Diagnosis of infertility in men

Features of infertility diagnosis in men

First of all, give a clear definition of what is infertility?

Infertility is the powerlessness of a sexually active couple who have not used contraceptives for several years, in the ability to conceive a child.

Unfortunately, in recent years, male infertility has become almost as relevant as the female infertility. Therefore, for some couples, the dream of giving birth to a baby becomes unrealizable. Nevertheless, it is necessary to understand the cause of the infertility that has arisen and, if possible, to eliminate it.

So, let's talk about male infertility and its diagnosis.

Causes of male infertility

Before deciding on methods of treating infertility in men, it is necessary to understand what caused this disease, and there may not be one, and each patient has different .

There are several main reasons for the development of male infertility:

  • congenital defects;
  • violations in genetics;
  • physiological and anatomical changes (pathology of the genital organs);
  • injuries of the genitals and pelvic organs;
  • dropsy of the testicle or seminal canal;
  • incorrect operative treatment of inguinal hernia;
  • adhesions, scars, narrowing of the canal;
  • stressful states of a protracted nature (hormonal failures occur);
  • exposure to harmful substances (chemicals, radiation, conditions of hyperthermia);
  • bad habits;
  • arterial hypertension;
  • lipid metabolism disorders;
  • diabetes mellitus;
  • obesity;
  • infectious diseases (including venereal diseases);
  • prostatitis.

If a man has infertility, then it reflects on the seed material (primarily on the quality of sperm), mobility and the number of spermatozoa.

The study of male reproductive health deals with an andrologist.

Diagnosis of infertility in men

As a rule, at the initial stage of the examination of the male reproductive system the diagnosis is minimal: an andrologist consultation, collection of complaints and anamnesis, examination of the patient by a doctor. At this stage of diagnosis, possible violations are identified, the functional-anatomical state of the reproductive organs is assessed - the primary or secondary infertility is determined.

Primary infertility implies that a man has never had children.

Second infertility implies that a man already has a child (with this or that partner), and it arises in the process of life, as a result of some reasons.

Further examination takes place depending on the results obtained, and then additional tests and procedures can be prescribed.

Usual examination is conducted according to the following scheme:

  • Spermogram: sperm quality indicators are evaluated - further diagnostics depend on the result of this examination. To collect reliable data of this analysis, a man should refrain for 3 days from going to the bath, drinking alcohol and sexual life. The analysis is collected in a specially designed room by masturbation.
  • MAR-test (collection of sperm is carried out in the same way as for spermogram) - confirms or excludes immunological infertility in men.
  • Doppler examination of scrotal organs and ultrasound - examination of testicles and appendages, blood supply of these organs: exclude or confirm inflammatory, physiological or surgical types of pathologies.
  • TRUZI seminal vesicles and prostate gland - a detailed examination of the prostate, which examines its structure, which allows at this stage to confirm or exclude the development of acute or chronic inflammatory processes.

    1. The hormonal background - the collection of blood for hormones responsible for male libido and the course of spermatogenesis

. They take this analysis on an empty stomach, blood collection is carried out for an hour from 9 to 10 am.

  • Genetic examination - is performed according to the doctor's appointment when pathospermia is detected.
  • PCR diagnosis of STD infections - confirms or excludes sexually transmitted infections; the effect of infection on the process of conception. Do not urinate for 2 hours before taking the test (a swab is taken from the urethra).
  • The secret of the prostate (or prostate juice) - confirms or excludes inflammation of the prostate. Before the study you need to abstain for 3 days from sexual intercourse.
  • Biochemistry of ejaculate - the study of seminal plasma. The result of biochemistry reflects the work of the prostate gland, epididymis and seminal vesicles.
  • ROS - setting the level of free radicals. One of the reasons for the decline in male fertility of ROS is the hyperproduction of reactive oxygen species (hydrogen peroxide, ozone, free radicals), which lead to a decrease in the level of motility of spermatozoa and a decrease in their ability to fertilize. This occurs as a result of damage to their membrane, and moreover - damage to the DNA of the chromosome, which provokes the emergence of apoptosis of spermatozoa.
  • Electron microscopic method of studying spermatozoa - a detailed study of the sperm, which allows to reveal the pathology of the internal structure and contents of the seminal plasma.
  • Sperm inoculation - is performed when bacteria are detected or the level of leukocytes is high.
  • Acrosomal reaction is a chemical reaction on the sperm head, which occurs at the moment of contact with the egg, which allows it to penetrate into it (this reaction occurs only in healthy spermatozoa).
  • Studying the Kruger morphology - usually performed together with a standard analysis of the spermogram. But sometimes an in-depth analysis of the spermogram is required, including standard sperm analysis, Kruger morphology and the MAR test.
  • HLA - "typing of a married couple." It is carried out when it is impossible to tolerate pregnancy - the definition of compatibility antigens of the spouses' tissues. For this analysis, blood is taken from the vein, cells of leukocytes are isolated (antigens of tissue compatibility are located on their surface).
  • Kurzloc-Miller test is a postcoital test that identifies an immunological conflict in a pair at the level of the cervix.
  • Shuvarsky's test - compatibility of partners - determine the number of capable sperm in the cervix after a certain time after sexual intercourse.
  • A testicular biopsy for diagnostic purposes is prescribed only with azoospermia, helps to make an accurate diagnosis and adjust the method of treating infertility men.
  • PSA (prostate spitsifichesky antigen) - is assigned to all men who have overcome the 45-year-old line.
  • Definition of oncomarkers - is prescribed only in cases where there are suspicions of cancer.
  • Laboratory tests (prescribed by indications) - urinalysis, urine culture, blood test and biochemical blood test.
  • Methods of treating infertility in men

    There are two main approved ways to treat male infertility. The doctor must provide the patient with a complete picture of the situation and describe the chances of recovery in both cases. Under no circumstances should you agree to little-known or questionable methods of treatment, the use of unchecked drugs. The doctor should tell in detail about the recommendations for infertile men, as a result of which it is possible to eliminate this pathology.

    A man (together with his wife) can choose the way to solve the problem of conceiving a child:

    Pathogenetic path - diagnosis of the cause of the pathology, selection of the optimal treatment according to the results of the survey. The doctor must provide complete information about the treatment of infertility in all possible ways, taking into account the state of the couple.

    Empirical way - without identifying the causes of infertility men. In this case, a method of artificial insemination is proposed, in which only one spermatozoon will suffice.

    Infertility in itself is not dangerous for a man's life, and therefore it would be wiser to choose the method that will bring a minimum of harm to health and will not have many side effects.

    Be healthy!

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