INFERTILITY A RISING SCOURGE IN OUR ENVIRONMENT.

MALE FACTOR-
Up to 15 percent of couples are infertile. This means they aren't able to conceive a child even though they've had frequent, unprotected sexual intercourse for a year or longer  2-3 times a week for about a year. In up to half of these couples, male infertility plays a role.
Male infertility is due to low sperm production, abnormal sperm function or blockages that prevent the delivery of sperm. Illnesses, injuries, chronic health problems, lifestyle choices and other factors can play a role in causing male infertility ,herbs consumption may play a significant role for this male factor infertility.
Over time infertility has been present but a lot of emphasis was on female factor infertility rather than male factor. Understanding that our environment is a male dominant culture type.
this has led to many women going to perform investigations for what they didn't need.
male factor contributes up to 50% of infertility cases. the reason this is so may be because in most cases of infections men are usually quite or may not show symptoms. This rising cases of infertility has become a major concern. Sperm motility and count seem to be more important than the morphology, all this parameters are important in their own way
we would analyze  a sperm test and explain the possible causes  and treatment options we can employ to seek solutions. Important to note that sexual performance is not usually affected in most cases and the quality of the sperm may look normal in the eye .microscopic examination will reveal in detail what we are dealing with.
what is sperm analysis? This is  a simple test that involves the ml/;e producing ejaculate into  a wide mouth sterile container. this usually should be the first test to be done in an infertile couple but unfortunately in our society(Africa)its usually the very last to be done. the sperm is most preferably to be collection by masturbation.

The male reproductive system

The male reproductive system is made up of the testes, a system of ducts (tubes) and other glands that open into the ducts. The brain plays an important part in the control of the male reproductive system.

A side view showing the main parts of the male reproductive system

The pituitary gland and the hypothalamus, located at the base of the brain, control the production of male hormones and sperm. Luteinizing hormone (LH) and follicle stimulating hormone (FSH) are the two important messenger hormones made by the pituitary gland that act on the testes.

Two messenger hormones act on the testes

The testes (testis: singular) are a pair of egg-shaped glands that sit in the scrotum next to the base of the penis on the outside of the body. The testes make sperm and the male sex hormone testosterone. It takes about 70 days for sperm to become mature and able to fertilize an egg.
When released from the testes, the sperm spend two to 10 days passing through the epididymis where they gain the vital ability to swim strongly (become ‘motile’), and to attach to and penetrate (get into) the egg.
At orgasm, waves of muscle contractions transport the sperm, with a small amount of fluid, from the testes through to the vas deferens. The seminal vesicles and prostate contribute extra fluid to protect the sperm. This mixture of sperm and fluid (the semen) travels along the urethra to the tip of the penis where it is ejaculated (released).

SRERM ANALYSIS AND  MEANING.
COLOUR-
gray opalescent  normal
gray opaque-infective
yellow opalescent-infective
yellow opaque-infective amongst other causes

PH- Usually 7.2 tending more to alkaline

MOTILITY-At least 40% of the count should be motile with 32% showing fast progressive linear motion. This parameter is very important in determining fertility.

COUNT- The total count is the volume of ejaculate x concentration of sperm /ml.  15 million /ml is the accepted value.

LIQUEFACTION-This should occur within 1hr.

VISCOUSITY-tells the consistency of the ejaculate. 1/4 is regarded as normal,4/4 is a highly viscous medium.

MORPHOLOGY- This tells the shape and structure of sperms.4% normal forms is accepted  and can achieve conception.

ANTISPERM ANTIBDIES-This may be present in some cases and its routinely seen. Trauma and surgery may be predisposing factors.

Known causes of male infertility

Sperm production problems	• Chromosomal or genetic causes • Undescended testes (failure of the testes to descend at birth) • Infections • Torsion (twisting of the testis in scrotum) • Varicocele (varicose veins of the testes) • Medicines and chemicals • Radiation damage • Unknown cause
Blockage of sperm transport	• Infections • Prostate-related problems • Absence of vas deferens • Vasectomy
Sexual problems (erection and ejaculation problems)	• Retrograde and premature ejaculation • Failure of ejaculation • Erectile dysfunction • Infrequent intercourse • Spinal cord injury • Prostate surgery • Damage to nerves • Some medicines
Hormonal problems	• Pituitary tumors • Congenital lack of LH/FSH (pituitary problem from birth) • Anabolic (androgenic) steroid abuse
Sperm antibodies	• Vasectomy • Injury or infection in the epididymis • Unknown cause

Its worthy of note that some of this conditions can be treated and fertility outcome have improved. The role of intra cytoplasmic sperm injection has made the very hopeless cases fruitful.
So if you are looking for a child and you have been trying for over a year, seek medical help as soon as possible. We will write a little more on female causes in the next article. Questions or contributions  you can email us naijadoctors@gmail.com,  drchidi@alpinehealthng.com