How do I treat inexplicable infertility

Male Infertility: Causes, Diagnosis, Solutions



It is still a widespread prejudice that infertility is a feminine issue when a desire to have children remains unfulfilled. But this is not the case. On the contrary, the causes of infertility are equally distributed among men and women. 30 percent of the The causes of infertility lie in the man.30 percent for women. In 20 percent of the cases, causes are found in both partners. The remaining 20 percent are unclear or cannot be clearly assigned. A man's inability to father children can be for a number of reasons. Therefore, the exact analysis is a Infertility in men inevitable. A hormonal disorder comes into consideration as well as an infection, a genetic defect as well as a disease in early childhood. Men faced with infertility often respond with doubts about their manhood. There is no reason to do so. Infertility in men has nothing to do with masculinity.


Understanding and openness of the partners

Because many men find this diagnosis unprepared, it is important that the couple speak about it openly and treat each other with patience, openness, and understanding in this situation. Our specialists at the IVI clinics know that infertility, whether on the part of the man or the woman, is fundamentally a sensitive issue and therefore offer you psychological support. It is also important for us that you, the patient, are fully informed before we go through the options for infertility treatment with you. In this blog we clarify the causes of the Infertility in men and show you ways so that the dream of having a dream child does not remain a dream.


Can you determine infertility yourself?

The inability to conceive does not in itself cause any complaints. It is only diagnosed in a man if there is functional potency or sexual dysfunction and the wish to have a baby is not fulfilled. At this point one begins to look for a cause. To a certain extent, a man can be his beginning Determine infertility yourselfnamely when he notices serious changes and complaints. The swelling of the testicles could be related to this. Also a noticeable but inexplicable weight gain or loss can Infertility symptom as well as pain in the testicles, urination and discharge from the penis. However, because there are numerous reasons for infertility, ultimately only a semenogram is meaningful.


Causes of Infertility in Men

Among the most common causes of Infertility in men include disturbances in sperm production and / or poor sperm quality. Occasionally, several reasons come together:


  • Mumps in childhood
  • Undescended testicles in newborns that have either been untreated or operated on very late
  • Hormonal imbalances. The hormones LH (luteinizing hormone) and FSH (follicle-stimulating hormone) are crucial for the formation of new sperm. LH ensures testosterone production in the testes. Deficiency usually reduces libido. FSH has a direct influence on the formation of new sperm in the testes
  • Inflammation of the testicles or epididymides at a young age or as a child
  • STDs such as gonorrhea or syphilis
  • Erectile dysfunction
  • Failure to ejaculate
  • Inflammation of the sex glands such as prostate, seminal vesicles
  • diabetes
  • Chemotherapy and radiation therapy for cancer
  • Chromosomal changes. In Klinefelter syndrome, men have two X chromosomes and do not produce enough testosterone
  • Overheated testicles, such as those caused by varicose veins. Sports (cycling in tight clothing) and workplaces with permanent temperatures above 32 degrees also reduce the amount of sperm
  • Limited sperm transport (obstructive azoospermia) due to a chlamydial infection, testicular or prostate inflammation, urethral narrowing, after an inguinal hernia operation or in the case of the metabolic disease cystic fibrosis
  • Antibodies against your own semen
  • Anabolic steroids
  • Alcohol and tobacco consumption, stress, medication and environmental toxins


Lifestyle questions

To the How to recognize infertility in a man, a thorough medical history is essential for our doctors at the IVI fertility clinics. The amount of care that must be taken is shown by the multitude of causes mentioned. Therefore, we first ask questions about lifestyle, previous illnesses, operations, medication, stress factors, sporting activities, nicotine and alcohol consumption and eating habits. Then the genital organs will be examined and a blood analysis will be done to determine the hormone levels. In order to complete the diagnosis, we create a semen analysis. That is one of the most important investigations into the Test for infertility.


The importance of a semenogram

A semen analysis provides all the parameters that are necessary for the Infertility in men ascertain. A man who wants to father a child needs around 20 million sperm cells per milliliter in his ejaculate. However, it is not quantity alone that makes the difference. The sperm must be sufficiently mobile and normally shaped. Survival time also plays a role. Another important point is free transport routes. There must be no obstacles for the sperm on their way from the testes to the epididymis via the spermatic duct to the outside of the ejaculation. And finally, the way into the uterus must also be successful.


Abstinence before the semen sample

In order to perform a semen analysis, we need a semen sample for our laboratories. A period of abstinence of three to five days is required before the semen is donated in order to get as many high-quality sperm as possible. Since the sperm count is reduced with every ejaculation, this waiting period is necessary. However, if you wait too long, the mobility of the sperm can deteriorate. However, since a semen analysis is only a snapshot, at least one additional semen analysis is carried out.


Sperm under the microscope

As soon as the semen sample is available, the properties of the ejaculate are broken down under the microscope. The sperm concentration per milliliter, the total number of sperm, the proportion of living sperm, mobility, morphology (shape), the ejaculate volume and the pH value are measured. The smell and color are also checked. Once these results are available, they will be compared to the standards set by the World Health Organization. According to the standard values ​​of the WHO, there must be a sperm concentration of at least 20 million per milliliter, a total sperm count of at least 40 million per ejaculate and a minimum mobility of 32 percent. According to the WHO, 4 percent of the seeds must have a normal shape.


What the semen analysis reveals

If the result of the spermiogram shows that the number, shape and mobility of the semen are restricted at the same time, it is called OAT syndrome (oligo-astheno-teratozoospermia syndrome). O stands for oligo and means too little, A for Astheno means little mobility and T for Terato means misshapen. We can also read other factors from the results. An increased number of white blood cells in the ejaculate suggests inflammation. You can also see whether there are antibodies that destroy your own seeds. In this case, it is possible to take semen from the testicular tissue in order to use it later for an artificial insemination.


With a variety of methods you can still achieve your dream child

As soon as we have all the results, we discuss how to proceed with our patients **. Because the Infertility of a man does not mean giving up a desired child. The experts at our IVI clinics can offer you different treatment methods. Artificial insemination, for example, is one of the most common methods of assistive reproductive medicine. The insemination is carried out either with your own or with donor sperm. Which variant we recommend depends, of course, on the quality of the semen.



To improve and prepare the semen, our doctors use the two techniques ICSI and MACS. ICSI is an intracytoplasmic injection that requires a semen sample or a testicular biopsy. The most suitable sperm is selected and transferred directly to the woman's egg. This makes fertilization easier and increases the chances of conceiving. This technique is mainly used in men whose sperm are only slightly mobile and have a negative shape. We also recommend ICSI in the case of teratozoospermia, i.e. if the proportion of abnormal sperm is very high.


With MACS we have a technique with which the semen sample can be processed in a special way. MACS means "Magnetically Activated Cell Sorting". Tiny magnetic particles attach themselves to the sperm that have little chance of survival and will die before an egg is fertilized. In this way, healthy sperm with the best properties can be selected for artificial insemination. The MACS technique can basically be used with all patients **, but is particularly suitable for artificial insemination and in vitro fertilization (IVF) and for a combination of IVF and ICSI.


Artificial insemination with donor sperm

Artificial insemination with donor sperm will then be considered if the cause of the Infertility in men lies in a highly pathological change in the semen. Likewise, if sperm could not be found in the ejaculate or a testicular biopsy. Sperm donation is also advisable in the case of chromosomal abnormalities in the semen or a genetic disease that cannot be investigated in the embryo.


Donor sperm is also necessary for other treatment methods if the quality of your own sperm is insufficient for successful fertilization. This applies to classic in vitro fertilization, the most frequently used treatment method in reproductive medicine, as well as to egg donation. We also recommend IVF Genetic, a combination of IVF (In Vitro Fertilization) and PGS (Preimplantation Genetic Screening) sterile men to donor sperm.


No reason to give up hope

Will the Infertility of a man diagnosed, it may initially be a severe blow for both partners - but it is by no means a reason to give up hope in a child. On the contrary: In this blog we not only give you the complex background and Symptoms of infertility in men explained, but also showed you the ways that reproductive medicine can achieve. And ways in which we at the IVI clinics can help you. Our highly specialized physicians will be at your side with advice and action right from the start and will expertly accompany you on your way to having your dream child.

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