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Male infertility corresponds to the man's inability to produce enough sperm and / or that are viable, that is, that are able to fertilize the egg and result in pregnancy. Often man's reproductive capacity can be influenced by lifestyle habits such as smoking, drinking alcohol frequently, being overweight or using illicit drugs, for example, decreasing the production and quality of sperm.
In addition to being related to life habits, man's infertility may also be due to changes in the reproductive system, infections, hormonal or genetic changes, or be a consequence of varicocele, which is a type of varicose that appears in the testicles and that directly interferes with the production of sperm.
It is important that the cause of infertility is identified so that the urologist can indicate the most appropriate treatment, which can be with changes in habits, the use of medications, hormones or surgery.
The main causes of male infertility are:
1. Life habits
Some habits and lifestyle can decrease man's reproductive capacity, such as smoking, drinking and being overweight, for example, because it can lead to metabolic and hormonal changes, which can decrease the ability to produce sperm. In addition, men who are frequently under stress may also experience hormonal dysregulation, which can interfere with reproductive capacity.
The use of injectable drugs, such as anabolics to gain muscle mass, for example, can also lead to infertility, as they can shrink the testicles and, consequently, decrease the production of sperm.
What to do: In these situations, it is important to identify which factor may be related to infertility. In the case of smoking and alcoholic beverages, it is recommended to stop using, while in the case of obesity, change in eating habits and physical activity, for example, is recommended.
In the case of infertility is related to the use of injectable drugs, it is important that the drug is no longer used and treatment is recommended by the doctor, especially if there is any other associated alteration.
2. Varicocele
Varicocele is the most frequent cause of infertility in men and corresponds to the dilation of testicular veins, which promotes blood accumulation and an increase in local temperature, directly interfering with the production of sperm. This situation is more common to happen in the left testicle, but it can also happen only in the right testicle or reach both testicles at the same time. Learn more about varicocele
What to do: When the doctor verifies the dilation in the veins indicating varicocele, the recommendation is that surgery be done to solve the problem. The surgery is simple and the man is discharged on the same day or the day after the procedure, being able to resume normal activities after about 1 week.
3. Infections in the reproductive system
Some infections in the male reproductive system can reach the testicles and result in changes in the semen production process and in the quality of the sperm produced, being more common as a result of infection by the virus responsible for mumps.
In addition to infertility as a consequence of mumps, urinary infections that have not been identified or treated correctly can also reach the testicle and compromise the production of sperm.
What to do: It is important that the cause of the infection is identified so that the most appropriate medication is indicated to treat the infection, which can be antifungal, antiviral or antibiotic. It is important that the partner of the man with the infection also undergoes treatment, even if he has no symptoms, to avoid recurrence of the infection.
4. Ejaculation problems
Some situations related to ejaculation, such as retrograde ejaculation or no ejaculation, can also be the cause of infertility, since the man is unable to release the semen at the moment of orgasm or produces little or no semen.
What to do: In these cases, the treatment must be indicated by the urologist and consists of the use of drugs that favor the exit of the semen, such as ephedrine or phenylpropanolamine. However, when drug treatment does not work, it may be necessary to perform sperm collection and artificial insemination. Understand how ejaculation changes are treated.
5. Hormonal changes
Hormonal changes, especially with regard to the amount of circulating testosterone, can also cause infertility. In addition, the high production of prolactin, changes in the thyroid, use of anabolic steroids, the presence of a tumor in the pituitary gland and radiotherapy can also interfere in the reproductive capacity of men.
What to do: In these cases, the treatment for infertility is recommended by the doctor according to the hormonal change identified and aims to regulate the amount of hormones and, thus, favor the normal production of sperm.
6. Genetic problems
Genetic problems mean that a man naturally does not have sperm in his semen or that produces sperm in a very small amount, so that the woman's egg does not fertilize.
How to treat it: When infertility is due to genetic alterations, the option that the couple has to get pregnant is through assisted reproduction techniques, in which the sperm are removed directly from the testicles with the help of a needle, and then are placed in the woman's uterus for fertilization to occur. Another alternative is to do the so-called in vitro fertilization, in which the man's sperm are joined to the woman's egg in the laboratory, forming an embryo that is then placed in the woman's uterus.
How the diagnosis is made
The main test that is carried out to evaluate and diagnose male infertility is the spermogram, which should be recommended by the urologist, and which aims to assess the quantity and quality of the sperm produced. This examination is done from the laboratory analysis of a semen sample that must be collected on the same day in the laboratory after masturbation. Understand how the spermogram is made.
In addition to the spermogram, the doctor may request other tests to identify the cause of infertility. Thus, testosterone, thyroid hormone and prolactin dosage, urine test, both type 1 urine test and urine microbiological test, pelvic ultrasound to assess the male reproductive system and physical examination, which is especially important for the diagnosis of varicocele.
Learn about other tests that assess fertility.