Male infertility is influenced by civilization factors, diseases and lifestyle. More and more often it is men who are sterile because the quality of sperm is worse. What tests can assess male fertility? What is it caused and how is male infertility treated?

Male infertilityhas several causes, but doctors emphasize that the most important of them isdeterioration of sperm quality . In the last 4 years,semen testsare performed three times more often, of which men under 30 are tested five times more often. The results are shocking. Systematic deterioration of semen quality is observed. This is largely the result of factors such as stress, stimulants, lack of exercise, medications, diet and work that exposes you to contact with toxic substances.

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It all boils down to a higher incidence of oligozoospermia (i.e. sperm concentration below 20 million / ml) by up to 500 percent. more often than four years ago!

Causes of male infertility

The World He alth Organization (WHO) states that the so-called the male factor in infertility accounts for approx. 45 percent. cases, and 20 percent. infertility affects only men. The diseases that may cause fertility disorders are:

  • hormonal disorders,
  • inflammation or obstruction in the sperm extraction tract
  • varicose veins.

In these cases, an andrologist who treats the male reproductive system prescribes antibiotics, hormones, or orders surgery or surgery.

Diagnosis of male infertility - semen analysis

The basic step in assessing male fertility is semen analysis. A man preparing for it should observe 3 to 5 days of sexual abstinence. This test describes semen parameters such as liquefaction time, volume, viscosity, pH, percentage of live and motile sperm, their number in 1ml of semen, and the total number of sperm in the ejaculate. Sperm morphology is also tested.

It is checked if they are well built, if they have any defects. All these factors determine their usefulness and the ability to fertilize the cellegg. When all parameters are normal, but there are still problems with pregnancy, or if the basic tests showed any abnormalities, then extended tests are ordered. These include HOS (measurement of sperm membranes integrity) and SCSA informing about the level of sperm DNA fragmentation. Only if these parameters do not differ from the norm, it is recommended to continue natural conception as well as diagnostics and treatment of the female factor. Treatment should be started when parameters are lowered.

Male infertility treatment - IMSI method

IMSI is the latest achievement in the field of in vitro fertilization recently available in Poland. This method enables the selection of sperm with the correct morphological structure and their intracellular injection. Before using the method, a preliminary MSOME test is performed, which enables the analysis of the morphology of live sperm at a magnification of up to 8000 times, which allows for precise observation of their structure and changes.

Thanks to this, it is possible to select only those fully he althy sperm whose ability to fertilize is the highest. For comparison, in the so far available ICSI method, it was possible to magnify 200-400 times, which only allowed for the observation of the general structure and motility of the sperm. The IMSI method gives a better chance for fertilization, because better quality and higher development potential of the embryos are obtained.

Clinical trials have shown that couples with sperm concentration below 20 million / ml have less than 50% of normal movement sperm or less than 14% of normal sperm morphology, the percentage of clinical pregnancies after using this method was higher by 12.7% than with the ICSI method, and the implantation (embryo implantation) rate was higher by 6%.

How effective is the IMSI method?

Using the IMSI method you can get 16.9% more pregnancies and 20.1% fewer miscarriages than with the ICSI method. Thanks to the IMSI method, with 30-40% DNA defragmentation, the success rate of implantation was 17.4%, and with DNA defragmentation above 40% -33.3%. In contrast, the pregnancy rate was 17.4% and 28.6%, respectively. With this degree of DNA defragmentation, it was not possible to obtain implantation or births using the ICSI method.

The IMSI procedure is recommended in cases of frequent habitual miscarriages, if previous ICSI procedures were unsuccessful, and when semen showed DNA defragmentation, very low sperm concentration, numerous abnormalities in their morphological structure and motility.

Important

Modern techniques to assist in getting pregnant

There are a few of today's medicinespecialized techniques of assisting reproduction:

  • IVF - consisting in placing a mature egg among a selected group of 50 thousand sperm in the laboratory and then the fertilized cell is placed in the uterus. The method is used when the number or quality of sperm is slightly below normal;
  • IVF-ICSI - is a micromanipulation procedure, i.e. the introduction of sperm into the cytoplasm of the egg cell using a micropipette. A cell fertilized in this way is placed in the uterus. The indication for the use of this method is very low sperm parameters, which do not ensure fertilization even in in vitro conditions.
  • IVF-IMSI - intracytoplasmic injection of morphologically selected sperm into the egg cell.

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Pregnancy