Varicocele is the dilatation of the veins of the testicle and is a venous insufficiency. Its confirmation is done by a colored triplex of the scrotum. It is observed in about 20% of all men and is the cause of 40% of infertile men. It is treated surgically and in cases of mild problem, the sperm count seems to be treated. However, when it causes a severe decrease in sperm count, then varicocele repair will have little success in re-controlling the man's fertility.
Genetic abnormalities can disrupt sperm DNA, resulting in infertility. The main abnormalities are mutations that lead to agenesis of the seminal duct, a decrease in the number of sperm and azoospermia.
The main hormones that control or influence spermatogenesis are FSH, LH, testosterone, prolactin, TSH, SHBG and inhibin B. Disorders in these hormones can be due to thyroid diseases, some congenital syndromes, etc. In some cases, treating these abnormalities can restore a man's fertility.
Anatomical abnormalities of the penis, such as epispadias, hypospadias and phimosis, can affect the proper deposition of sperm in the woman's vagina. Surgical treatment of these abnormalities usually resolves the infertility problem.
Inflammations such as prostatitis, epididymitis, orchitis, etc., can affect sperm quality. The treatment of these diseases is mainly done with medication and is usually effective.
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Diabetes affects both the erectile function of the penis and the quality of spermatogenesis. Unfortunately, once the damage to spermatogenesis is established, then this condition can no longer be reversed and IVF is required.
Chronic renal failure is a major cause of male infertility. The only solution for these men is a kidney transplant or, when this solution is delayed or not possible, assisted conception should be addressed. Male infertility can also be due to other causes, such as
smoking,
alcohol, or exposure to
toxic factors etc. When the main cause of male infertility cannot be identified (idiopathic infertility), cannot be treated, or is treated, but without a satisfactory result, then the couple turns to specialized centers of assisted reproduction, in order to apply some method of assisted conception on a case-by-case basis.
