Common are Fertility Problems
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Reproduction is a normal human event that is absolutely necessary for the survival of the human race. Infertility is therefore not meant to be the normal course of events and will have a cause.
Infertility affects at least 20-25% of couples who are of reproductive age.
This means that at least one in five of the couples you know will be affected by some degree of infertility ! A sobering thought but fortunately many of these couples can benefit from help. Statistics vary but it would seem that around 30% of men are sub-fertile and at least 2% of men are totally infertile. Furthermore there is a great scientific debate going on just now about evdience suggesting that male fertility is decreasing markedly as a result of modern living.
Many couples also leave 'having a family' much later so that often the woman may be over 30 years of age. These couples are often quite anxious to conceive quickly given that time is running short for them.
The advent of In Vitro Fertilization (IVF) and the Assisted Reproductive Technologies (ARTs) have helped several thousand otherwise infertile couples to have children over the last few decades. Even so as many as 10% of couples will be left with an inability to have children.
For all these reasons, the number of couples seeking medical attention for infertility related problems has rapidly grown in recent years. This has also provided the push for new home-testing technology which provide the chance for more control, more privacy and also results that are useful if couples find it necessary to involve doctors.
One of the main advantages of home tests is that they will help fertile couples conceive more quickly and they will help others to identify that there might be a problem. This means that your doctor is more likely to help if you have used home tests - otherwise the doctor will just send you away and ask you to keep trying for at least one year before he/she will help.
Myth 1: Infertility! How can a male ever be infertile?
Fact 1: There is tangible and recorded scientific evidence that various physiological aberrations diminish the sperm count and sperm quality to a degree that inhibits a couple's chance of having a child. If the sperm count is less than 20 million per ml, the motility is less than 50% or the percentage of normally-shaped sperm is less than 30% the patient is said to be infertile or properly, sub-fertile.
Myth 2: Male infertility the same as male sterility
Fact 2: Infertility does not amount to total sterility but rather a form of sub-fertility. Male sterility refers to the complete absence of sperm production by the testicles and thus, the total unlikelihood of pregnancy. Male infertility refers to a reduced, but not a complete absence of sperm, and thus the possibility of pregnancy cannot be ruled out. However, without medical assistance the chance of pregnancy per cycle is greatly reduced.
Myth 3: Infertility is deficiency in the woman, and rarely a shortcoming in the male partner
Fact 3: Findings in Postgraduate Medicine, February 2000, present facts summarising that up to 50% of infertile couples have male factor involvement. This group is typically split into 30% who have strictly male factors and 20% with both male and female factors. These clinical findings have conclusive shifted the onus from the woman, exonerating her from the traditional bias of culpable infertility. Infertility, therefore, is a problem of the couple and should be addressed as such.
Myth 4: Partners approaching forty must give up expectations of pregnancy owing to male infertility?
Fact 4: If the male is tested as infertile the recourse varies from intrauterine insemination (IUI) to In Vitro Fertilization (IVF) with Intracytoplasmic Sperm Injection (ICSI). Individualized treatment protocols are provided by the physician after the diagnostic evaluation is completed.
For the female partner not more than 39 years of age, the patient will usually be treated with advanced infertility therapies more quickly because the chance of pregnancy decreases rapidly from age 35-39. Findings indicate that women 40 years of age and older need to progress rapidly to advanced therapies so as not to waste precious time on treatments with a lower chance of success.
Myth 5: One cannot cure or enhance sperm count
Fact 5: Some clinicians still believe that not much can be done for male factor infertility. While many of the causes of male infertility are progressive, treatment is needed to halt further damage or dysfunction. In some patients, sub-fertility is the first sign of various systemic diseases, such as pituitary tumour or testicular cancer. The fact is, numerous studies have demonstrated the efficacy of conventional therapy in the treatment of the male partner to increase fertility (as manifested by improved sperm counts or pregnancy).
Myth 6: Varicoceles can never cause infertility
Fact 6: The most common cause of male infertility is varicocele. A varicocele is an abnormal dilation of the pampiniform plexus of the internal spermatic vein and is typically identified on the left side. This condition has been found to be a contributing factor in up to 40% of cases of primary and up to 80% of cases of secondary male sub-fertility. Varicoceles have also been identified in up to 15% of the general population.
In the healthy state, the intra-testicular temperature is maintained at several degrees below body temperature by means of a countercurrent temperature system. The spermatic arteries are surrounded by the multiple veins of the pampiniform plexus. The warm arterial blood is cooled by convection from these veins. Varicoceles are thought to increase the intra-testicular temperature through the loss of venous valvular function.
This leads to pooling of the warm blood in the testis, thus causing altered spermatogenesis, Leydig's cell dysfunction, and subsequent infertility.
Myth 7: Oligospermia means an ejaculate sans sperm
Fact 7: The term 'OLIGO' means few. Oligospermia is the presence of fewer than the normal number of sperm in the semen. Men with fewer than 20 million sperm/ml are usually defined as having oligospermia, or a low sperm count.
Myth 8: Azoospermia is the same as oligospermia
Fact 8: No. Azoospermia is the complete lack of sperm in the ejaculate.
Myth 9: Ayurvedic medicine's response to clinical tests is inconclusive so herbal medicine is suspect, despite unexplained therapeutic successes and tangible improvement and cure that have been observed
Fact 9: OLIGO is the proprietary name of an Ayurvedic preparation. The Ayurvedic premise that systemic aberrations, acquired infections, and some congenital deformities can be addressed by herbal therapy to cure and prevent damage is too "far-fetched" in the view of Western medical science.
Myth 10: Azoospermia is a congenital, incorrigible and permanent defect
Fact 10: There are two different types of azoospermia. Obstructive azoospermia is the complete lack of sperm in the ejaculate due to a blockage in the male reproductive tract or the absence of the part of the reproductive tract that carries sperm from the testicle to outside the body. A blockage, or obstruction, may have been present at birth or may have occurred as a result of an infection or severe trauma to the testicles or the tubules surrounding the testicles that transport the sperm out of the body.
Men with obstructive azoospermia almost always have some sperm in their testicles, but these sperm are not found in the semen because of the blockage or absence of part of the reproductive tract. Corrective surgery can remove the obstruction and open the reproductive tract.
Men who undergo a vasectomy for contraceptive purposes have obstructive azoospermia. If pregnancy is later desired, a surgical procedure called a vasectomy reversal, can be attempted to remove the blockage in the vas deferens. If the vasectomy reversal is not successful, sperm aspiration techniques can be used in conjunction with IVF-ICSI to treat the male's obstructive azoospermia.
Nonobstructive azoospermia is the lack of sperm in the ejaculate due to a very low production, or no production of sperm in the testicles. About 50% of men with nonobstructive azoospermia have some sperm production in one or both testicles.
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