, who experienced vasectomy, but now want to conceive.

Scar tissue formed after previous surgery or infection are among the causes leading to obstruction issues in the male reproductive system.


Varices growing in testicles can also interfere with semen carrying. Some structural defects can be birth-related.

If a structural issue is diagnosed, surgery can be the solution. If surgery does not solve the problem, it is possible for semen to be taken directly form the testicles, for being used in assisted reproduction procedures, such as in vitro fertilization.


Erection issues (erectile dysfunction) or ejaculation can hinder the semen from entering the woman’s vagina for fertilization purposes. Approximately one to two out of every 100 infertile couples have erection, ejaculation or other sexual problems.

Inability to maintain an erection can be caused by low testosterone levels. Although believed to be a psychological problem for a long term, surveys proved that 90% of the erectile dysfunction cases have somatic roots. However, most men facing that problem also have a secondary cause, the psychological one manifested by performance anxiety, guilt, and low self-esteem.


Ejaculation issues, which can cause infertility include:

• retrograde ejaculation, a problem if the seminal fluid flows back to the urinary bladder instead to exiting the penis during orgasm,

• premature ejaculation if ejaculation occurs earlier than desired,

• anorgasmia, if ejaculation fails to occur.

Most of these sexual problems can be treated, thus diminishing the infertility risk.


In approximately one out of 100 infertile men, the problem is caused by low level of hormones produced by the pituitary gland, which act on the testicles. Low production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) can affect the testosterone level in testicles and leads to low semen production. The most common hormonal issues are pituitary gland tumors or pituitary gland development conditions, which lead to FSH and LH low levels. The very low testosterone levels also affect male fertility, as well as the prolactin hormone surplus, which inhibits gonadotropic hormones, thus leading to low LH and testosterone levels.


Hormonal imbalances hindering the semen development and growth can cause fertility issues. Testicles may or may not be sensitive to the hormonal stimuli and may not receive signals for stimulating the semen production. Hormonal problems can be birth defects or can develop subsequently. Even excessive workouts, malnutrition or diseases can cause hormonal imbalances affecting fertility.​


In some men, antisperm antibodies are produced when their immunity system reacts to their own semen, believing it to be foreign tissue. Approximately four out of five men develop antisperm antibodies after vasectomy.

In most men, antisperm antibodies do not cause problems and will not affect their chances if conceiving. Nevertheless, in some men, antisperm antibodies can reduce fertility by decreasing the number of sperms in seminal fluid,


by sperm agglutination, which reduces sperm motility, hindering them from moving towards the egg or by stopping the sperms from getting closer to the egg and penetrating it for fertilization.

Usually, the antisperm antibodies do not affect the general health of men and give no symptoms signaling their presence. Antisperm antibodies are found in approximately one out of every 16 infertile men.


Sexually transmitted infections, particularly gonorrhea and chlamydia, can affect fertility in both women and men. There is only one manner of avoiding sexually transmitted diseases. In fact, there are two, but the first involves complete abstinence. Thus, it is better to have safe sex, by the use of a condom and when you are ready to have a family, both parties can be tested for sexually transmitted diseases, thus that you would not risk passing the infection to your partner or your child.

Chlamydia is a very common bacterial infection, which can affect any person that had unprotected sex.

It is estimated that at least 75% of all women and 25% of all men have no symptoms. Because Chlamydia infection symptoms can resemble those of other conditions, such as candidiasis and cystitis, they can be overlooked. If they appear, symptoms can include:

• unusual penis discharge

• burning or pain when urinating

• itching or irritation around the meatus

• pain or tenderness of the testicles.

Chlamydia causes urethra inflammation. Left untreated, infection can expand to epididymes (tubes carrying semen). It can cause pain, scars and more rarely, fertility issues.

Chlamydia infection is treated by antibiotics.

In men, Chlamydia infestation can have severe consequences on the male reproductive system: testicle or urinary tract conditions. If left untreated, men can become sterile.


Gonorrhea is a bacterial infection usually affecting the genitalia, although the throat or anus can also be affected. Gonorrhea can affect both men and women and is easy to pass on during intercourse, be it vaginal, anal or oral.

Gonorrhea usually infects the inside of the penis (urethra). Symptoms may include:

• burning sensation during urination

• white or yellow pus flowing from the penis

• swells and pains in testicles, which can appear if the gonorrhea infection is left untreated.

Some men lack all symptoms.

Gonorrhea can damage the epididymes (tubes carrying semen), hindering the semen from exiting the testicles by ejaculation.

Gonorrhea infection is treated by antibiotics.

Men infected with gonorrhea and not treated are exposed to the risk of allowing the infection to spread towards the urethra, where the prostate, seminal vesicles, bulbourethral glands, and epididymis can become infected too. Painful lesions will result and fevers accompanied by chills.

If that lesion leads to scarring, the man could face fertility issues later in life.


Some medicines can have a negative impact on the male fertility and they must be avoided, if possible. If you take any medicines, you must tell your doctor and check whether they influence fertility. That is valid particularly if you take long-term medicines for cholesterol, heart conditions, high blood pressure or any other chronic condition.

Some medicines can have side effects, leading to nervous tension, which causes psychological problems: stress, emotional imbalance, and anxiety.


The following is a list of medicines and medical treatments known for having negative effects on male fertility:

  • Tagamet, sulfasalazine, or nitrofurantoin – anti-inflammatory medicines significantly decreasing the sperm count
  • Anabolizing steroids, including prednisone and cortisone – long-term consumption diminishes semen quantity and sperm motility, and could also lead to testicle shrinking
  • Chemotherapy and radiations – decreases the semen production and can even lead to sterility
 

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