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Male Factor
It is found 40% of the infertility cases are due to male factor defects.
The sperms have to travel a long route before emission. The Vas Deference, which carries the semen containing the sperms after production in the testes, traverse from the bottom of the scrotum to the top. The Vas Deference, from either side, then curve towards the penis. In a common passage in the penis, semen is ejaculated from the tip. |
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Male factor defects can be classified under two broad heads
Obstructive Defects
Obstructive Defects are due to blockage in the passage of the sperm. The blockage could be due to infections like tuberculosis or due to bacterial infections. Any injury to the organs or surgery for Hernia, Hydrocoel can cause fibrosis and obstruction.
Non Obstructive Defects
Non Obstructive Defects are due to
- Gene defects leading to very low sperm counts
- Destruction of testes due to infections like tuberculosis and mumps
- Low counts due to varicocoel.(a condition wherein the veins in the scrotum are dilated and the resulting heat in the scrotum depresses the count
- Erectile dysfunctions: Impotency, infrequent coitus, premature ejaculation, retrograde ejaculation.
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| Male Factor Infertility |
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| Factors affecting sperm production |
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The treatment of male factor infertility is one of the true success stories in the field of reproductive medicine. Male fertility screening is done through semen analysis. Disorders of sperm quality range from a low count or motility to a complete absence of sperm production. Deformities of the sperm cell shape (morphology) are also important to its ability to fertilize the egg. Mild abnormalities of semen parameters can be effectively treated using techniques that “wash” out the seminal plasma and improve the concentration of normally shaped motile sperm, which are then transferred to the uterus via an intrauterine insemination. However, for more severe conditions this treatment is inadequate. With a total motile cell concentration of less than 10 million cells per ml or a normal morphology of less than |
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4% by strict Kruger criteria, the chance of fertilization failure is very high, even with IVF. As a general principle, if the male factor cannot be reversed in the man’s body, by simple medical or surgical treatment, then IVF with ICSI represents the only rational approach, the results are excellent. Intrauterine insemination is not an effective way of treating mild to moderate male infertility.
The most common causes of low sperm count are temporary and treatable. Research has shown that emotional or physical stress, cigarette smoking or heavy alcohol consumption can affect sperm production and male fertility. Sperm counts usually return to normal levels after such lifestyle issues are addressed. Certain drugs, radiation and radiotherapy may have a detrimental effect on the production of sperm. The presence of a varicocele may lead to a rise in the temperature around the testicles, which may adversely affect sperm production and motility. Testosterone deficiencies and certain autoimmune disorders that cause the body’s defenses to attack developing sperm. |
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