Written by Dr.M.D.Mazumdar, MD
Tests to identify the causes of infertility in the male are usually focussed on the semen analysis. Other tests like hormonal analysis and postcoital tests are carried out on the basis of the report of the semen analysis.
But it is essential that a thorough history of factors like weight, smoking, alcoholism, history of infections like mumps in childhood, history of any STD, history of the frequency of sexual intercourse and any difficulty in sexual intercourse should be taken. He should be specifically asked if he has a history of causing a pregnancy in any former partner.
The male partner should be examined for general health and weight. The testes should be examined by an urologist to assess the size, position - whether the testes is descended fully or partially or not at all, any pain and the presence of a varicocele or hernia - both of which can interfere with proper sperm development. The normal testicular volume is 20 ml. If volume is less than 10 ml, it usually indicates primary testicular failure.
The semen is examined within 2 hours of collection. If the semen sample shows any anomaly, another sample should be collected and examined after 1 month.
The table below is generally accepted for diagnostic purposes.
The following terms are used for diagnosis in male infertility:
Oligospermia / Oligozoospermia - is diagnosed when the sperm count is less than 10 million per ml.
Azoospermia - when there is complete absence of sperm.
Teratozoospermia - high number of abnormal sperms.
Necrozoospermia - loss of sperm motility.
Pyospermia - Presence of pus cells in the semen sample usually denotes some type of infection. However pregnancy has occurred even in couples where the male partner has pyospermia.
Fructose Level- Fructose is secreted by the seminal vesicles and absence or decreased levels of fructose usually signifies blocked ejaculatory duct. Low fructose levels cause low motility of sperms.
Prostaglandin Levels- Low prostaglandin levels may impede motility of sperms.
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So, if sperms come in contact with the immune system in injuries or infections of the testes, the immune system develops antisperm antibodies as a protective measure. These antibodies can pass into the semen and cause damage to the sperm.
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