A couple of reproductive age is considered infertile if after one year of prolonged unprotected sexual intercourses fails to conceive. Worldwide, about 15% of the adult couples face this problem and if in a year period, without using contraceptive methods, the couple still fails to procreate, it must be submitted to medical evaluation and infertility must be regarded as a possible cause of their failure to conceive. Although the systemic problem can be found most times in the female reproductive pathology, male systemic abnormalities must also be carefully taken into consideration, examined and diagnosed.
Male infertility can be triggered by sexual dysfunctions, diseases, traumas or obstructions of the reproductive system or hormonal unbalances, which can persist more and become more difficult to treat, depending on the period they are left without medical attention, as they affect temporarily or even permanently sperm and lead to impotence or infertility.
In order to fully understand male infertility, first of all we must understand the physiology of the male reproductive system and its main coordinates:
1. The hypophysis-testicular-axis which coordinates man’s spermatogenesis.
2. The hypophysis- Seminiferous Tubules.
3. The complex process of spermatogenesis.
4. Sperm maturation at epididymis’ level.
5. Hormonal control of spermatogenesis.
6. The sperm’s transport, maturation and storage.
7. The physiologic changes which occur when the sperm reaches the oocyte enabling it to fertilize it and to create the embryo- process called capacitation.
8.The spermatogram which assumes the analysis of man’s sperm, its quality the spermatozoid health and concentration.
Male infertility can have two types of causes: pre-testicular causes as hypogonadism, which may have various causes, strenuous riding, bicycle or horse riding, or alcohol, cigarettes and drugs consume, and testicular causes like bad semen quality, teratospermia (abnormal sperm morphology), oligospermia (low semen volume), azoospermia ( condition characterized by complete lack of sperm in man’s semen).
Other factors which affect the quality of semen and may contribute to infertility are: genetic abnormalities of the Y chromosome, abnormal set of chromosomes- Klinefelter syndrome, seminoma (a type of testicular cancer), idiopathic failure, varicocele, hydrocele, cryptorchidism (absence of one or both testicles), mumps and malaria.