Men Fertility Treatment

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AZOOSPERMIA

Azoospermia is the complete absence of sperm in the neat and centrifuged sample of semen. It is always important to remember that the semen analysis has to be repeated at least twice if a diagnosis of Azoospermia is to be entertained. The Etiology of Azoospermia can either be Obstructive or Non-Obstructive.

In Obstructive Azoospermia there is an obstruction to the path the sperm travels from the testis to the penis. The obstruction could be in the testis, the epidydymis, the vas deferens (the vas could also be absent) or the ejaculatory duct.

ASTHENOZOOSPERMIA

Asthenic means Weak. Asthenozoospermia is a condition where the sperms have reduced motility (movement) compared to healthy ones. Some men have 100% immotile sperms and that happens to 1 in 5000 men.

It is this inability of the sperm to move efficiently inside a woman’s body which is vital to reach the egg and cause pregnancy. Yes, your guess is correct, asthenozoospermia causes Infertility in men. The motile and healthy sperm needs to move through the woman’s reproductive tract to fertilise the egg for it to result in a pregnancy.

Men are diagnosed with low sperm motility when less than 40 per cent of the sperms can move efficiently. For the sperm to get through the cervical mucus to fertilize a woman’s egg it needs to have a progressive motility of at least 25 micrometres per second, anything less than that results in low sperm motility.

There are different types of sperm motility issues, which include; slow or sluggish progressive motility, non-progressive motility (less than 5 micrometres) and no motility. Progressive motility is where the sperms move linearly. Non progressive motility may be either when the sperms move sluggishly or go around and around in the same place.

Causes of Asthenozoospermia

The reasons for poor sperm motility is not well understood, but research claims it can be affected by:

Presence of antisperm antibodies
Excessive consumption of alcohol or drugs (tobacco, marijuana)
Age (motility decreases from 45 years of age)
Exposure to toxic products (fertilisers, chemicals)
Infections in semen
Problems in testicles
Abnormal sperm morphology
Varicocele
Poor diet
Vasectomy
Fever
Chemotherapy and radiotherapy
Habits which increase the temperature in the testicles

OLIGOZOOSPERMIA

Oligozoospermia is diagnosed when the concentration of sperm in semen is less than 15million/ml. As in Azoospermia, the semen analysis should be repeated twice. There are many reasons for Oligozoospermia. Endocrinopathies are a predominant reason for a reducing sperm count. Prolactinomas are notorious for reducing sperm counts.

Genetic factors like Y chromosome microdeletions occur in 6% of men with low sperm counts. An abnormal karyotype is seen in about 2% of these men. Varicoceles have always been a point of semantics for ages. However, there is a lot of irrefutable evidence to prove that varicoceles do affect semen parameters.

Classification of Oligozoospermia

Depending on the quantity of sperm present in a man’s sperm, Oligozoospermia is classified into 3 types:
Mild – When the sperm count is between 5 to 14 million / millimeter of semen
Moderate – When the sperm count is between 1 to 5 million / mm of semen
Severe – When the sperm count is less than 1 million / mm of semen.

What is Cryptozoospermia?

Cryptozoospermia is a special case of Oligozoospermia when the sperm count is less than 100,000 in one millimeter of semen.

Possible reasons for Oligozoospermia

Sperm travels from testes to the urethra. When there is a partial obstruction of the ducts, oligozoospermia condition can be experienced.

Varicocele

Problems in Epididymis (the place where the development of sperms happen)
Trauma or inflammation of testicles (for any reason, injury or infection etc)
Due to side effects of medication or negative effects of drugs, alcohol, tobacco products etc.
Lifestyle related – activities that increase the temperature of the testicles (clothing, saunas etc).
If left untreated or unrecognized, Oligozoospermia can turn into cryptozoospermia (very low
concentration of sperms in semen as mentioned above) or into azoospermia, a condition where the sperms are completely absent.

TERATOZOOSPERMIA

Teratozoospermia refers to abnormal sperm morphology. Sperm morphology refers to the size and shape of the sperm. Any deviation from the normal size and shape of the sperms is referred to as teratozoospermia. A normal appearing sperm has an oval elongated head with the dark staining nucleus (DNA) and 1 or 2 empty spaces (vacuoles). The head is connected to the tail by a mid-piece which has a neck. Under the microscope at least 4-5% of sperms should appear normal. To be more specific teratozoospermia is diagnosed when more than 95% of sperms in a man’s semen sample is of abnormal morphology. However, this is highly subjective as it depends on the person looking under the microscope. Toxins, infections and Varicoceles again contribute to abnormal sperm morphology.

What does a normal sperm look like?

What a normal sperm looks like. The different parts of a sperm are head, neck, mid-piece and tail. A normal sperm is about 3-5 micrometer in length and 2-3 micrometer in width. The head is oval in shape and covered by a structure called the acrosome. The acrosome should be about 40-70% of the sperm size.

Teratozoospermia – Morphology of Sperm

What are the different types of defects in the shape of the sperm?

Sperm head defects:
Large Head
Small Head
An Elongated Head
Irregularly shaped head
Globozoospermia or round headed sperm with absent acrosome.

The acrosome covering the head of the sperm may sometimes be too small or absent altogether. The head of the sperm may sometimes be totally detached from the rest of the sperm.

Neck and mid-piece defects

Asymmetric neck or mid-piece
Bent neck
Too thin or too thick neck or mid-piece
Irregular neck or mid-piece
Presence of abnormal droplet within the mid-piece

Sperm tail defects

Short
Coiled
Bent in hairpin fashion
Broken
Duplicated
With an abnormal terminal droplet

Causes of Teratozoospermia :

Many a times the cause of teratozoospermia is unknown. Alterations in the sperm morphology ensue during the last stage of spermatogenesis. Some possible causes of teratozoospermia are:

Cancer chemotherapy and radiotherapy.
Radiation exposure
Some drugs that interact with sex hormones
Diabetes mellitus and certain other chronic medical conditions
Trauma to the testes
Alcohol and drug abuse
Smoking
High fever and viral infections
Acute stress
Testicular infections
Meningitis which is the infection of the covering layers of the brain
Cancers such as Hodgkins lymphoma
Autoimmune conditions such as Coeliac disease and Crohns disease
Varicocele in which there is abnormal dilatation of veins of the scrotum hampering testicular blood flow

INFERTILITY

Infertility is a condition known as being unable to conceive children despite unprotected sex between male.

Among partner either male or female or both can be the cause of Infertility.

Causes of Infertility in Men

Abnormal sperm production
Abnormal sperm Functioning
Problem in the delivery of the sperms
Pre-ejaculation
Smoking alcohol consumption and intake of drugs and medicine.
Cancer under treatment.

Symptoms of infertility in men.

There are changes in his hair growth and style in quick gap of time.
Desire for sex and mood changes quickly
Free quant pain in the testicles
Swelling in testicles.
Small size of testicles.
Hardness in Testicles.
Problem in reaction
Problem in Ejaculation
Low sperm count – In men, generally, the sperm count is the major reason for being unable to have a child.
Problems with erections – Inability to maintain erections can also aggravate this condition.