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    • Testosterone TRT
    • ERECTILE DYSFUNCTION ED
      • Libido
      • Erectile Dysfunction ED
      • Ejaculation
    • Infertility
    • Anatomy
      • Penis
      • Prostate
    • Medications
      • Supplements
      • Peptides
      • DECA
      • Trimix
      • PrEP
    • Contact Us
      • Contact Us
      • New Patient Forms
  • Testosterone TRT
  • ERECTILE DYSFUNCTION ED
    • Libido
    • Erectile Dysfunction ED
    • Ejaculation
  • Infertility
  • Anatomy
    • Penis
    • Prostate
  • Medications
    • Supplements
    • Peptides
    • DECA
    • Trimix
    • PrEP
  • Contact Us
    • Contact Us
    • New Patient Forms

VITAL MEN'S HEALTH Testosterone Replacement-TRT Human Growth Hormone-HGH Rx

VITAL MEN'S HEALTH Testosterone Replacement-TRT Human Growth Hormone-HGH RxVITAL MEN'S HEALTH Testosterone Replacement-TRT Human Growth Hormone-HGH RxVITAL MEN'S HEALTH Testosterone Replacement-TRT Human Growth Hormone-HGH RxVITAL MEN'S HEALTH Testosterone Replacement-TRT Human Growth Hormone-HGH Rx

Male Fertility

Infertility

causes of male infertility

Decrease sperm

Nearly 1 in 7 couples have difficulty in conceiving after trying for over one year.  In 1 out of 3, the problem is with the male, and it can increase with age.

Decrease sperm

causes of male infertility

Decrease sperm

The quantiy and quality of a man's sperm are the determining factor on male infertility.   Low sperm production, abnormal sperm function or blockages that prevent the delivery of sperm can affect male fertility. 

causes of male infertility

causes of male infertility

causes of male infertility

Men ejaculate and produce semen, which is a combination of sperm suspended in a viscous whitish fluid produced by the seminal vesicles, prostate and  bulbourethral Cowper's gland.  Any disruption in the quality of this fluid, can  impact the survival and transport of the sperm, and adds to the multitude of known and unknown causes of male infertility, which may include:

  • General Health
  • Genetics
  • Past surgeries and medical treatments
  • Sexually transmitted diseases 

symptoms and signs

environmental factors

causes of male infertility

Some of the known causes of male infertility include inherited disorder, hormonal imbalance, dilated veins around the testicle (varicocele), or a condition that blocks the passage of sperm. 


Signs and symptoms may include:

  • Problems with sexual function, such as, difficulty with ejaculation,  small volumes of fluid ejaculated, reduced sexual desire, or difficulty maintaining an erection
  • Pain, swelling or a lump in the scrotum 
  • Undescended testicle
  • Recurrent respiratory infections
  • Inability to smell
  • Abnormal breast growth 
  • Decreased facial or body hair
  • A lower than normal sperm count (fewer than 20 million sperm per milliliter of semen or a total sperm count of less than 40 million per ejaculate)

environmental factors

environmental factors

environmental factors

Add to that, scientific studies have shown that since 1973, there has been a 50-60% drop in sperm count in developed nations.  There are known reasons, and though people want to associate certain activities with this decrease, there is no cause and effect to a proven cause.


Indeed, often no cause can be found to account for the decrease and absence of sperm count.

treatments

environmental factors

environmental factors

Treatment options:

  • Identify a cause or causes for the low sperm count.  This include a workup that may involve sperm analysis, diagnostic ultrasound, MRI study, hormonal and comprehensive lab tests, and genetic testing.
  • Review present and past medications
  • Improve diet, nutrition with supplements.  Loosing weight if obese.
  • Exercises for Pelvic Area, and other hygeinic measures.
  • Consider off-label use of prescription medication to improve sperm count and quality
  • Antibiotics, if an infection is a factor.
  • Hormone treatment, if hormonal factors are imbalanced.
  • Surgery for varicocele if present
  • Referral for  intrauterine insemination (IUI), in vitro fertilization   (IVF), IVF with intracytoplasmic sperm injection (ICSI).

Sperm Analysis

Normal Ejaculate

For the purpose of fertility, we are concerned about two things, the function of ejaculation and the ejaculate itself.  The Function of ejaculation includes the force and even frequency of ejaculation.  The ejaculate itself consist of its properties.  Grossly, this  would include the volume, consistency, and color,  Microscopically, this would include the number of sperms, their shape, and their motility.

SEMEn ANALYSIS

After a period of 3 to 5 days of no ejaculation, a semen sample is obtained and analyzed near body temperature.  Analysis factors include:

  • Volume.  Normally about half a teaspoon.  If less, then there may be blockage.
  • Sperm Concentration & Total Sperm Count.  A Sperm Count of 40 million or more is normal.
  • Sperm Morphology, that is the size and shape of the sperm.  Measure the percentage of normal sperm which are  oval with a smooth contour, versus abnormal sperm which are amorphous, tapered, duplicated, immature, coiled or blunted in the tail.
  • Sperm Motility.  Visualize sperm movement, with healthy sperm swimming actively in a straight line, while abnormal function is slow or curved motion.
  •  Sperm viability.  Are the immotile sperms alive or dead. 
  •  Liquefaction Time.    The time it takes for the semen to become liquid after leaving the body.  

AZOOSPERMIA

There is absence of spermatozoa in the ejaculate.

OLIGOZOOSPERMIA

The spermatozoa is less than 20 million per cc or milliliter, or less than 40 million spermatozoa in the ejaculate.

ASTHENOZOOSPERMIA

Sperm motility is reduced and less that 40 %  of spermatozoa have forward progression measured one after ejaculation.

TERATOZOOSPERMIA

Sperm morphology is affected with only less than 30 % of the spermatozoa having normal anatomy.

Klinefelter's Syndrome

Klinefelter's Syndrome or 47XXY syndrome

One of the most common genetic cause of male Infertility  is Klinefleter's Syndrome.  It is a congenital condition, and not hereditary.  It is said to occur in 1 out of 650 male births. 


Common Presenting Signs can include:

  • taller than average height
  • sparse facial hair
  • sparse body hair
  • reduced muscle strength
  • breast enlargement (gynecomastia)
  • feminine fat distribution
  • osteoporosis
  • varicose veins
  • smaller testes
  • low energy


Laboratory findings include:

  • decreased Testosterone level
  • elevated pituitary gonadotropins FSH and LH
  • no sperm count on semen analysis if pure 47XXY
  • low sperm count on semen analysis if mosaic 46XY/47XXY
  • an abnormal blood karyotype of 47 XXY


Management includes:

  • Testosterone replacement and stimulation
  • Supplements
  • IVF with micro-dissection testicular sperm aspiration (micro-TESE) along with ICSI (intracytoplasmic sperm injection).


47XXY

47,XXY Syndrome

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