Male Infertility: Detection and Treatment

Infertility or the inability to conceive a child has been regarded as a woman’s health issue, through the centuries. However, in the last few decades, there is a significant change in outlook, and more men are accepting the reality of male infertility. 

Causes

The most common causes attributed to male infertility are low count and motility of sperms. However, there are other factors which affect the production and transportation of sperms, consequently causing infertility. 

Factors Relating to Sperm Production 

• Chromosomal or genetic defects such as Klinefelter’s syndrome, Kallman’s syndrome and cystic fibrosis
• Undescended testes, a condition wherethe testes have not descended from the abdomen into the scrotal sac after birth
• Infections: Sexually transmitted diseases such as Chlamydia, Gonorrhea, Syphilis, and inflammations of the prostate or testicles
• Varicocele, a condition where the veins that drain the testicles are swollen up
•  Medications and drugs: Prolonged use of medicines containing anabolic steroids, and abuse of drugs such as crack, cocaine, marijuana among others

Blockage of Sperm Transportation

The testicles produce sperms andthe prostate produce semen. The testicles and prostateare connected by two ducts called thevas deferens, whichend in the urethra, from where the sperms are transported out of the body during ejaculation. Prostate issues, or vasectomy, or in rare cases, a missing vas deferens can inhibit the transportation of sperms outside the body. 

Factors Related to Sexual Performance 

Erectile dysfunction, premature ejaculation or retrograde ejaculation (sperms enter the bladder instead of the urethra) affects sperm production and sperm count. These factors could occur due to surgery, or injuries to the back and spine.  

Factors Related to Hormonal Imbalances

The production and count of sperms, is regulated by the Pituitary Gland, through the hormones LH (Luteinizing hormone) and SFH (follicle stimulating hormone). Prolonged use/abuse of anabolic steroids, and tumors in the pituitary gland can severely hinder the production of these hormones, and hence sperm production. 

Sperm Antibodies      

The human immune system wrongly interprets sperms as anti-bodies and tries to eliminate them.

Surgery

Surgeries forHernia, testicular cancer, prostate problems, prostate cancer and rectal cancercan cause minor damage to the reproductive system and inhibit production of sperm.

EnvironmentalCauses

People who are exposed to industrial chemicals, heavy metals such as lead, and X-rays, as part of their occupation are at a high risk of low sperm count or motility.

Lifestyle Related Causes

• Cycling, saunas and hot tub baths raise the temperature in the genital area and hinder sperm production
• Excessive smoking and alcohol consumption
• Obesity
• Mental or emotional distress
• Occupations that involve sitting for long hours, night shifts, and bearing heavy load

Diagnosis

Diagnosis of male infertility issues involves a physical examination of the genitalia followed by a thorough understanding of the patient’s genetic history and sexual behavior. Subsequently, the patient’s semen is analyzed for shape, count and motility of the sperms. Depending on theresults, the specialist may recommend secondary tests such as an ultrasound of the scrotal and transrectal area, an analysis of the urine after ejaculation, anda blood test to measure levels of testosterone, LH and SFH hormones. In some cases, the doctor may also recommend a biopsy of the testicles.

Treatment

There are several options available for treating male infertility. A physician who specializes in male infertility may recommend surgery to correct conditions such as varicocele or blocked vas deferens, or to reverse a vasectomy. Medication and hormone replacement are used to cure infections and various causes that hinder sperm production or count. Counseling is used to overcome psychological causes that affect sexual performance. If none of these options work, the man’s sperms are extracted using different methods and 

ARTs (assisted reproductive technologies) are used to help the woman conceive.

If you suspect that you sufferfrom any of the conditions listed above, consult a doctor who specializes in male infertility. He will conduct various tests and recommend a relevant course of actionbased on the results. This will help your partner conceive and fulfill your dream of havinga family.

Cholesterol Tests: What do they reveal?

Cholesterol related health disorders are one of the primary causes of adult mortality in the United States.

According to the Physicians Committee for Responsible Medicine (source: www.pcrm.org):

• As many as 2200 adult Americans die of Cardio Vascular Disease (CVD) every day
• More than 7% of Americans have some form of CVD
• According to the Center for Disease Control and Prevention (source: www.cdc.gov):
• Nearly 31.7 % of the adult US population have high ‘bad cholesterol’ (LDL) levels. Out of this:
• 29.5 % have the condition in control
• 48.1 % are receiving treatment

Cholesterol, a waxy, fat-like substance, is regularly produced by the liver, and it is needed by the body, to generate specific hormones, Vitamin D, and bile. Cholesterol is also ingested from animal and plant products, consumed through food. Over time, cholesterol levels in the blood can build up to unhealthy levels. The excess cholesterol depositson the inner walls of the arteries, in the heart, and hardens over time. This restricts the flow of blood to the heart and triggers heart attacks.

Cholesterol levels, poor diet, sedentary lifestyle, and heart health are closely linked to each other. Doctors recommend that people above 40 years of age, undergo a cholesterol test, one every two years.

It is recommended that men undergo a Cholesterol Testbefore they turn 35 years of age, and women, before their 45thyear. People with high risk factors are advised to undergo the cholesterol test in their early 20s.

Risk Factors for High Cholesterol 

• Family background of high cholesterol, CVD or CHD (coronary heart disease)
• Slightly to excessively overweight
• Consumption of alcohol on a regular basis
• Sedentary or inactive lifestyle
• Desk job
• Smoking
• Suffering from Diabetes mellitus, kidney diseases, thyroid issues, or polycystic ovary syndrome

Purpose of the Cholesterol Test

The Cholesterol Test measures four primary types of lipids (or ‘fat’) in the blood:

• Total cholesterol: This is a function of the other three types mentioned below and is calculated as LDL + HDL + triglycerides/5
• LDL: Low-density lipoprotein (LDL), also called ‘bad cholesterol’ is attributed to health risks such as stroke,heart attack, and atherosclerosis. Ideally, LDL levels must be low.
• HDL: High-density lipoprotein (HDL), also called ‘good cholesterol’ is beneficial to heart health as it transports bad cholesterol to the liver where it is processed and then excreted from the body. Ideally, HDL levels must be high.
• Triglycerides: The food that we consume is converted into energy, which is required for functioning of the body. The excess calories not used by the body are converted into triglycerides and stored in fat cells of the body. People who are overweight or those who follow a sedentary lifestyle or consume unhealthy foods, have high levels of triglycerides.

Taking the Test

After a preliminary diagnosis, the physician may recommend that either Total Cholesterol + HDL be measured; or a full lipid profile of the patient be created (called ‘Lipid Panel’ test). In case of the former, the patient can eat or drink before the test. In case of a full lipid profile test, the patient cannot consume anything other than water 9-12 hours before the test. The test is usually conducted in the morning. A few ml of blood is drawn from the arm of the patient, and then diagnosed in a laboratory.

Next steps

Based on the test results, the doctor may infer that the lipid levels are either normal, or outside the healthy range. Subsequently, he/she may recommend other tests such as blood glucose and thyroid function tests to be conducted.

If you have a family history of high cholesterol, or match any of the risk factors mentioned above, contact your primary care physician, who will conductthese tests and recommend a comprehensive course of treatment. This may include changes to your diet, your lifestyle, and an exercise program that willregulate your cholesterol levels.