Health And Wellness Center: What factors influence male fertility?

Although the most decisive or at least the most important in achieving a pregnancy factor is the age of women, it is equally important also to study the man.

To rule out possible problems in getting pregnant, related to male fertility, the first step is to make a good anamnesis and a thorough medical history of male collect all backgrounds, both familiar and personal. Especially:

Problems in childbirth, fetal distress.
Presence of cryptorchidism (condition of the testicles)
Chronic diseases such as cystic fibrosis, diabetes, hypertension.
Acute diseases such as sexually transmitted infections, genitourinary trauma.
Lifestyle habits such as continued exposure to heat (saunas, ovens), exposure to toxic substances in the workplace (paints, solvents), consumption of snuff and other harmful substances, bicycle or motorbike as usual.
Surgical history as inguinal hernias, retroperitoneal surgery, surgery on the rectum.
Taking medication as cytotoxic, hormones, chemotherapy, which can alter the quality of semen and other functional integrity altering reproductive system as alpha blockers, generating retrograde ejaculation, some antihypertensives generating erectile dysfunction.
Interview on sexual life, coital frequency, problems with ejaculation, erectile dysfunction. Something that sometimes wonders and it is essential to know is the presence of previous children or history of abortions or abortion with previous partners. All these issues can be carried out by the gynecologist who performed the study of the infertile couple, but when in doubt or need to delve into some of the data we send the man to a urologist andrologist.

Seminogram. Test for measuring male fertility

The most important complementary test for male is the semen analysis, used to assess the number and sperm motility, and morphology.

Given a pathological result'd better repeat sample after a few weeks, at least 15 days later. The result of this test will guide the couple to what type of treatment should be done, it should be required Assisted Reproduction Technique. In cases of doubt REMT (total sperm count) will be made after training sample. If the REMT exceeds 5 million, the sample is suitable for inseminations. Below this value conventional IVF is indicated, and if it is less than 1 million IVF is by microinjection.

In cases of male factor in couples who go to a technique of in vitro fertilization, also cases of repeat abortions or suspected genetic alterations, must apply in peripheral blood karyotyping performed. This analytical study of 22 pairs of homologous chromosomes and sex chromosomes X and Y. Other genetic male analytical determinations are microdeletions of the Y chromosome studies cystic fibrosis gene, both in blood.

Other studies measuring male fertility

Other studies are performed genetic information on sperm, it is Fishe (fluorescent in situ hybridization sperm), which determines the chromosomes of the sperm. Others are the study of meiosis and the study of DNA fragmentation of sperm. The ultimate goal of all these genetic analysis is able to select genetically normal sperm when performing an assisted reproduction technique and thus avoid or at least minimize the possibility of genetic alterations and / or abortions in these couples.

In cases of azoospermia (no sperm in ejaculate presence of) the most important thing is whether it is a azoospermia by seminal tract obstruction or is a azoospermia for having no sperm production. In cases of azoospermia obstruction you can perform a testicular biopsy, which involves taking a small piece of testicular pulp and look under the microscope whether or not sperm in the tissue. In case we find sperm that are not mobile, you must perform an IVF cycle to fertilize oocytes by introducing the egg or sperm in ICSI. If we get no sperm in the sample must be raised to change male couple and attend gamete sperm bank.