Infertility : Conditions Affecting Men

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For men, the major problem with fertility is a failure to produce enough viable sperm. Unlike women, who are born with all the egg cells they will ever have, a healthy man is constantly producing sperms, and at a rate of 10 to 30 billion each month. Azoospermia is a condition in which there is no sperm at all present in the ejaculate, and is usually a result of blockage, a testicular disorder, and/or congenital malformation of some type. Oligospermia is the medical term for an abnormally low sperm count.

Infertility can also result if the sperm produced are defective in some way. In some cases, the sperm do not live long enough after ejaculation to travel the distance necessary to reach the egg. The production of defective sperm can be due to blockage of the spermatic tubes or damage to the spermatic ducts, a situation that can be a consequence of a sexually transmitted disease. It can also be a result of abnormal development of the testes or damage to the testes. If a man or boy after the age of puberty has mumps that causes pain and swelling of the testicles, the disease may interfere with his ability to produce normal sperm. Certain illnesses, such as high fever within the past three months, and certain drugs can also cause fertility problems. Medications that can have this effect include phenytoin, which is used to control seizures; cimetidine, a stomach-acid blocker; sulfasalazine, a drug used to treat ulcerative colitis and rheumatoid arthritis; and nitrofurantoin, an antibiotic. Most have the effect of depressing either the development or the motility of sperm. Alcohol and marijuana also affect motility, while androgenic steroids can impair sperm development. Varicocele in the scrotum may be a factor in infertility as well. In very rare cases, a chromosomal abnormality such as Klinefelter's syndrome or a genetic disease such as cystic fibrosis can cause infertility.

Diagnosis of a fertility problem begins with a through physical examination to rule out any physical disorders that may be contributing to the problem. If the general state of your health is satisfactory, a semen analysis is the next step. For two days prior to the test, you will be instructed to refrain from intercourse and masturbation so that the number of sperm in the sample is at its highest level. It is also important that the semen be examined as soon as possible after collection.

A laboratory technician will do an actual count of live sperm present in the sample, closely examine their shape to detect any abnormalities, and evaluate their degree of motility and shape, is considered to begin at about 50 million sperm per milliliter of semen. A count of 100 million viable sperm per milliliter makes conception likely.

Be aware that sperm count varies. A man found to have a low sperm count one day may have a much higher count a week or a month later. It may be necessary to have a second test to determine if a low count merely represented a temporary fluctuation. Under normal conditions, sperm production is continuous. However, severe illness of any kind, as well as intense exercise and mental stress, may temporarily suspend the production of sperm. Then, too, sperm production is most efficient at about 93oF, or roughly 6oF below normal body temperature. High temperatures prevent new sperm from forming, which can result in temporary infertility. Wearing tight fitting underwear that holds the scrotum close to the body can raise the temperature of the testes enough to interfere with sperm production.

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