If a couple planning a child and actively living sex for two years does not have a pregnancy, examine not only the woman, but also the man. Often, the problem arises from the partner as a result of certain pathologies, chronic inflammation. Infections with childhood complications in the childhood or adolescence with complications to the genitals may result in infertility.   injury   or exchange disorders. Not uncommon today and the violation of the immune system, leading to incompatibility of partners and autoimmune lesions of testicular tissue.

Male infertility: its types

If we talk in general about male infertility, as a problem of urology and andrology, we can distinguish two main types of pathology.

This may be an obstructive form of the disorder, which is formed as a result of infections or chronic inflammation, injuries of the genital organs. In this form, sperm are synthesized in the male testicles in sufficient quantity and of good quality, without abnormalities in the structure. However, there are obstacles (obstruction) in the way of their isolation, which does not allow the male sex cells to get into the body of a woman and fertilize the egg.

Secretory infertility distinguishes the violation of the synthesis of the sperm cells themselves. With this form of infertility, they are either practically not produced, or their number is critically low for fertilization. Infertility is also possible with a sufficient number of spermatozoa, if they are inferior in structure, in this case their motor functions and activity are impaired, vitality and they cannot fertilize the egg.

Causes of secretory infertility: infection, hormones, external causes

Most often, the secretory form of infertility is formed by pathogenic effects on the testes and their appendages, which leads to disruption of germ cell synthesis. As a result, the number of spermatozoa in a portion of seminal fluid decreases, they may have mobility disorders or they die almost immediately after exposure. It is possible to make a diagnosis of a similar pathology variant by analyzing the spermogram, the ejaculate test. In the laboratory, determine the number and quality of cells, the presence of inflammation according to the results of the analysis. Sometimes a testicle biopsy is also shown to determine the problem at the level of the epithelium that secretes sperm.

A similar option happens if a man in childhood had a severe infection with complications on the genitals (parotitis, brucellosis, influenza). The influence of viruses is especially dangerous, such infections form irreversible destructive changes in the spermatogenic epithelium. Often the infection affects already at reproductive age, when infected with specific pathogens, such as chlamydia. There is a reversible or irreversible damage to the spermatogenic epithelium, which violates the synthesis of germ cells.

Other causes of damage

Often, secretory forms are triggered by a violation of hormonal metabolism, against the background of testosterone and androgen deficiencies, the effects of adrenal hormones or thyroid gland. A common cause of impaired testicular function is varicocele or dropsy, as well as trauma to the genitals. Against the background of an acute injury, swelling and hemorrhage in the testicular tissue is possible, aseptic inflammation with the replacement of functional tissue with connective tissue. Chronic injury to the genitals during professional sports, if the genitalia are subjected to pressure, is also negatively affected. Vibrations and high temperature, chemicals and some medications can negatively affect the spermatogenic epithelium.

Causes of obstructive infertility: the effects of inflammation

With this form of pathology, spermatozoa are synthesized quite qualitatively and in sufficient volume, but they cannot enter the region of the urethra, during ejaculation without getting into the body of the partner. Perhaps one-sided defeat of the vas deferens or bilateral. The cause of this is usually the inflammation of the epididymis and the vas deferens with their obstruction and obstruction. There may also be a traumatic lesion of the ducts with their subsequent inflammation, blockage by hematoma with the formation of adhesions. Inflammation caused by sexually transmitted infections is often the result of such consequences, especially if self-medication has been practiced. In rare cases, congenital obstruction of the seminiferous tubules or anomalies of their structure occurs.

The role of immunity in infertility

Immunological sterility is considered one of the specific forms. If for any reason the male immunity is impaired, the formation of antibodies to its own sperm cells is possible. This leads to the fact that the spermatozoa attacked by their own immunity in the seminal fluid actively die. This does not allow fertilization of the egg naturally. It is possible to deceive immunity only by artificial insemination, taking germ cells from the testicle and carrying out fertilization outside the body. We have not yet succeeded in finding out the reasons for such reactions of the immune system to our own germ cells, theories have been put forward regarding the effects of injury, certain infections or metabolic disorders, and hereditary susceptibility.

Other forms of pathology

Often infertility occurs as a result of anomalies of the structure of the genitals, in particular, the urethra – hypospadias. With her, the urethral discharge opening is located not on the head of the penis, but below it, in the area of ​​the penis body or even at its base. A similar anomaly is corrected even in children, at an early age by surgery.

maybe   infertility   and because of problems with erection and ejaculation – if there are disorders of potency, early ejaculation, problems with blood circulation in the pelvic cavity, which does not allow to maintain an erection at the proper level.

To identify such problems can be according to the sperm, supplemented by examination and analysis of infection, an ultrasound of the genitals. Based on the results of all surveys, conclusions can be drawn about how a man can be helped in the case of one or another form of infertility.