Hormonal disorders
There are two hormones secreted by the pituitary gland in the brain that play an important role in sperm production and the production of testosterone, the male hormone: FSH and LH. A disturbed balance between these hormones can cause infethility.
Testis Causes
These causes can be classified as obstructive and non-obstructive. In obstructive causes, sperm production is normal but there are problems with hard excretion. In non-obstructive causes, the problem is in sperm production.
What does low sperm count mean in male infertility?
In men, sperm production takes place in the testicles. The testicles begin their development in the abdomen and then descend into the scrotum. This is because the temperature required for sperm production is lower than body temperature.
There are parameters that indicate that a healthy man is fertile, such as sperm concentration, total sperm count, motile sperm count, sperm morphology and motile sperm count. If these parameters are normal, a man can be said to be fertile.
To check these factors, a spermiogram test is performed. Before performing a spermiogram test, an ejaculate obtained after 2-3 days of sexual abstinence is examined for these factors.
In a normal fertile man, the sperm concentration should be above 20 million sperm per milliliter.
Sperm count is therefore extremely important for fertility. Low sperm count is a factor that increases the risk of infertility. This is because a low sperm count reduces the variety of sperm that can potentially fertilize the egg.
Low sperm count is usually accompanied by motility and morphology disorders. Therefore, the importance of sperm count in male infertility cannot be underestimated.
What are the causes of low sperm count?
- Varikocele
- An out-of-place testicle affects sperm count. If the testicle does not descend from the abdomen into the scrotum during development and remains there, sperm production is not observed because the temperature is not suitable.
- Testosterone is an important hormone in sperm development. If there is a testosterone deficiency, this negatively affects the quality and quantity of sperm produced.
- Infections
- Retrograde ejaculation, where the sperm goes to the bladder instead of being expelled from the penis, is also a reason that affects the number of sperm in the ejaculate.
- Radiotherapy and chemotherapy for cancer
- Warming of the testicles
- Febrile illnesses as a child
Do previous febrile illnesses in men cause infertility?
Male problems account for 40% of the causes of infertility. These causes are as follows:
- Cryptorchidism
- Undescended testis
- Testicular tumors
- Testicular trauma (injury)
- Varikocele
- Infections
- Systemic diseases
- Congestion in the reproductive tract
- Reverse ejaculation due to side effects of medication
- Nervous system causes
- Genetic disorders (Mediterranean anemia, sickle cell anemia and bladder disorders, etc.)
- Alcohol, smoking, drugs
- Chemotherapy, Radiotherapy
- High temperature, sauna, hot water baths
- Endocrine problems
- General anomalies
What Factors Affect Sperm Quality?
In men, especially with advancing age, sperm quality decreases. Therefore, men over the age of 50 who are thinking of becoming fathers should be informed about the possibility of their children being born with a disease (such as autism, schizophrenia, etc.).
In addition, the strenuousness and stress level of the man's life, alcohol and cigarette use, chemical and radiological factors he is exposed to and obesity are among the factors that reduce sperm quality. Therefore, it would be better for men to avoid these factors for their sperm health.
What is a spermiogram?
The spermiogram test, also commonly known as semen analysis, is a microscopic examination that reveals the fertilization potential of sperm cells. It can be requested not only from infertile men but also in cases such as varicocele, orchitis, undescended testicle, radiotherapy/chemotherapy to monitor sperm quality. Before the spermiogram test, the patient is taken into the room and questioned whether he has had any illnesses during childhood, adolescence and adulthood. Because some diseases in these periods may affect the testicles and impair the function of the organ. The reproductive organs are then examined in detail. The man's diseases, occupational conditions, habits such as alcohol and smoking, which contraception method the couple uses, etc. are questioned. Because this information can be meaningful for the specialist in the treatment plan or diagnosis. Before giving a sperm sample for the spermiogram test, the man must abstain from sex for at least 2 and at most 5 days. Your doctor may ask you for this test at least twice between 3 and 8 weeks. The following points should be taken into consideration when giving a sperm sample:
- Sperm sample should be given in a hospital environment. If the patient is unable to give a sample under hospital conditions due to psychological reasons, he/she should leave the sperm sample in the container given to him/her by the hospital and deliver it to the hospital as soon as possible and keep it at a temperature close to body temperature. Otherwise, the test results may not reflect the truth.
- For patients who cannot give sperm by masturbation, specially produced condoms that do not contain any substances that can damage sperm are given. Patients can give a sample with the help of their partners.
- Penis and fingers should never touch the sterile container provided for sperm sampling.
- The entire ejaculate should be placed in the container.
- If some of the ejaculate is smeared outside the container, this must be reported when the sample is handed over.
What to Look for in a Spermiogram Test
The spermiogram test shows that the sperm
- Motion features
- Number
- Concentration
- Criteria such as morphology are used to make a conclusion about the sperm's ability to fertilize.
What to do for sperm health
First of all, eating habits should be changed for sperm health. Fast food style foods should be avoided. If any, habits such as alcohol and smoking should be quit. Extreme heat should be avoided. Excessively tight underwear also increases the temperature in the testicles and can damage sperm production. Be very careful against sexually transmitted diseases.
What is Varicocele?
Varicocele is a varicose vein condition that occurs after dysfunction of the valves of the veins that drain the dirty blood in the testicles. It can be seen in 15% of men and can lead to problems such as pain, infertility and testicular shrinkage. As venous blood accumulates in the testicles, it may cause symptoms such as swelling, swelling, pain, sweating, hot sensation. Although the cause is not clear, varicocele is seen in 30% of men who present with infertility. Varicocele is observed in the left testicle in 90% of cases. The reason for this is mostly related to the anatomical features of the left testicle. It is observed bilaterally in 8% and on the right side in 2% of cases. Since varicocele disrupts the venous drainage of the testicle, it causes an increase in testicular temperature and prevents the removal of harmful metabolites. As a result, the spermiogram of a man with varicocele
- Decrease in sperm cell count
- Decreased sperm mortality (motility)
- Impaired sperm morphology (shape) occurs.
- Irregularity, swelling, pain over the testis
- Pain after exertional activities such as prolonged standing, sports or sexual activity may indicate varicocele.