Infertility in men

Infertility in men (impotentia generandi) - the inability to conceive, associated with pathological changes seed or diseases and malformations of the seminal tract and urinary tract.
Male infertility can be observed in Hypo - and epispadias, in which due to the incorrect location of the urethra seed at the moment of ejaculation does not enter the vagina. Mechanical Aspirmatic celebrated with the stricture and obliteration of the urethra. Aspirmatic occurs sometimes when unchanged urethra, if at the moment of ejaculation occurs reduce internal sphincter and the seed goes into the bladder. Possible infertility in men with huge crotch-scrotal hernia or dropsy of testicular membranes, prevents normal sexual act.
When the incompatibility of protein components of the sperm and the egg there is a so-called relative infertility in healthy people. Relative infertility may be due to sensitization of the female body to the sperm that sometimes possible to detect intradermal introduction extract from the ejaculate.
Most often infertility in men is associated with pathological changes of the seed. The complete absence of sperm in the ejaculate (azoospermia) depends either on violations of spermatogenic testicles (true azoospermia), or from obturation of the seminal tract (obstructive, or false, azoospermia). The ability to fertilize decreases the number of sperm in the ejaculate (less than 40 million in 1 ml) - oligozoospermia. In the absence of sperm motility talk about necrosphere.
True azoospermia observed degenerative changes spermatogenic epithelium, which can be both congenital and acquired (after orchitis with brucellosis, infectious parotitis, typhoid, tuberculosis, gonorrhea). Secretory (true) azoospermia always occurs when cryptorchidism. Obstructive azoospermia usually develops after epididymitis, deferentia and sometimes prostatitis different etiology, causing the obliteration of the lumen of the seminal tract, in rare cases - as a result of congenital anomalies of the seminal tract. Without all of the ductus deferens or part of his or broken the link between the tubules of the testes and duct appendage. Although no sperm out of the testicle or epididymis, sperm production, such patients may persist for a long time because of compensatory mechanisms.
In patients with azoospermia production of the male hormone is not disturbed. In this regard, the development of the bone-muscular system, growth and hair growth occurs on the male type. Normal remain libido and potency.
Diagnosis of male infertility with hypospadias and epispadias, and also in case of dropsy of the ovary and large hernias is easy. The obliteration and narrowing of the urethra diagnosed with urethrography. Azoospermia, oligozoospermia and necrosphere establish a microscopic examination of ejaculate. You should pay attention to the condition of the veins in the scrotum, as varicose expansion is often observed oligozoospermia. Diagnosing male infertility conduct and testis. Picture of spermatogenesis in case of azoospermia can be represented by four major groups: 1) aplasia spermatogenic epithelium; 2) generalized fibrosis; 3) stop spermatogenesis at the stage of primary spermatocyte; 4) normal sperm production. The last two groups meet with the seal of the seminal tract. When oligozoospermia there are various forms of disruption spermatogenic epithelium.
Treatment of infertility in men are often ineffective. If hypospadias and epispadias and when narrowing of the urethra necessary operations aimed at creating conditions conducive to the sperm into the vagina. Patients with obstructive azoospermia surgical treatment: various modifications anastomoses to restore the lumen of the seminal tract (Fig). In some cases, the operation over the recovery. Failure is often associated with secondary obliteration designated anastomosis. Azoospermia due aplasia spermatogenic epithelium and generalized fibrosis, no cure. If necrosphere and oligozoospermia apply vitamin E in combination with vitamin a, gonadotropic hormone of pituitary follicle-stimulating better) and thyroid hormone. Sometimes when oligozoospermia effective large doses of testosterone: inhibition of spermatogenesis is replaced by a noticeable activation of spermatogenic options after termination of the introduction of the hormone - the so-called reverse phenomenon. When oligozoospermia, combined with varicose veins of the spermatic cord, shown operation, restoring normal venous outflow from the testis and epididymis.