The numbers say that 30 percent of infertility cases are attributed to men. The causes range from the purely biological, bad habits that take their toll, risk factors that are usually ignored and even the absence of values .
In recent years, fertility centers and specialists in this area have witnessed a gradual change in what could be called the ‘profile’ of those who consult them.
Before, almost all the responsibility was attributed to women and that is why they were the most numerous users. Little by little, men became involved and stopped isolating themselves from the problem.
Today, faced with a pregnancy that does not occur, the couple – forming a common front – decides to seek help and arrives at the consultation with a very clear concept: the matter is not exclusive to one or the other… it belongs to both of us. Of course, from a biological point of view, it is undeniable that women contribute more variables to the reproductive cycle, as we are talking about possible alterations in the uterus, endometrium, fallopian tubes, eggs, etc. According to Dr. Fidel Cano, gynecologist, specialist in Reproductive Medicine, “if we wanted to break a percentage cake, we would say that between 50 to 60 percent of the causes of infertility are due to a female problem. However, by making that partition we could not obtain such exact data, since a good percentage is also the couple’s problem. For example: the most complex pathology at the reproductive level and the most difficult to deal with in terms of treatment is habitual abortion (the woman has had more than three losses); In general, these cases were attributed exclusively to the woman, but today we know that a good part corresponds to an alteration in the chromosomal packing of spermatozoa.”
In other words, men also have a role in this type of pathology.
A MATTER OF SPERM
Approximately 30 percent of infertility cases are attributable to men. And one of the most frequent causes is varicocele (dilation of the veins inside the scrotum, in which blood begins to accumulate, a condition that can cause a low concentration and low mobility of sperm). A fact: in 60 percent of varicocele cases, the man does not have symptoms.
And in order to determine the concentration, motility and morphology of the sperm, a test called a spermogram is done. Dr. Cano indicates that to obtain reliable results, the sample should be taken with three to five days of abstinence (without having had ejaculation) and through masturbation, not by interrupted intercourse.
“The patterns of normality in terms of concentration,” explains our advisor, “are given by the WHO: in a volume of 1.5 centimeters, the concentration must be at least 15 million sperm (to achieve a natural pregnancy).”
Regarding motility: sperm are classified into A, B, C, and D. The A and B are the ones that move well and have the ability to reach the egg. The C they don’t do it so well.
Finally, morphology. The study analyzes the shape of the sperm and the parts that make them up – head, neck and tail – and then counts how many normal sperm there are and how many abnormal. According to the WHO’s criteria, if out of one hundred spermatozoa four or more have a normal morphology, it is within the appropriate values.
Depending on the results of the study, the specialist may order more advanced exams and laboratory tests, which include, among others, hormonal profile, thyroid, testosterone, ultrasounds, etc. After these tests will come the diagnosis and then the appropriate and specific treatment for the couple.
RISK
FACTORSAs always, prevention will always be the best treatment. And here, Dr. Cano is reiterative regarding the need to educate about good habits for a healthy reproductive life.
“The consumption of alcohol, tobacco and drugs, in any amount, can affect sperm production. In addition, it is known that these three substances also cause alterations in the morphology of spermatozoa, these being one of the causes of miscarriage.”
Taking care of your weight is another key. “The testicles,” explains the expert, “are located on the outside of the body, covered by the scrotum; and this location is not free, because there the body temperature is much lower than the internal one. Obesity increases testicular temperature and can produce sperm alterations.”
In this same sense, there is still a lack of knowledge about men who, due to their work activity, are facing greater risk factors; those who work in environments where there are high temperatures or who spend up to 8 hours sitting (drivers, for example), and even worse, wearing tight clothing or clothing made with synthetic materials such as lycra.
A QUESTION OF VALUES
The causes of male infertility do not stop here. From adolescence it is vital to instill values for the development of sexual life. And promiscuity is the enemy. Suffice it to say that the leading cause of infertility in developing countries is diseases such as blenorrhagia, gonorrhea, syphilis and chlamidya (the most common).
Dr. Cano advocates, among other solutions, a change in policy by the State. “This has been limited to generating massive policies for the prevention of adolescent pregnancy based on contraception, but not in programs that educate on how to exercise responsible sexuality”
THIS IS HOW SEX LIFE IS AFFECTED
When we hear about infertility treatments, we immediately think of a calendar that marks pre-set days for the couple to have their sexual encounters. And so it is.
Dr. Fidel Cano indicates that many reproductive treatments have the tendency, especially those of low complexity, to condition the sexuality of the couple to specific dates for sexual activity. “And definitely, this conditioning generates stress. So, if we neglect the partner and everything becomes a simple reproductive purpose, it is possible to cause sexual dysfunction in both men and women.
Hence the need for reproductive help centers to humanize their processes.”
ADVISOR: Dr. John Fidel Cano Franco.
Specialist in Reproductive Medicine.
Medical Director IN SER. www.inser.com.co
Article for the New Magazine
