It is estimated that 40% of infertility in couples is due to problems in the man, according to figures from the World Health Organization (WHO).
Expert: Patricio Gonzalez, head of Unit of Reproductive Medicine
The male fertility depends on a normal ejaculation and the appropriate condition of the semen. However, there are variations that produce sterility, as the absence of sperm, called Azoospermia; or the low number and mobility of these, called Oligospermia.
Compared to this, it is important to determine what factors influence and what not, since there are so many myths around this topic. So says dr. Patricio Gonzalez, head of Unit of Reproductive Medicine Clínica Alemana.
“In general, there are more beliefs of what science has been able to demonstrate. As there are also many cases of couples are subfertile, meaning that they are not infertile, but they are going to take a lot more time, so sometimes they need a little help to conceive,” he says.
These perturbations can be of genetic origin, such as the existence of micro-deletions or deficiencies in the chromosome Y. To establish the genetic reasons that can cause this disorder, is carried out by the test of infertility, male (TIM).
This test is devised to study the specific areas of the chromosome And, with the purpose of ascertaining the presence of any deficiency. It also applies to rule out other factors behind infertility. To perform this test you need to saliva samples, or samples of liquid sperm removed from the semen. The analysis delay of about 15 days and this will determine the presence or absence of micro-deletions analyzed.
The specialist explains that the assessment of man is done through semen analysis or semen analysis is done. The variables most important are: concentration (number of sperm per ml), motility (mobility transfer), and percentage of sperm with normal forms, or abnormal.
The values of these tests are very relative and may vary from one ejaculate to another, so it is recommended to perform at least two analyses of semen. The same person can have a count of 70 million sperm and three days after 16 million.
Then, the specialist check out some of the variables and determines which ones are which could effectively affect male fertility.
TemperatureThere is evidence to show that the local increase of the temperature can influence the reproductive capacity of men, so that any prolonged exposure in the weather could have an impact.
The condition called an undescended testicle, a congenital condition that does not allow the testicles to descend from the abdominal cavity into the scrotum, which exposes them to a higher temperature in the abdomen, is related to a bad production of the sperm.
“The problem is that in the treatment of this disease the pregnancy rates do not increase, so that there would be other mechanisms that interfere with, in addition to temperature,” emphasizes the expert.
Could also affect, for example, the use of the laptop on the lap, saunas, or hot baths and tight underwear, among other things, although there is nothing scientifically proven to substantiate this hypothesis.
TobaccoDr. Gonzalez is emphatic in asserting that it is proven that the tobacco consumption causes a fall in the fertility of the man. “Before, it was more evident in women, but there are studies that say that the man also has an influence,” he added.
In these cases it is difficult to establish a cut line, so the specialist recommended to all couples who come to the consultation, which both stop smoking. In addition, as data, tobacco is one of the main risk factors for microabortos and malformations.
Age of manIn man there is a fall in reproductive capacity after 40 years of age who, unlike the woman in the menopause, is not so obvious.
For example, men and women of 60 can be kept fertile, but it is difficult to test in the general population, as they would have to be played with couples in the stage of more female fertility, between 20 and 30. On the other hand, a couple in which the man is subfértil may not have problems as long as the woman is young, but as you get older it is possible that present difficulties. “What happens is that the higher fertility of the young woman ‘conceals’ male subfertility”, emphasizes the specialist.
Consumption of the drugToday, it is proven that in men poliadictos there would also be a decrease in the ability of fertile, as well as in those who consume cocaine and marijuana on a regular basis.
PathologiesThere are several diseases that decrease the ability of the sperm. One of the most common is the above-mentioned cryptorchidism (undescended testicle), and varicose (a dilation of the veins along the cord that holds the testicles).
However, studies have not shown that surgery for the varicocele results in better pregnancy rates in their partners, that does not mean that you will not need to operate, but you should investigate other causes of infertility.
Another disease that can affect male fertility is the mumps or mumps, which can cause orchitis urliana, or a swelling testicle which, secondarily, may leave sequelae of infertility, although with a very low incidence. The important thing, in this case, it is not the age, but that the mumps are presented with orchitis.
Other factorsThe use of hormones to affect fertility due to the decrease of the sperm by inhibiting the testosterone levels.
Also, men with obesity may also lower your likelihood of becoming pregnant.
For the specialist, the stress is very subjective and difficult to evaluate, especially in a couple subfield, because of the patients that come to consult, the majority are stressed by not being able to get pregnant, so it requires more studies to assess the real impact.
The psychiatric conditions are another thing. For example, patients with depression experience a decrease in libido, maintaining a sex life is low, so the chance of getting pregnant in fertile period is lower.
TreatmentsThe modern treatments of sub-fertility and male infertility, remain the techniques of assisted fertilization, that is to say, “zoom in” the sperm to the egg. The most used are intrauterine insemination and in vitro fertilization.
The great revolution in therapeutics is the ICSI (injection of one sperm inside the egg), which allows couples with a diagnosis of severe male factor may be parents.