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Treating Male Infertility

25 May 2013

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It is a scientific fact, from research findings and clinical evaluations, that either the male or female partner can be the primary cause of inability to achieve a pregnancy in desiring couples. As a matter of fact, some fertility centers have reported that the root of the problem is ascribable in the proportion 40:40:20 i.e. the cause could be ascribed to the woman, man or both/unexplainable factors respectively. In other words, both partners are of equal “guilt”, so to say. My interest today is to raise the issues as it affects the male partner.


An effective reproductive functioning in the male involves the ability to manufacture an adequate amount of effective and healthy sperm cells and an enduring ability to effectively deposit these into the reproductive vault (the vagina) of a woman during sexual intercourse.
Meanwhile it is important to note that the semen which is produced during ejaculation is made up of sperm cells (10 percent) and the watery fluid component (90 percent). Sperm cells are produced in the two testes while other organs like the seminal vesicle and the prostate contribute to the watery component of the semen.


With the aforementioned in mind, anything that will lead to an inadequate production of good quality sperm cells will invariably result in infertility or sub-fertility in the male partner.
Similarly, inability to effectively deposit the pre-formed semen into the vaginal canal, as is the case with impotence, is also a factor in male infertility.
The testes which are located inside the dangling scrotal sac at the groin require an appropriate temperature that is a little lower than the core body temperature for effective production of spermatozoa in adequate amount. Hence, it is known that in male who have a history of non-descent of the testes into the scrotum by the age of two, the tendency to develop male infertility later in adult life is very high. The effect that a tight-fitting pant will have on sperm production in a man is however almost inconsequential, since this has been proven not to lead to any significant rise in temperature inside the scrotum.

Infection
Another common cause of infertility in male is a past history of sexually-transmitted infection. This can lead to painful ejaculation and blockage of the tubes through which the semen transverses from the storage point in the testis (epididymis) en-route the connecting tube, called the vas deferens, to the urethra which is the tube inside the penis through which the semen, and also urine, passes to the exterior. These conditions can therefore cause very low sperm count (oligospermia) or no sperm cell at all in the ejaculated fluid (azoospermia) later in life, sometimes long after the aforementioned infection.
Fortunately, some cases, certainly not all, of low sperm count that is due to previous STI are known to respond to medications, after appropriate semen culture and sensitivity tests have been carried out. Others may have to make do with the now available advanced assisted reproductive technologies.

Hormone problems and torsion
Another factor that can lead to low sperm count is unbalanced hormonal interplay in the production of sperm cells and their nourishment. Hormones – particularly FSH, LH and Testosterone – play important and complex interdependent roles in the production and maintenance of the spermatozoa; meaning that an unbalanced production in any of these hormones might invariably lead to low production or less survival of the sperm cells. Suffice to say that, in some cases of male infertility, low sperm cell count can be improved after appropriate hormonal therapy. This must come after a blood test that would have ascertained the hormonal profile of the man before treatment is commenced. 


Serious surgical condition such as Torsion of the testis can also compromise the integrity of the testis in future. Torsion, as the name implies, is a condition where the testis is twisted on itself causing an excruciating abdominal pain in the testes that is sudden in onset and could be quite distressing. To relieve the pain and preserve the fertility integrity of the testes, emergency surgical operation to correct the situation is the norm; otherwise, the victim risk having problem producing inadequate and unhealthy sperm in the future.

Artificial insemination
This involves the artificial collection of semen which is then directly introduced into the woman’s womb, thus, improving the chances of the sperm making it to the egg, thus by-passing the hostile vaginal environment where most of the sperm cells in tens of millions usually perished during intercourse. This procedure readily overcomes the disadvantaged situation in men that have low sperm count.


Another very effective procedure that compensates for low sperm count in men is the advanced form of In-vitro fertilization (IVF), called Intracytoplasmic Injection (ICSI). This procedure involves harvesting of egg (ovum) from the woman, collection of semen from the man and the injection of a sperm cell into the egg outside the woman’s body; having achieved fertilization outside the body, the resulting embryo is now introduced into the womb for implantation and pregnancy to result. This is one procedure that works many times ahead of others.  


On this, I must say that ICSI is a giant step in the management of male infertility; it has reduced the language of low sperm count to almost meaningless phrase in the so-called infertile males. For desiring couples, it is readily available for those who can afford the cost of treatment in almost all the fertility centers around.

Worried About High Cholesterol Blood Level

Recently I went for pre-employment medicals, which included chest x-ray, blood tests and clinical evaluation by a doctor. At the end of the exercise, I was told that my cholesterol blood level is very much on the high side.
Unfortunately, the impression I got from the doctor who broke the news to me is that I am in a pretty bad state of health going by the cholesterol result. On the contrary, I feel very healthy and I consider myself well preserved – I neither take alcohol nor smoke. Also, I’m not a philander.
Kindly enlighten me on what could have gone wrong with me. I am seriously worried.
Thanks for your anticipated prompt response.

Babs


Babs,
I share in your worries but I should quickly add that the situation does not appear to me as irredeemable. High blood cholesterol is quite common and it is now seen as a modern day epidemic.


High blood cholesterol, also called hypercholesterolemia or hyperlipidemia, is a very common condition in which the level of total cholesterol in the blood is higher than normal.


Cholesterol is a naturally occurring waxy, fat-like substance that is present in the blood and in the body’s cells. It is both made by the body itself and is also brought into the body through eating certain foods such as animal meat, which contains various levels of cholesterol.


Cholesterol is comprised primarily of three components - HDL (good cholesterol), LDL (bad cholesterol) and triglycerides. These components of cholesterol are a necessary element in the proper functioning of the body. When the HDL, LDL, and triglycerides are present in the right levels and balance in the body, cholesterol functions to protect health, including cardiovascular health.


However, when the total cholesterol levels become too high, and the levels and balance of HDL, LDL, and triglycerides in the body are not normal, it can result in the buildup of plaque on the walls of the arteries and increase the risk for developing cardiovascular diseases. These include atherosclerosis, heart disease, blood clots, hypertension, myocardial infarction and stroke. There generally are no symptoms of high cholesterol until complications develop.


Making a diagnosis of high cholesterol includes completing a complete medical evaluation and history and physical examination. Diagnostic testing includes a blood test that measures cholesterol levels. Cholesterol testing primarily measures the total amount of cholesterol and the three components of cholesterol, HDL, LDL and triglycerides.


However, blood cholesterol levels are only one aspect that can help determine a person’s total risk for developing cardiovascular disease. A comprehensive evaluation from a licensed health care professional includes compiling and analyzing many factors that impact cardiovascular disease risk. These include lifestyle, family history, personal history, dietary habits, weight, blood pressure, stress levels, and smoking/drinking habits. Other tests, including blood tests, EKG, and imaging tests, such as heart scans, are also evaluated to assess risk and if any complications of high cholesterol have developed.


It is very possible that a diagnosis of high cholesterol can be missed or delayed because there are generally no symptoms.
High cholesterol can be successfully treated with an individualized treatment plan that best fits the individual case of high cholesterol and a person’s life style. Treatment generally involves regular medical monitoring and cholesterol testing and lifestyle and dietary changes. Treatment may also include medication for some people who are unable to normalize their cholesterol levels through diet and lifestyle changes.


Going from the aforementioned, my candid advise to you is to elect to see a physician, if possible a specialist metabolic physician who is trained to specially handle cases like yours. I reiterate: your case is very much               redeemable.
Best wishes.

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