Infertility

Infertility is defined as a couple's inability to become pregnant after one year of  regular, unprotected sex. Male infertility means the male is unable to impregnate the female because of male factors.

Approximately 15% of couples attempting their first pregnancy meet with failure. Most authorities define these patients as primarily infertile if they have been unable to achieve a pregnancy after one year of unprotected intercourse. Conception normally is achieved within twelve months in 80-85% of couples who use no contraceptive measures, and persons presenting after this time should therefore be regarded as possibly infertile and should be evaluated. Data available over the past twenty years reveal that in approximately 30% of cases pathology is found in the man alone, and in another 20% both the man and woman are abnormal. Therefore, the male factor is at least partly responsible in about 50% of infertile couples.
 

The most common causes of male infertility include

• Varicocele  Varicocele is a dilation (enlargement) of the veins along the spermatic cord (vas deferens) in the scrotum. It is caused by incompetent or inadequate valves within the veins along the spermatic cord. The abnormal valves obstruct normal blood flow causing a backup of blood, resulting in dilation of the veins. This condition is the most common reversible cause of male factor infertility.

• Abnormalities in the seminal fluid  If the seminal fluid is very thick it may be difficult for the sperm to move through it and into the woman's reproductive tract.
  
  Often the semen can be processed to separate the moving sperm from the surrounding debris, dead sperm and seminal fluid. The processed sperm is usually placed directly inside the uterus with a small tube (catheter). This is called intrauterine insemination (IUI).

• Oligospermia (Low sperm count)  Most cases of male infertility are due to low sperm count. The normal range of sperm count is between 20 million/ml and 200 million/ml. That sperm count is below 20 million/ml indicates oligospermia. There are many biologic and environmental factors that can lead to low sperm count. For instance, abnormalities in production or obstruction of the tubes that carry sperm can reduce sperm levels.

• Necrospermia (Dead sperm)  Necrospermia is a condition in which sperm are produced and found in the semen but are not alive and are unable to fertilize eggs. That over 40% sperms are dead in the semen analysis indicates necrospermia.

• Azoospermia (Lack of sperm) Azoospermia is the complete absence of sperm in the semen. The diagnosis of azoospermia is sometimes still made even though as many as 500,000 sperm per ml of semen may have been seen because it is extremely unlikely that the man will be able to father a child naturally.

• Positive anti-sperm antibody There is much scientific evidence that sperm antibodies in males and females cause infertility. Sperm antibodies are chemical substances in the semen, cervical mucus, blood and other body fluids that neutralize the purpose of sperm which is to fertilize an egg.

Symptoms of Male infertility

Male infertility occurs when the man's partner does not conceive after one year of attempting to become pregnant. Other signs and symptoms depend on the underlying cause of the man's infertility.irritability. Patient may also feel drowsiness.A rapid, deep breathing, known as “kussmaul breathing” may also be noted.There may be smell of acetone in the patient’s breath (a sign of ketoacidosis), a severely dangerous condition.

        Fluctuations in blood glucose levels can lead to altered vision. In them prolonged high blood glucose causes changes in the shape of the lens in the eye, leading to blurred vision. So, regular visit to ophalmologist is necessary. All unexplained quick changes in eyesight should force as fasting blood glucose test. There are nowadays quick inexpensive and can be safely performed.

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