CAUSES OF MALE INFERTILITY
Several factors can cause infertility in men. The main problem common to all these factors is the ability of sperm to fertilize the egg cell. Unlike female infertility, the male infertility factor does not have a rapidly declining age-related rate. The male infertility factor can be widely categorized into two main groups:
• Problems with sperm production, which means the production of too few sperm or no production at all. This category is further divided into categories of obstructive azoospermia and non-obstructive azoospermia. In these cases, Surgical methods of sperm extraction are often shown to be successful and men with obstructive azoospermia may often have their own biological children using IVF/ ICSI treatment. In these cases, genetic problems are most commonly talked about, which cause problems with production or maturation. Surgical sperm finding can sometimes lead to success, however, in most cases in order to achieve pregnancy, IVF treatment may be needed using donor sperm.
1. Problems with the ability of sperm to reach the egg cell and fertilize it, which may be the case when the abnormal shape or structure of sperm prevents them from moving properly. Sometimes a man is born with problems that affect his sperm. In other cases, problems begin later in life due to illness or injury. For example, cystic fibrosis often causes infertility in men. The number and quality of a person’s sperm may also be affected by his overall health and lifestyle. Some things that may reduce the number and/or quality of sperm are:
– Alcohol
– Drugs
– Ecological toxins, including pesticides and lead
– Smoking cigarettes.
– Health problems
– Medicines
– Radiation therapy and chemotherapy for cancer, or exposure to radiation at work.
– Age
In order to understand the cause and severity of the problem, sperm analysis is very important. Sperm analysis will show very important parameters, such as sperm volume, and the number of sperm that will in turn show whether there are enough sperm in the ejaculate to fertilize egg cells. However, having enough sperm is not a satisfactory condition. These sperm will also need to have a certain level of mobility, indicating the ability of sperm to move freely and reach egg cells for fertilization to occur. Similarly, sperm morphology is another very important factor that shows how many percent of sperm have a normal structure and therefore are sustainable. According to published World Health Organisation standards for sperm sustainability in 2010, the following parameters are established for normal sperm:
Volume:> 2.0 ml
Concentration:> 20 million /ml
Mobility:> 50%
Morphology: > 30% with normal morphology
White blood cells (leukocytes): <1 million /ml
pH: 7,2-7,8
Please be sure that you have provided 3–5 days of abstinence before giving your seminal sample for analysis to obtain more precise results. This is also important initially for providing the sample before fertility treatment. In any case, if you are asked to give a semen sample, it is best to have abstinence over a period of 3 to 5 days, unless otherwise stated.
For more information about what seed analysis numbers mean, and how to categorize the seed sample based on its parameters, please see the section “Interpreting test results.” In this section, you will find information regarding the classification of sperm based on its parameters.
In some cases, even if sperm production is not enough to produce sperm through ejaculation, small surgical procedures such as TESA and MESA can be used to obtain sperm. These interventions are relatively easy, fast and painless. If live sperm are found during these procedures, fertilization may be possible. However, it should be borne in mind that the fertilization rate with TESA/MESA sperm will be lower than fertilization with normally found sperm in the ejaculate. Given the quality and maturation, the level of surgically extracted sperm will be less compared to the level of standard sperm, freezing of surgically extracted/extracted sperm is often not recommended.
In other cases, where sperm cannot be found or quality is extremely low, the use of a sperm donor becomes the only alternative. Please see the Treatments section for more information about IVF/ ICSI treatment using a sperm donor.