Male infertility
The analysis of spermatogram is adequate if abstinence from ejaculation for 3-5 days was maintained prior to the examination. The sample is collected in a sterile container. The sample may be analyzed following liquefaction (20-30 minutes) and it is advisable to start within 1 hour. If the spermatogram is pathologic hormonal treatment is applied depending on the result of the physical examination. Genetic testing may be required depending on the severity of changes or in case of multiple miscarriages. The function of organs participating in spermatogenesis (sperm production), obstruction of the ejaculatory duct or the effects of inflammation may be evaluated by the laboratory examination of biochemical markers. Diagnostic imaging (ultrasonography, CT, MRI) may be performed when required.
Possible causes of male infertility
- Congenital disorders of the testicles and/or male ejaculatory duct
- Acquired differences (lesions, condition following testicular torsion, testicular cancer, surgical interventions)
- Incomplete testis descent
- Genetic disorders (pl.: Klinefelter syndrome, chromosome aberrations)
- Stem cell disorders
- Treatment of malignant diseases (cytostatics, radiation therapy)
- Inhibition of spermatogenesis
- Viral inflammation of the testicles (e.g. mumps)
- Orchitis and epididimytis
- External effects (medications, toxins, radiation, heat)
- Systematic diseases (hepatic or renal insufficiency)
- Testicular tumor
- Testicular varicocele
- Hormonal disorders
- Immunological causes
- Sexual disorders
- Life style factors (doping, alcohol-, nicotine-, drug consumption)
- Other, non-recognizable causes
Treatment of male infertility
The disorders diagnosed by the above detailed examinations may be treated by surgical intervention or medication therapy. Medication therapy of andrologic problems lasts for a longer period (usually for 3 months); its the efficiency should be checked 3 or 6 months later. Artificial insemination with a method according to the quality of spermatogram is the solution in those cases where the cause remains unknown. If no sperm was found in the semen a small sample is removed from the tissue of the testicle (testicular biopsy) and its histological examination will assess spermatogenesis. The deep-freezing of the sample is recommended for subsequent possible artificial insemination methods. If the obstruction of the ejaculatory duct is diagnosed as the cause of male infertility microsurgical reconstruction is suggested.
