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Types of Male Infertility

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German specialists share one opinion that in 75% of all cases the male infertility can be cured. It is important to timely determine the type and causes of infertility. Usually eliminating the factors that lead to infertility it is possible to quickly solve the problem. The most common factors that may impair male fertility are:

  • cystic fibrosis
  • hormonal disorders
  • obstruction of spermatic duct
  • traumas of scrotum and testes
  • erection problems
  • ejaculation problems
  • infectious diseases
  • consequences of operations on the bladder, prostate, urethra

Some factors can increase the risk of male infertility. Those are:

  • chemotherapy or radiation therapy
  • exposure to environmental toxic substances (lead and pesticides)
  • drug and alcohol addiction
  • traumas of scrotum and testes
  • smoking
  • testicles overheating, due to wearing of tight clothing or a sedentary lifestyle

One should "ring the alarm" if the desired pregnancy does not occur in a year of unprotected sexual activity. Please note that in this case both the man and the woman should undergo the examination.

Many different diseases can lead to disruptions of spermatogenesis: varicose veins of the spermatic cords, inguinal hernia, congenital genetic defects, diabetes, disruption of the thyroid and adrenal glands.

According to the WHO (World Health Organization) classification, there are several main types of infertility:

  • Aspermatogenic sterility: caused by a spermatogenesis disorder, i.e. formation of spermatozoa
  • Obstructive infertility: arises because of the obstruction of the spermatic ducts
  • Autoimmune infertility: antibody response to sperm (this pathology can occur in both men and women)
  • Genetically determined infertility

Only a specialist can determine the cause of infertility in the course of a comprehensive examination of the man.

Diagnostics of male infertility is a a fine process that includes clinical, laboratory and molecular biological tests, ultrasound screenings, genetic researches and so on.

German centers of reproduction and clinical embryology are usually multidisciplinary, which means they are medical institutions where different specialists cooperate: andrologists, endocrinologists, geneticists, reproductologists, bacteriologists, and others. VIVANEO Family Reproduction and Family Planning Center is one of these German centers, its divisions are located in Wiesbaden, Berlin and Düsseldorf. Annually, about 1500 patients from all over the world come to receive a consultation and treatment in the VIVANEO medical center. Head of the Center prof. Dr M. Khan makes a point that “as a rule, infertility is not a disease, but only a manifestation of previously unnoticed pathology. If one can identify and eliminate that pathology, in 80% of cases it is possible to achieve the positive result, i.e. a healthy pregnancy”.

The following types of examinations are performed in case of a suspected infertility:

  • Urogenital examination
  • Exclusion of infections
  • Spermatogenesis analysis
  • Hormonal profile evaluation
  • Ultrasound examination

Let us cover some of them in more details.

Diagnostics of male infertility involves, above all, urogenital examination. If congenital or acquired physiological pathologies are present, it is advisable to conduct a small surgical intervention to eliminate the problem.

Infectious screening test includes bacteriological examination of the urethra smear, prostate secretion. A chronic infection seldom takes its toll, but it negatively affects the man's fertility.

Spermatogenesis analysis (spermogram) is usually performed twice with an interval of 2-3 weeks. In Germany, the examination of the morphological and physiological properties of spermatic fluid is carried out at the highest technological level which allows to exclude errors. Modern medical practice in Germany has clear criteria for judging the quality of sperm. First of all, the acid-base balance, concentration and motility, as well as the morphological characteristics of spermatozoa, are established. A particularly important step in assessing the spermatogenesis is the presence of sperm antibodies that provoke immunological infertility.

If the results of spermogram are unsatisfactory one prescribes a full hormonal examination.

The examination also includes an ultrasound screening and a scrotum tomography and some innovative techniques of optical laser diagnostics. In some cases the patients should have a testicular biopsy performed. It is usually performed in patients with oligospermia and azoospermia. During the biopsy an aspiration of testicular sperm is carried out according to TESA or MESA methods which allows one to obtain the sperm of high quality even in case of unsatisfactory spermogram results.

There is an abundance of articles dedicated to the treatment of female infertility. We, on the other hand, will talk about types and methods of treating male infertility Male infertility can be treated either conservatively, or surgically. Quite often the patient should receive the combination of both surgical and pharmacological methods.

Treatment of infertility developed as the result of spermatic duct obstruction can, in most cases, be performed only by means of surgical correction. In this case it is important to determine whether the sperm cells in testicles get mature. If spermatogenesis process is not disturbed and the problem lies only in the obstruction of sperm ducts a minimally invasive (laparoscopic) intervention under local anesthesia is assigned. This is a quick low traumatic and effective surgery allows one to eliminate the obstructive infertility.

It is a question that worries many patients. The answer is simple: If the precious time is not lost, the fertility in men diagnosed with varicocele can be restored surgically. The treatment with hormone preparations is prescribed which activates the sperm production. As a rule, when varicocele is eliminated the normal spermatogenesis is restored within a year in 95% of all cases, the sperm quality is greatly improved.

A question often asked is whether the type of infertility such as immune infertility can be cured. This type of infertility is caused by the influence if antibodies on the sperm. The antibodies can block spermatogenesis eliminating the possibility of conception.

The treatment of immune male infertility begins with the elimination of all factors that can trigger the production of antibodies. The systematic hormonal therapy and enzymotherapy are a part of the treatment.

Specialists in reproductive centers of Germany can perform sperm washing. It is a procedure that separates movable and high quality sperm from seminal fluid and unviable cells. In Germany this process is done using a special centrifuge that „sorts“ best sperm for the further intrauterine insemination.

Regardless of the infertility type German specialists look at the problem in a complex, based on the patient's clinical record and individual situation.

If you are confronted with the infertility problem you should not postpone a doctor's appointment. Regardless of the infertility type German specialists look at the problem in a complex, based on the patient's clinical record and individual situation.

We will help you choose the right andrology and reproductive medicine clinic in Germany and solve all the issues regarding the organization of diagnosis and treatment of infertility in Germany. We are waiting for your call. Hot line phone number: +49(7221) 39-65-785

Author: MD Florian Götze on Xing, .

GermanMedicalGroup + 49 (7221) 39-65-785 Flugstrasse 8a 76532 Baden-Baden Germany Types of male infertility Types of male infertility 2018-03-27 Types of male infertility

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