What kind of male infertility cannot be treated? Is infertility in men treated? Instrumental diagnostic methods

Infertility is the absence of pregnancy for 1 year or more in a woman who is regularly sexually active and does not use contraceptives. This is not a diagnosis, but is a term applied to couples who are trying to conceive when the cause of failure is unknown. In 60% of cases, the cause of infertility is disorders in the woman’s body, in 40% - in the man’s body (sperm deficiency, ejaculation disorders, impotence).

What can a man expect when visiting a doctor about infertility? What are the diagnostic methods for infertility and possible treatment options for men? About this in our article.

Under male infertility understand a man’s lack of ability to fertilize, even despite normal sexual intercourse.

In previous years, responsibility for the infertility of a marriage was more often placed on the woman. Recently, thanks to more frequent examinations of husbands and, in particular, laboratory tests of seminal fluid, it has become clear that in approximately half of infertile marriages, the culprit of infertility is not the woman, but the man.

Congenital forms of infertility include various types of testicular anomalies: primary hypogonadism, that is, congenital underdevelopment of the genital organs, congenital absence of both testicles (an extremely rare developmental defect), cryptorchidism (undescended testicles into the scrotum) and some other, rarer congenital disorders of the structure of the testicles.

Acquired infertility can be the result of the influence of various unfavorable factors on the spermatogenic epithelium of the testicles: infectious diseases, nutritional disorders, prolonged cooling of the body, X-rays or radioactive radiation. According to modern data, in approximately one fourth of infertile men, the cause of this defect is infectious mumps (mumps), complicated by bilateral orchitis. More rare causes of male infertility are other infectious diseases: typhoid, influenza, malaria, syphilis, tuberculosis. As with infectious mumps, the cause of infertility after these diseases can be not only clinically pronounced orchitis, that is, clear inflammation of the testicle, but also the toxic effect of infection on the sprematogenous epithelium of the testicle without obvious signs of orchitis. The younger the patient, the greater the risk of harmful effects of an infectious disease on the testicles, especially during or before puberty.

Prolonged fever, that is, an increase in body temperature, itself can also lead to impaired spermatogenesis due to an increase in local temperature in the testicle. This factor should be paid attention to in people who are exposed to high temperatures at work for a long time.

Among the various types of chronic intoxication, alcohol and smoking abuse are of greatest practical importance. Under the influence of alcohol abuse, fatty degeneration of the seminiferous tubules and growth of connective tissue in their place occurs in the testicles, that is, scar replacement of the testicular parenchyma. Clinical observations indicate a significant incidence of infertility in chronic alcoholics, as well as a high probability of giving birth to defective offspring. Chronic exposure to nicotine can also cause fertility problems, which disappear when smoking is stopped or significantly limited.

Sufficient blood supply to the testicle is of great importance for the normal spermatogenic function of the testicle. Those diseases that disrupt blood circulation in the testicle often lead to changes in its external sector function, and if the disease is bilateral, to infertility. These diseases include varicose veins of the spermatic cord (varicocele), torsion of the spermatic cord.

A fundamentally different origin is found in those forms of male infertility in which it is not the formation of the seed in the testicles that is impaired, but its excretion through the vas deferens (epidydymis, vas deferens, seminal vesicle, urethra). At each of these areas, there may be an obstacle to the passage of seminal fluid of a congenital or acquired nature. Congenital malformations of the urethra - a defect in its posterior wall (hypospadias) - lead to the fact that sperm erupting from the incorrectly located external opening of the urethra does not enter the vagina, but is poured out in front of it. A narrowing (stricture) that develops as a result of a chronic inflammatory process or damage to the urethra can also, although very rarely, cause infertility: in this case, seminal fluid is retained in the canal, thrown into the bladder, or gradually flows out at the end of sexual intercourse.

The most common cause of the excretory form of male infertility is anomalies and diseases of the epididymis. Bilateral anomalies of the epididymis in the form of hypoglasia (reduction in size), aplasia (congenital absence) or obliteration (lack of lumen in this organ) are rare.

Much more often the cause of infertility is bilateral inflammatory diseases of the epididymis (epididymitis). After specific (gonorrheal, tuberculous) epididymitis, scar changes very often remain, which can sharply disrupt the movement of sperm along the lumen of the appendage, up to its complete obstruction. If such a lesion is bilateral, infertility occurs.

Diseases of the prostate gland and seminal vesicles can also cause infertility. With chronic inflammatory processes in these organs, the composition of their secretion occurs, which leads to a decrease in the activity of sperm in the seminal fluid.

Folk remedies for treating infertility in men, as a rule, are ineffective, but some rules of lifestyle and nutrition (diet) for conception will help to slightly improve the quality of sperm.

Causes of male infertility

A comprehensive clinical and laboratory examination of men in infertile marriages allows us to identify the following main causes of infertility:

• Sexual and/or ejaculatory dysfunction;
• Infection of the accessory sex glands;
• Varicocele;
• Idiopathic oligozoospermia;
• Idiopathic asthenozoospermia;
• Idiopathic teratozoospermia;
• Isolated pathology of seminal fluid;
• Immunological factor;
• Iatrogenic factor;
• Systemic diseases;
• Congenital anomalies of the genital organs;
• Acquired pathology of the genital organs;
• Endocrine causes;
• Obstructive azoospermia;
• Idiopathic azoospermia;
• Genetic factor;

The incidence of reproductive dysfunction in men is 48%. The main causes of male infertility are: genital infections (11%), varicocele (7%) and idiopathic oligo-, astheno-, teratozoospermia (15%). A combination of 2 or more infertility factors in patients was identified in 32% of cases.

Conservative methods of treating male infertility

Drug treatment is mainly used for impaired spermatogenesis caused by genital infection, endocrine pathology and sexual-ejaculatory changes. For this purpose, the following groups of drugs are used:

• Androgens: testosterone andecanoate (andriol), testosterone propionate (testoviron), testenate (sustanon-250).
• Antiestrogens: clostilbegid, tamoxifen Gonadotropins: menotropin (humegon, pergonal), choriogonadotropin (pregnyl, prophasy).
• Releasing hormones: LH-RH (lyuliberin), Gn-RH (cryptocur).
• Prolactin secretion inhibitors: bromocriptine (Parlodel).
• Chemotherapeutic agents.
• Immunostimulants: taktivin, pyrogenal, normal human immunoglobulin.
• Angioprotectors: pentoxifyline (trental).
• Biogenic preparations: solcoseryl, raveron, trianol
• Means for correcting sexual function: caverject, andriol, yohimbine, tentex, himcolin.

Treatment of sexually transmitted infections

Therapy of patients suffering from inflammatory diseases of the male reproductive system is a difficult and complex task. Therefore, only comprehensive step-by-step treatment of both spouses or sexual partners at the same time, even if an infection is detected in one of them, allows one to achieve clinical recovery.

Complex methods include the following types of treatment: 1) etiological, 2) pathogenetic, 3) hormonal, 4) immunological, 5) restorative and psychotherapy.

Etiological treatment is aimed at eliminating the infection based on cytological, cultural and other studies. Treatment is carried out for 20-30 days with sequential administration of 2-3 drugs. For this purpose, drugs from the group of tetracyclines (doxycycline), fluoroquinolones (abactal, tarivid), cephalosporins (claforan), macrolides (rulid), as well as acyclovir, nystatin and trichopolum are used. If ineffective, treatment is repeated under the supervision of identifying the infectious agent and choosing other drugs. To prevent intestinal dysbiosis, bactisubtil is simultaneously prescribed for 10-15 days. Drugs related to sulfonamides and nitrofuran derivatives should be excluded from therapy due to their gonadotoxic effects.

Pathogenetic treatment includes measures to eliminate the primary source of infection and reinfection, eliminate neurotrophic disorders at the site of inflammation and possible complications. In this regard, examination and treatment of the sexual partner, identification and sanitation of foci of infection are carried out, antimicrobial drugs are applied locally for injection into the urethra and bladder, prostate massage, and physiotherapy.

Hormonal drugs are prescribed in complex therapy for endogenous testosterone deficiency or to stimulate metabolic and regenerative processes. These include: Proviron, Andriol, Sustanon-250.

An increase in the body's immunological reactivity is achieved by using thymolin, tactivin, normal human immunoglobulin and biogenic drugs (raveron, trianol).

To consolidate and stabilize the results of therapy, at the final stage, sanatorium-resort treatment is carried out, including the establishment of a normal lifestyle.

Clinical criteria for recovery are: 1) absence or< 1,0х10 6 /мл лейкоцитов в сперме; 2) отсутствие микрофлоры или при обсемененности Staphylococcus epidermidis < 10 3 КОЕ/мл; 3) отсутствие других видов инфекции; 4) нормализация показателей спермы.

If pregnancy does not occur 6 to 12 months after the end of treatment, both spouses are prescribed hormone-stimulating therapy.

Artificial insemination

The first successful attempt at artificial insemination, the purpose of which was to overcome infertility due to male factor, was carried out by J. Hunter in 1790. In Russia, the first artificial insemination with her husband’s sperm was performed in 1925 by A. A. Shorokhova for azoospermia.

Depending on the source of sperm, a distinction is made between artificial insemination with the husband's sperm (homologous artificial insemination) and artificial insemination with the donor's sperm (heterologous artificial insemination).

Indications for artificial insemination with the husband's sperm are mainly coital disorders that prevent the normal entry of ejaculate into the vagina; mild forms of spermatogenesis disorders or immunological aggression of cervical mucus.

Artificial insemination with the husband's sperm is performed if the wife has:

• old perineal tears;
• anatomical obstacles from the vagina and uterus;
• severe forms of vaginismus;
• adverse effects on sperm from vaginal contents or cervical mucus;
• ankylosis injuries of the hip joints.

Indications on the part of the husband for artificial insemination are:

• lack of erection or insufficient erection;
• large hydrocele or inguinal-scrotal hernia;
• premature ejaculation;
• severe hypospadias;
• some forms of oligozoospermia I - II degrees;
• pathological postcoital test.

Artificial insemination with the husband's sperm is used before the husband's sterilization, if he is prescribed medications that cause infertility, or before radiation. Before this, the sperm of men is pre-cryopreserved.

Recently, artificial insemination with husband's sperm is increasingly used to overcome the immunological aggression of cervical mucus in case of infertility.

Insemination with donor sperm is carried out in case of infertility caused by severe disorders of spermatogenesis (aspermia, azoospermia, oligospermia of the third degree). Insemination with donor sperm is also used in cases of severe general illnesses of the husband, post-Hodgkin disease, in the presence of cystic fibrosis, Werdhig-Hoffman disease; in the case of a negative genetic predisposition in the family (stillbirth, the birth of children with a severe form of hemolytic disease due to sensitization to the Rh factor, the birth of children with developmental defects due to the presence of a hereditary pathology in the husband).

In order to improve sperm parameters, it is proposed to fractionate the ejaculate, separate mobile forms by filtration, accumulate several ejaculates using cryopreservation, add kallikrein, dextrose, arginine, caffeine or prostaglandins.

In the normal state of the reproductive system in women, the cervical method of introducing ejaculate is used for artificial insemination; in the presence of antisperm antibodies, the intrauterine method is used. To increase the effectiveness of artificial insemination in women with a two-phase menstrual cycle, it is advisable to carry out this procedure against the background of ovulation induction by hormonal methods. Artificial insemination can be performed not only in absolutely healthy women, but also in patients with reduced fertility (ovulation disorders, one-sided or obstructed patency of the fallopian tubes, abnormalities of the uterus) after appropriate corrective therapy.

Artificial insemination must be carried out every other day during the period of expected ovulation, in the amount of 2 manipulations in one menstrual cycle.

Preference should be given to the introduction of native sperm, since the effectiveness of its use is 2-3 times higher than when using cryopreserved material. However, it has been proven that freezing reduces the antigenic properties of sperm, which makes the use of this method of artificial insemination promising in women with antisperm antibodies.

The effectiveness of insemination with the husband's sperm ranges from 6 to 22%, and the effectiveness of insemination with the donor's sperm ranges from 30-60%.

Hormone therapy for various spermatogenesis disorders

The main place in the treatment of pathozoospermia is occupied by hormonal drugs as independent or stimulating treatment after other correction methods (varicocele, genital infections).

There are the following types of hormone therapy for male infertility:

• Replacement therapy - the introduction of hormones is carried out to replace their endogenous deficiency and is one of the most successful methods of pharmacotherapy. In andrological practice, an example of replacement therapy is the treatment of hypogonadism, idiopathic pathozoospermia and sexual disorders caused by hypoandrogenism.
• Blocking (suppressive) therapy - the introduction of hormones leads to suppression of the function of the corresponding gland. Thus, prescribing large doses of testosterone (500 mg/week) to men for 3-4 months causes inhibition of gonadotropin production and suppression of spermatogenesis to the point of azoospermia. After discontinuation of the drug, against the background of an increase in the production of hormones of the anterior lobe of the pituitary gland, spermatogenesis is restored with the characteristics of its parameters exceeding the initial level before treatment. This method is known in the literature as the rebound effect and is called antifertility. Currently, the method is not widely used.
• Stimulating therapy is based on the introduction of small physiological doses of hormones that have a beneficial effect on metabolic, inflammatory, immune and other processes in the body, without pronounced changes in the hypothalamic-pituitary-testicular system. Such drugs include andriol and proviron, used in the treatment of idiopathic oligozoospermia.

The most commonly used drugs are: clostilbegit (25-150 mg/day), humegon (75-150 IU), pregnyl (1500-5000 IU), andriol (80-160 mg/day). The course of treatment at least corresponds to the duration of spermatogenesis, amounting to 12-15 weeks. Treatment results are monitored every 3 months. If the dynamics are positive, treatment can last up to 9 months. The appearance of undesirable symptoms or gynecomastia during treatment serves as a basis for reducing the dose of the drug or discontinuing it.

Therapy for oligozoospermia with sperm concentration<5 млн/мл, астенозооспермии с количеством подвижных сперматозоидов <20%, тератозооспермии с количеством нормальных форм <20%, некрозооспермии следует признать бесперспективной.

At primary (hypergonadotropic) hypogonadism treatment is carried out with drugs of male sex hormones that can suppress the secretion of gonadotropic hormones and restore spermatogenic function. 5% testosterone propionate, testenate (Sustanon-250) have this effect. In the absence of pronounced changes in the pituitary-testicular system, the drugs Andriol, Proviron, Clostilbegide are prescribed.

Treatment secondary (hypogonadotropic) hypogonadism consists of the use of gonadotropin. In case of LH deficiency, choriogonic gonadotropin and its analogues (pregnyl, prophase) are prescribed. In case of FSH deficiency, serum gonadotropin or the drugs Humegon and Pergonal are used. In treatment, a combination of serum and choriogonic gonadotropin is possible. If the reserve function of Leydig cells is insufficient, the effectiveness of therapy is increased by combining serum gonadotropin with testosterone preparations (andriol).

Surgical methods for correcting male infertility

Any therapy begins with general organizational and therapeutic measures aimed at eliminating household and professional hazards, normalizing the patient’s work, rest, and nutrition regimen, prescribing sedative and antidepressant therapy, drugs that increase the antitoxic function of the liver, vitamin therapy, and the treatment of concomitant diseases.

Varicocele. Treatment includes interruption of retrograde blood flow through the testicular vein to correct hemodynamic disturbances in the testicle. The method of choice is the Ivanissevich operation, the essence of which is high retroperitoneal ligation of the testicular vein. A similar clinical effect can be achieved by X-ray endovascular occlusion of the testicular vein by introducing sclerosing substances, metal spirals, electroocclusion of the vein with high-frequency current, and endoscopic ligation of the vein. With bilateral varicocele, blood flow is interrupted through the testicular vein on the left and right. Less commonly, the external spermatic vein or vein and artery are ligated (Palomo operation). In cases where the cause of left-sided varicocele is venous renal hypertension, interruption of retrograde blood flow is carried out through the central vein of the left adrenal gland.

Cryptorchidism.

The main method of treatment is surgery. Orchiopexy should be performed at an earlier age, before the development of irreversible changes in the spermatogenic epithelium. The promising period for surgical treatment is considered to be up to 2-3 years of age. Reduction of testicles at a later age does not guarantee against infertility. The tactics of conservative treatment of cryptorchidism with gonadotropic drugs in the hope of spontaneous reduction of the testicles should be considered ineffective and unjustified.. Inguinal and inguinoscrotal hernias

Particular attention in surgical correction is paid to minimal trauma to the elements of the spermatic cord and to performing pressure-free suturing of the inguinal canal. These interventions should be performed by a urological surgeon to minimize the risk of iatrogenic injury or excision of the vas deferens. Congenital anomalies of the urethra

(epispadias and hypospadias). Plastic surgery aims to recreate the urethra with an external opening on the head, which will allow ejaculation intravaginally. Surgical treatment - resection of the narrowed area followed by anastomosis of the ends of the urethra with a normal lumen allows achieving adequate correction. Urethral stricture has recently been eliminated using the endoscopic method.

Obstructive azoospermia. The genesis of this form of infertility lies in the obstruction of the vas deferens. The reasons for this condition may be:

1. complete or partial aplasia of the epididymis, vas deferens, seminal vesicles;
2. acquired obstruction of the ducts as a result of inflammatory obstruction;
3. cysts and tumors of the epididymis, compressing the epididymal duct;
4. Iatrogenic obstruction of the ducts due to surgical manipulations in this area.

All methods of surgical treatment, depending on the location of the anastomosis, are divided into 3 main groups:

1. vaso-vasoanastomosis;
2. vasoepidymoanastomosis;
3. Vasotesticuloanastomosis.

The most effective treatment is an end-to-end anastomosis along the duct. In case of obstruction of the initial part of the vas deferens or the duct of the epididymis, microdissection is performed until a normal lumen is detected and the duct of the epididymis is connected to the lumen of the vas deferens using a double-row suture. Usually, the obstruction zone (tail, body of the epididymis, initial part of the vas deferens) is resected. Anastomosis of the vas deferens with the testicle is performed after resection of the epididymis in the rete testis area. In case of obstruction of the pelvic sections of the vas deferens, extremely rarely, due to a serious complication caused by the formation of a urinary fistula, the vas deferens is anastomosed with the scrotal urethra.

Among the various options, mention should be made of anastomosis of the vas deferens with a spermatocele and a cross anastomosis between the vas deferens or the vas deferens on the other side.

Rare types of surgical treatment for congenital absence of the vas deferens, duct and part of the epididymis, obstruction of the abdominal part of the vas deferens, impaired ejaculation caused by paraplegia, include implantation of synthetic sperm reservoirs (artificial spermatocele) into the epididymis or into the subcutaneous pocket above the inguinal ligament. The obtained spermatozoa from the seminal receptacles using aspiration are used for alternative treatment methods (ISM, ICSI).

Alternative treatments for male infertility

Any therapy begins with general organizational and therapeutic measures aimed at eliminating household and professional hazards, normalizing the patient’s work, rest, and nutrition regimen, prescribing sedative and antidepressant therapy, drugs that increase the antitoxic function of the liver, vitamin therapy, and the treatment of concomitant diseases.

If conservative and surgical treatment of male infertility is unsuccessful, alternative methods are used, which include:

• insemination with husband's sperm (ISM),
• insemination with donor sperm (ISD),
• intracytoplasmic sperm injection (ICSI), part of the in vitro fertilization program.

For oligo-, astheno- and teratozoospermia, various capacitation methods are used to improve sperm fertility and prepare it for insemination and preservation.

The choice of artificial insemination method is based on existing medical indications.

Indications for ISM are: 1) anatomical and functional disorders of the reproductive system in men and women (epispadias, premature ejaculation, vaginismus); 2) subfertile sperm parameters; 3) isolated disorders of seminal fluid with normal values ​​of sperm quantity and quality; 4) retrograde ejaculation with preserved normal sperm; 5) immunological infertility caused by the cervical factor.

For ISD, the indications are as follows: 1) infertile condition of men caused by aspermia, primary azoospermia, necro- and teratozoospermia; 2) genetically encoded carriage of dominant hereditary diseases; 3) retrograde ejaculation with the absence of normal sperm.

In case of serious disorders of the reproductive function of men, leading to a critical decrease in sperm concentration (<500х10 3 /мл), подвижных и морфологически нормальных форм (<20% сперматозоидов), осуществляется ИКСИ. При обструктивной форме азооспермии и других тяжелых органических поражениях репродуктивной системы мужчин возможно использовать для микроинъекций в ооцит эпидермальные и тестикулярные сперматозоиды и даже сперматиды поздней стадии дифференцировки.

Not so long ago, women were most often blamed for family infertility. Today, existing statistics suggest that in approximately half of the cases the inability to have children in a couple is due precisely to male infertility. And no matter how the representatives of the stronger half of humanity oppose it, the fact remains a fact.

What it is?

The forms of male infertility are quite diverse. All of them can lead to the breakup of a family, to a great personal tragedy for a man. In almost 99% of cases, the reason for the inability to have offspring among representatives of the stronger sex lies in a violation of the composition of sperm. Seminal fluid with sperm is a rather sensitive and vulnerable environment; a wide variety of factors can affect it. A man can suffer inflammation, infection, even slightly injure the scrotum, and his ejaculate will no longer be considered healthy and capable of fertilization.

Men do not like to admit that the reason for their wife’s infertility may not lie in her. For such “stubborn” people, the Ministry of Health has statistics: only in 40% of cases is the reason for the absence of children in marriage due to female infertility. In 45%, the cause lies in the male factor, and the remaining 15% includes cases of genetic incompatibility of partners and rare forms of infertility.

The probability of conception, it should be noted, is not so high even in completely healthy men. If both mom and dad are in perfect reproductive health, the chance of conceiving a child on the first try is only 11-13%. Depending on the form of infertility in men with abnormalities in reproductive function, this probability decreases.

Infertility is said to occur when a couple is unable to conceive a child after regular unprotected sex for a year.

For couples in which the age of the spouses is above 35 years, the “critical” period is considered to be a period of six months. If during this time all attempts are unsuccessful, conception is called into question and an examination is ordered.

Both women and men need to go through it. Only then can the cause be established and a way to eliminate it be found.

Norm

The main reproductive cell of a man is the sperm. The sperm carries the genetic information of the father. It is concentrated in the head of the sperm. The tail helps the cell move so it can reach the egg.

Young sperm are born in the testicles. This process begins during puberty in boys and continues throughout the life of the stronger sex. From the testicles, young sperm enter the seminal ducts - tubules, and at the moment of ejaculation, mature cells mix with the seminal fluid, with the secretion of the prostate gland and enter the woman’s genital tract.

The seminiferous tubules are very long. Almost immobile germ cells have to travel through them for a long time: about 2-3 months. During this time they have time to ripen. The final stage of germ cell maturation takes place in the epididymis.

The ejaculate of a healthy man always contains both living and dead sperm, both motile and inactive cells. It is important that the ratio of healthy and strong sperm is sufficient for fertilization, because only the hardiest specimens will reach the egg. It is not enough for the cells to be produced - they still need to mature, passing through the tubules, and also gain access to the secretory products of the male body.

• secretory – associated with secretion disorders at any stage of spermatogenesis;
• obstructive – associated with obstruction of one of the sections of the vas deferens;
• other forms associated with immune and autoimmune processes.

There are also more rare forms of infertility, usually genetic, in which healthy and viable germ cells are not produced at all or are produced, but critically few. But such cases are rare in the practice of a reproductive specialist.

Causes of infertility

Secretory infertility

The reasons why men become incapable of fertilization are numerous and multifaceted. In all cases, except for congenital genetic infertility, they are, one way or another, associated with a harmful effect on the processes of spermatogenesis or the mechanical release of ejaculate.

The secretory form of male infertility is most often associated with impaired sperm production. The testicles do not produce enough healthy cells. In addition, all morphological changes in male germ cells, as well as disturbances in their mobility and viability, are usually classified as the secretory form. If the sperm is not fast enough, and it has developmental defects and anomalies (two heads, two tails, no tail and other variations of a distorted shape), then spontaneous conception is unlikely.

The most common cause of secretory infertility is varicocele. With varicose veins, the outflow of blood from the scrotum becomes difficult - “stagnation” occurs, which gradually leads to inhibition of testicular function. Unilateral varicocele often develops into a bilateral form.

If a man is not provided with surgical assistance to eliminate varicose veins, then secretory infertility can become total and advanced.

The tissue that produces young sperm is very susceptible to the influence of fluid and pressure. Therefore, infertility often develops against the background of testicular hydrocele, as well as an existing inguinal hernia. Infertility can be caused by cryptorchidism or undescended testicles into the scrotum.. The risk of negative consequences is high if a boy is not given proper treatment before the age of seven.

When at least half of the detected sperm are mobile and can not only move, but move straight and with sufficient speed, then this is considered normal. If the number of such mobile and linearly moving sperm turns out to be low, then a diagnosis of “asthenozoospermia” will be made. In the event that no motile sperm are found at all, a diagnosis of “necrospermia” will be made.

Normally, approximately half of the sperm should be morphologically healthy. During the MAP test, as part of the spermogram, the patient's cells are compared with an existing standard - all defective cells are rejected. If the head, tail or neck of the sperm does not meet the strict standard requirements in appearance, the cell is also rejected. For conception, it is necessary that a man’s seminal fluid contains at least 40% healthy and complete cells.

If clots are visually detected in the ejaculate, the sperm is heterogeneous, then it is possible that the spermogram will show the presence of agglutination. It reduces the motility of germ cells, making conception difficult or impossible. If the spermogram shows an increase in the number of leukocytes, the doctor may suspect an inflammatory process and refer the man for additional examination - ultrasound, as well as tests for sexually transmitted and sexually transmitted infections. The doctor will do the same if pus is detected in the semen (pyospermia).

These spermograms are considered variable, and even the time of day can affect certain characteristics of the test. Therefore, a man should prepare for the fact that he may have to take the test again to check his fertility over time.

Depending on the identified type of infertility, the true cause of the fertility disorder is determined. For full treatment, additional diagnostics may be required - immunological blood tests, blood tests for hormonal profiles, radiography of the seminiferous tubules with contrast.

Treatment

It is quite possible to cure male infertility. The exception is cases of genetic, congenital infertility. For example, the absence of glandular tissue that produces sperm, or malformations of the spermatic ducts that cannot be eliminated. In all other cases, doctors can offer an individual treatment regimen. According to statistics, it is possible to cure infertility in men in 85-90% of cases.

Treatment directly depends on the true cause of the pathology. If it lies in a varicocele or inguinal hernia, then the man needs to undergo a surgical operation, after which he will be able to become a father, because the cause of infertility will be eliminated. In case of inflammation, the exact localization and degree are established - for grades 1 and 2, treatment can be carried out at home; more advanced forms require hospitalization in a hospital. When the seminal ducts are blocked, an operation is often prescribed that completely removes the obstacle to the passage of germ cells.

D Antibiotics and anti-inflammatory drugs are used to treat inflammatory processes. After completing the course of treatment, fertility is checked again and a course of therapy that supports spermatogenesis is prescribed.

Regardless of the reason that led to infertility, all men are prescribed vitamins, drugs to improve spermatogenesis (usually dietary supplements), and sedatives designed to bring the man’s psychological state in order. Vitamin complexes for men must necessarily contain zinc, selenium, iron, B vitamins, vitamins A and E, as well as folic acid. Dietary supplements (Spermaktiv, Viardot and others) contain zinc and selenium, as well as some plant substances that have a positive effect on the production and maturation of sperm.

All men who are being treated for infertility are recommended to correct their lifestyle, and very often this already has a decisive effect, and pregnancy occurs. Correction involves reducing excessive physical activity to moderate, giving up nicotine and alcohol, and proper nutrition, which should be rich in animal proteins and fats.

A man must put his weight in order: he must lose weight or gain the missing kilograms in order to reach the physiological norm. It is useful to refuse to work the night shift, because during night sleep the body produces the necessary hormones that are involved in the functioning of the reproductive system. Working in hazardous production is a reason to find another income without contact with salts of heavy metals, paints and varnishes, and nitrates.

Those who like to take a steam bath or sit in a sauna are advised to reduce such activities to a minimum, or better yet, abandon them altogether. All factors of overheating and compression of the scrotum should be excluded. You need to wear loose “family” type panties and loose-fitting trousers. Regular sexual intercourse is recommended: at least twice a week, so that sperm has time to effectively renew itself.

Couples who intend to treat male infertility need to be patient, as the course of treatment can take quite a long time: from three months to a year. Most men manage to cope with the problem and improve their sperm count within six months. If treatment and compliance with all recommendations for a year does not bring the desired result, then hormonal treatment is prescribed.

In some pathological conditions, for example, with large testicular hydrocele or oligozoospermia of 1-2 degrees, a woman undergoes artificial insemination with her husband’s sperm, in which it is injected into the cervix. If spermatogenesis disorders in a man are significant, and treatment, including hormonal treatment, does not produce results, then insemination with donor sperm is recommended for the couple.

The decision to undergo donor insemination is a voluntary matter. Many couples do not agree to this because the man does not believe that the child born will be his child.

Insemination with donor sperm

Modern reproductive technologies make it possible to fertilize a woman even with her husband’s dead sperm, however, provided that the structure of the head of the reproductive cell is not damaged and there are no violations in the DNA information. In this case, fertilization is carried out microscopically, after taking the egg from the woman. If conception has taken place, the embryo is implanted into the uterine cavity and preserved using hormonal therapy.

Treatment with hormones

As already mentioned, doctors try to resort to hormonal therapy only when sperm motility is severely impaired, as well as when there is no effect from other infertility treatment methods. Hormones are prescribed as the main treatment when the cause of infertility itself lies in an imbalance of hormones.

Treatment can be carried out using the blocking method. Its essence is quite simple: for several months the patient takes pills that, at the hormonal level, completely block the production of new germ cells. After a man stops taking medications, the body begins spermatogenesis with double strength and spermogram indicators usually improve significantly.

Despite the rather impressive results from such blocking treatment, this method is used relatively rarely.

Doctors always try to leave room for the intervention of inexplicable “higher” powers, because sometimes a man who simply takes vitamins, after several years of infertility, suddenly becomes a dad. More often, hormonal treatment is carried out using the stimulating method. It is based on the introduction of small doses of hormones, which, on the contrary, stimulate the process of sperm production, but do not affect the pituitary gland and hypothalamus.. All this time, the man will have to undergo a spermogram every three months (that’s how long one spermatogenesis cycle lasts) to determine the effectiveness of the treatment provided.

In some cases, doctors do not agree to hormone therapy. If they believe that such treatment has no prospects, they immediately recommend assisted reproductive technologies or other options.

Psychology

It is not without reason that a man who is being treated for infertility is recommended to take sedatives. The psychological consequences that can follow the news of the inability to conceive a baby can be devastating. Stress itself makes the situation worse. Added to this is depression, loss of interest in sexual relations with his wife, loss of tenderness in his relationship with his partner.

However, tablets and herbal decoctions that act as sedatives are not all. A man needs to be helped to come to an understanding of a simple truth that is obvious to every woman: a biological father is not yet a father, but the one who raised and educated him is a real father.

That is why, during the treatment process, it is advisable for a man and his wife to visit a psychologist or psychotherapist, who will help get rid of prejudices and oppressive internal tension, and help look at the situation from different sides.

Very often, a man who accepted the situation, came to terms with it, stopped being nervous and worried, suddenly becomes a biological dad. The fact is that stress hormones block the production of sex hormones and have a detrimental effect on testosterone levels. When the stress factor disappears, the man becomes calmer, and after a while the sperm count improves.

The most common example is adoption. When there is no longer any hope for treatment or other methods, everything has been tried, the couple decides to adopt the baby. They calm down, focus on raising the child, experience positive emotions more often and suddenly become pregnant.

Treatment with folk remedies

Alternative medicine has accumulated a great variety of recipes and methods that, according to healers, increase male fertility. It should be noted that all recommendations are based on maintaining a healthy lifestyle, and in this, traditional healers are in full agreement with colleagues from the field of official medicine. If a man continues to abuse alcohol, drugs, nicotine, lies on the couch and does not want to lose any of his 200 kg, then no folk or traditional remedies will help.

Traditional medicine should be regarded as an auxiliary therapy in the treatment of infertility in men. In no case does it cancel traditional treatment, which is selected individually, but it can enhance the effect and help a man become a father.

Also, you should not practice treatment with folk remedies without the consent of your doctor, since herbs are not at all as harmless as they might seem.

Different types of male infertility require different approaches, and there are no universal recipes. For example, freshly squeezed pumpkin juice is used to increase sperm motility. Its man is recommended to take a glass on an empty stomach every morning. And to improve the morphology of sperm, honey and bee products are useful, of course, provided that the man is not allergic to them.

Since ancient times, healers have revered St. John's wort for increasing male strength. The dried branches of this herb are burned and fumigated with them in the room in which the man is located, once a day. Inhaling this smoke has a positive effect on sperm production. Men living in mountainous regions and in the south have long used fresh quince juice, drinking a tablespoon of it in the evening before bed.

Traditional medicine highly values ​​the properties of plantain seeds for the treatment of infertility in men. Brew a tablespoon of seeds in a glass of water, let it brew and take a tablespoon twice a day. The same decoction is added to the bath for water procedures. It is important that the temperature of the water in the bath does not exceed 37 degrees.

A real storehouse of phytohormones is sage. A tablespoon of herbal raw materials is brewed in a glass of boiling water, simmered in a water bath for five minutes, after which the resulting decoction is divided into three equal parts. Take a third of a glass once a day. For especially romantic young ladies, alternative medicine offers an exquisite recipe made from rose petals. Red and pink petals are rich in vitamin E, so you can make homemade syrup from them and treat your loved one during daily tea parties in the amount of 2-3 tablespoons.

Instead of tea, a man can be offered a decoction of adonis or rosehip. Traditional medicine highly values ​​Adam's root for men's health. It can be purchased at pharmacies. Leave two tablespoons of the root in a thermos of boiling water for at least a day, after which the man is offered two tablespoons three times a day.

Since ancient times, infertility in men has been treated with leeches. Hirudotherapy allows you to achieve a targeted effect. For example, a leech installed at a biologically active point improves blood circulation in the pelvic organs, which has a positive effect on any stage of spermatogenesis. Special substances that leeches secrete into the human body reduce fibrinogen levels and make the blood more fluid. The man will definitely notice a general improvement in well-being, strengthening of the immune system, and after a while it is possible that he will be able to become a dad.

Hirudotherapy sessions should be conducted by qualified specialists. Leeches should only be used once. A clinic that provides such services must have all permits and certificates in order. For male infertility, leeches are placed on the area around the anus, in the perineum, grabbing the tailbone and sacrum.

Sulfur baths and mud clinics are also useful. At resorts that have such natural resources, the number of sessions and their duration for different types of infertility in men is determined by the doctor.

Male diseases - it is not customary to talk about them among men, and, unfortunately, the majority of our stronger sex reaches the doctor only as a last resort. In medicine, there is an entire section devoted to diseases of the male reproductive system, and special andrologists or urologists deal with them.

In our article we would like to present you with a short list of the most common diseases in men.

Perhaps this information, if there are appropriate signs, will help you not to procrastinate, but to visit your doctor!

1. Erectile dysfunction (erectile dysfunction) is one of the most common diseases in men.

For many men, erectile dysfunction is a taboo topic that is not usually discussed. But still this is in vain, since erectile dysfunction is not very uncommon in our time. Approximately 50% of men over 40 suffer from erectile dysfunction at least occasionally.

With age, the percentage of men with this problem increases, and it can also occur in very young people.

The reasons are varied, but most often the following are to blame:

• -psychological factors, such as stress due to previous negative experiences or fear of rejection,
• - some diseases, for example, cardiovascular system or diabetes,
• - nerve damage, for example, due to spinal cord injury,
• -disorders of internal secretion,
• - side effects of certain medications, for example, psychotropic drugs, some diuretics (furosemide), antihypertensive drugs (captopril, clonidine, apressin), beta-blockers (atenolol, betaxolol, bisoprolol, metoprolol, sotalol, etc.), NSAIDs, estrogens, antiandrogens, metoclopramide, cerucal and others,
• -overweight
• -alcohol and nicotine,
• -narcotic drugs.

2. Prostate cancer is one of the malignant diseases in men.

Prostate cancer is the most common type of cancer in men today, with about 60,000 new cases diagnosed annually.

The majority of people affected are elderly men; the average age of those affected is 69 years. Moreover, which is typical, this type of cancer can be familial in nature, and if a close member of the family suffers from it, then the risk of developing prostate cancer increases among other male representatives.

The first symptoms of prostate cancer are:

• - frequent urge to urinate,
• -painful sensations when urinating,
• -slow urination process, weak stream pressure,
• -presence of blood in the urine,
• -presence of blood in semen,
• -painful sensations in the lumbar spine, pain in the lower abdomen (above the pubis) and in the inner thighs,
• -erectile disfunction.

Interestingly, in countries where I eat a lot of soy products, men are less likely to get prostate cancer.

In general, a healthy diet with enough fruits, vegetables and nutritional supplements is good prevention for numerous types of cancer. Consumption of red meat, saturated fat and alcohol should be reduced to reduce the risk of cancer.

3. Cryptorchidism is a disease in men that affects them in infancy.

Cryptorchidism, or high position of the testicle, means that in a newborn boy one or both testicles are not located in the scrotum, but are located in the inguinal canal itself or at the exit from it.

About 3% of full-term boys at birth have a high testicle on one or both sides. In case of premature birth, on the contrary, the frequency is up to 30%. However, at the end of the first year of life, the testicles in most cases descend completely into the scrotum, so in many cases no special treatment was required.

The causes of cryptorchidism are different, for example:

• -anatomical feature of the development of the inguinal canal, which prevents the normal passage of the testicles to the scrotum,
• -hormonal disorders during pregnancy, which can also be a cause for cryptorchidism.

Another reason, as we said above, is premature birth, in which the development of the genitourinary system is not yet fully completed and the testicles at birth are located in the inguinal canal.

Treatment should be carried out no later than the first year of life, if they have not descended into the scrotum, to prevent future consequences such as infertility or testicular cancer. If hormonal therapy is not successful, then the disease is subject to surgical intervention.

4. Gynecomastia.

Gynecomastia is also one of the male diseases, which is characterized by enlargement of the mammary glands. An imbalance of the hormones estrogen and testosterone in favor of the former is responsible for gynecomastia, for example during puberty or in older men. Gynecomastia can affect one or both mammary glands, and the enlargement may vary.

Causes of hormonal imbalance:

• - certain medications, such as androgen drugs, anabolic steroids, drugs for the treatment of HIV, antidepressants, antibiotics or antitumor drugs, cardiac medications.
• -certain diseases, such as cancer, liver or kidney failure,
• -alcohol and unhealthy diet.

Treatment is carried out depending on the cause that led to gynecomastia; in most cases, surgical intervention is performed.

5. Penile cancer.

Penile cancer is a disease that mostly occurs only in men over 60 years of age.

However, this male disease also affects younger men 40 years of age and younger.

If the tumor is detected in a timely manner, the prognosis is favorable in most cases.

Penile cancer forms mainly on the glans and foreskin. If left untreated, the process spreads to the cavernous bodies, urethra, prostate and spreads further along the abdominal wall. Cancer cells can immigrate through lymphatic vessels to other organs, but the process generally occurs locally.

During the course of the disease, patients note foul-smelling discharge from the penis and bleeding when the tumor is large. Additionally, weight loss, exhaustion and increased fatigue are noted. And here are some more symptoms:

• Pain. It can occur during sexual contact, during urination, and also during showering. Any touch to the sores can be painful.
• Itching. The frenulum or the entire groin area will itch. Red dots and small lumps, like lichen, may also appear.
• Difficulties when going to the toilet become especially noticeable at stages 3-4, when metastases affect the urethra and urethra.
• The appearance of pustules. If the ulcers have opened, they can fester and at the same time emit an unpleasant odor of pus. The substance may be mixed with blood.
• The genital organs (penis shaft, glans) are swollen. This is expressed in swelling, an increase in diameter by 3-5 mm. Also, because of this, the foreskin may not fully retract.
• The lymph nodes in the groin have become larger, and pain appears when pressed.
• Discharge from the penis - it can remain both after sex and after urination. They are whitish in color with a yellow tint, have a viscous consistency and an unpleasant odor.

Causes of penile cancer:

• -elderly age,
• -lack of hygiene,
• -narrowing of the foreskin,
• - inflammatory processes,
• -human papillomavirus,
• -smoking,
• -staying in the sun without underwear.

Surgical treatment is carried out in combination with chemotherapy.

6. Premature ejaculation.

Premature ejaculation refers to a disease in men in which ejaculation occurs earlier than the desired moment, before or immediately after insertion of the penis into the woman’s vagina, without proper satisfaction and the person experiences discomfort.

Causes of premature ejaculation:

• -psychological problems,
• -fear of rejection based on bad experience,
• -very rarely the cause is inflammatory processes.

In treatment, psychosexual and behavioral therapy and self-regulation come first; if this does not help, then antidepressants are prescribed, but the quality of the erection will suffer.

Azoospermia is a disease in which there are no sperm in the ejaculate. This male disease has no visible symptoms, so it becomes known only when it is impossible to conceive a child. This is detected through sperm examination (spermogram), as well as genetic tests.

The cause of the disease may be:

• -impaired sperm maturation,
• -narrowing or rupture, obstruction in the vas deferens,
• -genetic defects,
• - endocrine diseases,
• - some diseases, for example, mumps, suffered during puberty,
• - various venereal diseases.

Treatment consists of eliminating the cause that led to the development of the disease: removing obstacles to the outflow of semen, reconstructive surgery, anti-inflammatory therapy, hormone replacement therapy. If the treatment does not help, then artificial sperm insemination or IVF is used to achieve fertilization.

8. Testicular cancer.

Testicular cancer manifests itself as a small and dense formation in the testicle, which does not hurt or interfere in any way. Some patients note discomfort in the scrotum, but still, many patients do not even feel it.

In most cases, the disease occurs in men under 35 years of age. Treatment is surgical followed by chemotherapy.

9. Narrowing of the foreskin (phimosis).

Approximately 95% of all boys are born with a naturally constricted foreskin. Basically, by the first year of life, the narrowing of the foreskin remains in about 50% of boys and by the age of 3 in about 10%. By the age of 15 years, this disease occurs in one case out of 100 people. In this case, the foreskin sticks to the head of the penis or heals in a ring-like manner.

At the same time, it is impossible to move it away and reveal the head of the penis. Opening cannot be done by force, as this will create small cracks with subsequent development of scars in their place. The causes of the disease include hereditary predisposition and inflammatory processes. Surgical treatment is performed.

10. Prostatitis is inflammation of the prostate gland.

This male disease is characterized by severe pain in the lower back, scrotum, anal area, perineum, pelvis or groin area. Symptoms include chills, fever, frequent urge to urinate, and pain during urination and ejaculation.

According to data, approximately 15% of men suffer from prostatitis at least once in their lives, and the risk increases with age.

Men aged 40 to 50 years are most affected.

Is there a cure for infertility in men? In order to answer this question, you need to understand the causes of infertility in men. Determining infertility in men is a complex process as symptoms can vary. If the patient notices that the seminal fluid has taken on the appearance of stretchy threads or lumps have appeared, you need to go to the doctor. An appointment with an andrologist should be made if a man notices that his sperm count has decreased.

If at the appointment it turns out that there are chronic inflammatory diseases of the reproductive system, which have led to inflammation in the testicles or prostate, then the patient may complain of a lack of sperm. The doctor will order tests and conduct infertility tests.

Mild pain in the lower abdomen may also appear during physical activity. This indicates the presence of a varicocele - excessive expansion of the testicular vein. It may have several stages, and infertility begins to develop already at the initial stage, when there are no symptoms of the disease. With this diagnosis, changes are associated with overheating of the testicles, which is caused by excess blood flow. Some sperm simply die. This disease can be diagnosed by ultrasound.

Also a reason to go to the doctor:

• pain during urination and sex;
• itching in the urethra;
• frequent headaches;
• unpleasant sensations in the lower abdomen, which intensify during sexual intercourse.

All this can be combined with infertility.

If you have a false urge to urinate, you should also be wary, as this may indicate the development of prostatitis.

All these diseases are treatable and with timely treatment, infertility can be prevented. But even if it has already developed, modern medicine can offer a lot of therapeutic methods to eliminate it.

However, no specialist can give an unambiguous answer to this question until the results of a comprehensive examination are received, since all cases are individual. You should undergo the necessary tests and consult with your doctor. It all depends on the cause and severity of the disease.

According to statistics, 15% of married couples cannot have children.

Which doctor is treating you?

Urologist and andrologist are specialists who treat pathology in men. Andrology is a section of modern medicine that combines several areas:

• sexopathology;
• urology and endocrinology;
• vascular and plastic surgery.

You may need to visit a therapist, geneticist, endocrinologist, cardiologist, vascular surgeon and undergo certain tests.

Complex therapy

How and with what to treat male pathology? The main task of complex therapy is to eliminate pathological and harmful everyday factors, restore the usual rhythm of life, and provide adequate nutrition. Treatment depends on doctor's orders.

How and with what to treat is determined by the doctor, based on the diagnosis. Even with the progression of the disease, there is a chance of recovery and restoration of reproductive function with the help of special medications.

Before prescribing a specific course, secondary risk factors are taken into account, which lead to:

• passive lifestyle;
• lack of regular sexual activity;
• presence of concomitant diseases;
• long-term use of antibiotics.

When treating pathology in men, it is imperative to follow all the instructions of the attending physician., undergo prescribed examinations in a timely manner, undergo regular examinations and stay on schedule. This is especially important during hormonal therapy for the correct regulation of hormonal levels.

It is also important to comply with the treatment regimen when taking antibacterial and anti-inflammatory drugs when the patient is receiving therapy for sexually transmitted diseases, sexually transmitted diseases, and other inflammatory diseases of the genital area.

Treatment of pathology can be done conservatively and surgically. For conservative therapy, men are usually prescribed:

• pills;
• injections;
• rectal suppositories;
• solutions for urethral douching.

During surgical treatment, various surgical and invasive interventions are used, prescribed depending on the cause of infertility.

In 84% of cases of infertility, a positive result can be achieved with an integrated approach.

Drugs

When treating pathology in men with medications, the following types of drugs are usually used:

1. Steroid hormonal drugs(prescribed when antibodies are detected in sperm that prevent conception).
2. Antibiotics(treat infectious venereal diseases).
3. Dopamine antagonists(taken when there is an increased level of prolactin in the blood).
4. Antiestrogenic drugs(prescribed to improve spermatogenesis).

If we talk about specific drugs, then most often experts prescribe:

• Lutain. It is an environmentally friendly and natural product, containing Altai deer extract. Normalizes reproductive function, increases sperm endurance.
• Spematon. Created on the basis of plant components, quickly restores male fertility.
• AndroDoz. Arginine-based product. Improves the fertilizing ability of sperm.
• Tribestan. Contains Tribulus extract. When taking the drug, libido increases and the ability of sperm to fertilize is actively stimulated. Prescribed for severe disorders of the reproductive system.
• Menogon. Activates the production of germ cells, helps increase testosterone in the blood.
• Proviron. A hormonal drug that is used for a variety of disorders in the intimate area.
• Proxy Plus. A nutritional supplement that improves sperm productivity. Used to increase potency.
• Spermstrong. The composition contains natural ingredients to improve sperm quality. Used to restore reproductive function.
• Pentoxifylline. The drug improves blood supply, including to the pelvic organs.

Depending on the factor causing infertility, the following therapy may be prescribed:

1. Bromocriptine. Used for secretory form of infertility.
2. Parlodel. Used for hyperprolactinemia.
3. For immunological infertility, methods of IVF and intrauterine insemination are indicated.
4. Obstructive infertility is treated surgically.

Procreation is one of the most important, interesting and complex functions of the human body. The inability of a biologically adult person to produce offspring is called infertility. Doctors make this diagnosis if pregnancy does not occur during the first year of normal sexual activity without the use of contraceptive methods.

Cases of infertility are observed on average in 10-20% of couples. One of the most common misconceptions is that this problem is predominantly female. Statistics refute this claim, showing that the causes of infertility are distributed almost equally between the sexes: one third of infertility cases are associated with men, one third with women, and the final third is divided between joint problems (20%) and unexplained cases (10%).

Female infertility is easier to define. Having learned about this problem, the woman begins treatment. It is much more difficult to persuade a man to undergo examination. Refusal to be examined is explained by the man’s fear of admitting his inferiority. Very often, infertility among representatives of the stronger sex is associated with impotence, although in fact it is by no means sexual weakness. A man's ability to reproduce depends entirely on the quality and quantity of his sperm.

Causes of male infertility

It is important to understand that infertility is not considered an independent disease. It is a consequence of a complex of different pathologies of the entire male body. This condition in a man can occur due to damage to the genital organs, pathology of the reproductive system, intoxication and somatic diseases of the body, infections, endocrinological diseases, neurological and mental disorders, chronic inflammatory diseases of the genitourinary organs, genetic, immune and chromosomal changes. Environmental factors, stress, medications, and bad habits (alcohol, smoking) also affect the male reproductive system.

Prevention of male infertility

To prevent male infertility, you should regularly consult a doctor and undergo preventive examinations. Eliminate all damaging factors such as alcohol, smoking, and use of various medications. Chronic and acute stressful situations should be avoided. A healthy lifestyle will only strengthen the reproductive functions of your body. That’s why it’s so important to eat right, maintain a normal weight, and maintain fairly high physical activity.

If you still have such a problem, then you need to start treatment immediately. Remember that treating infertility in men is a long and complex process, so above all, you will need faith and patience.

The success of infertility treatment lies in eliminating its causes. It is very important that the andrologist draw up a treatment plan that will determine the nature of the disease that caused infertility.

The doctor must also make realistic predictions about the potential success of treatment. Diagnostics starts from a minimum and expands as necessary, based on a comprehensive assessment of the condition of the male reproductive system.

There are two approaches to the treatment of male infertility: pathogenetic and empirical.

The pathogenetic approach is that the cause is first diagnosed, and then treatment is selected. Infertility, the causes of which are the inflammatory process, infections, and certain endocrine disorders, is treated with conservative therapy methods. When the causes of infertility are more serious (for example, varicose veins of the spermatic cord (varicocele) or uneven descent of the testicles into the scrotum (cryptorchidism)), then surgical intervention is indicated. Surgery will also be necessary in the case of obstructive azoospermia, when some kind of obstruction occurs in the vas deferens, which causes the absence of sperm in the ejaculate. Eliminating the influence of harmful factors can solve the problem of infertility, which lies in bad habits, environmental and other factors.

The empirical approach is based on the use of methods. If infertility does not respond to any of the listed treatment methods, then the IVF/ICSI method is used - intracytoplasmic sperm injection. At the same time, the reasons leading to infertility are not investigated. To carry out the IVF method, a sufficient number of sperm along with the egg are placed in a special container for fertilization. To carry out the ICSI method, a single sperm with the best characteristics is placed inside the egg. Such a sperm is placed in a viscous substance that protects it from possible damage. The sperm is unable to move and is then placed into a microscopic needle. The needle is inserted into the cytoplasm of the egg.

Patients with infertility are advised to give up smoking and alcohol, have regular sex life at least once every 3-4 days, avoid stress, and adhere to a healthy lifestyle. Do not forget about the means, but it is advisable to consult with a specialist before doing so. Your inner attitude is also very important. Remember that comprehensive treatment, your optimism and positive thinking can work wonders!

Especially for Love is simple