infertility in men and those factors and problems that are related to men in infertility and can have various reasons such as:
Varicocele
Varicocele or testicular varicose veins are the most common disease in men after puberty, and about one-sixth of men have varicocele. In men with infertility, the figure is as high as 40 percent. Varicocele is the most common cause of male infertility. The onset of the disease is usually during puberty or immediately after puberty, but may occur at a younger age or older age. The patient may present with a large complaint, or asymmetry of the testicles, or testicular pain, or after marriage, with infertility. But the most common form is asymptomatic, and accidentally, during the examination, they notice it. If varicocele is a complication, treatment is needed. Otherwise, no treatment is needed. Complications of varicocele include pain, atrophy (shrinking in size and softening of the testicles), and infertility. The pain caused by varicocele is a pain with a heavy feeling, which is aggravated by activity and standing, and is relieved by rest. Varicocele is the most common cause of low sperm production and low quality, although not all varicoceles affect sperm production.
Oligospermia
Oligospermia is a condition in which the sperm concentration (sperm count) in the semen is low. For example, a person with less than 20 million sperm per milliliter of semen is considered oligospermia. Low sperm counts in semen can be due to a variety of reasons, and this can be temporary or permanent. Diagnosis of oligospermia is possible with a simple semen test at infertility treatment center. Regarding oligospermia, it should be noted that there is currently no reliable and definitive drug treatment for this case. It is difficult for this group of patients to achieve a normal pregnancy due to the low sperm count, but it is not impossible. While achieving a normal pregnancy with low sperm counts is generally very rare, many cases of successful pregnancies have also been reported. Many couples who have problems with low sperm counts to achieve a normal pregnancy can use assisted reproductive technology techniques such as intrauterine insemination (IUI) or IVF for successful pregnancies.
Azoospermia
Azoospermia is a condition in which a person lacks sperm in the semen. This condition is often associated with a very low chance of fertility or even infertility. Azoospermia affects 1% of the male population and may be the cause of 20% of cases observed in male infertility. As mentioned above, it should not be confused with aspergillosis, which is the absence of semen. Azoospermia may be divided into three main types:
- Pre-testicular azoospermia:
It is a condition characterized by insufficient stimulation of the natural testicles and the natural reproductive system. This is due to low levels of the hormone FSH and insufficient stimulation of the testicles to produce sperm. Pre-testicular azoospermia is seen in 2% of all azoospermia types.
- Testicular azoospermia:
Under these conditions, the testicles are abnormal, atrophic, or non-existent, and sperm production is severely affected or not performed at all. The most important factors that causes testicular azoospermia are congenital causes including specific genetic factors such as Klinefelter syndrome, some cases of cryptorchidism, Sertoli cell-only syndrome, and so on. These include infections (testicular inflammation), surgery (trauma, cancer), radiation, or other factors.
- Post-testicular operative or obstructive azoospermia:
In azoospermia, a sperm test is produced but not ejaculated, which Include for 7 to 51% of azoospermia types. The most important reasons for this condition are the physical blockage of the reproductive system after the testicle. The most common reason can be due to vasectomy as a way to prevent pregnancy. However, the cause of some other obstructions may be congenital, due to infections. In Post-testicular azoospermia, ejaculatory disorders, including recurrent ejaculation or even ejaculation, may not be present, but in this type of azoospermia, sperm are produced but do not come out for the reasons mentioned.
Aspermia
Aspermia refers to the complete absence of semen and should not be confused with azoospermia or lack of sperm in the semen. This naturally leads to infertility. One of the causes of Aspermia is related to retrograde ejaculation or the entry of semen into the bladder instead of leaving the urethra during ejaculation. This can be due to overdose or prostate surgery. Other causes of aspergillosis include obstruction of the ejaculatory duct , the most important of which is the complete absence or very small volume of semen (oligospermia), in which semen only contains prostate gland secretions in the ejaculatory ducts.
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