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INFERTILITY Problems

1) No Ejaculation

2) Low Sperm count (Oligospermia)

3) Nil Sperm count ( Azoospermia)

Azoospermia is one of the most severe forms of male factor infertility. It is a condition in which a man has no sperm in his ejaculate. In order to transport sperm outside of the body, it mixes with ejaculate (semen) at certain places throughout the male reproductive system. Sometimes, due to blockages or sperm production problems, sperm does not mix with ejaculate, and therefore cannot leave the body. This is why so many men with azoospermia find it difficult to have children.

There are actually two types of azoospermia

• Obstructive Azoospermia : Obstructive azoospermia accounts for 40% of all cases of azoospermia. It occurs when a blockage in your duct system prevents your sperm from mixing with your semen. These obstructions may be present in your vas deferens or epididymis.

• Non-Obstructive Azoospermia : Non-obstructive azoospermia accounts for 60% of all cases of azoospermia. It occurs when there is a problem with the actual production of sperm within your body. It is often the result of hormonal imbalances

Symptoms

Unfortunately, it is very difficult to recognize azoospermia without undergoing fertility testing. This is because there are no symptoms that occur along with the condition. You will likely have semen of a normal color and texture, and will encounter few difficulties with ejaculation. Only a sperm count can diagnose the condition.

Causes of Azoospermia

There are typically two main causes of azoospermia: a problem with sperm production or a problem with sperm transport. There are a variety of factors that may contribute to either of these causes.

Sperm Production Problem

Sometimes, azoospermia is the result of a dysfunction within the testes themselves, making it impossible for your body to produce enough viable sperm. In order to produce sperm, the proper cells need to be present in the testes and the proper hormones need to trigger sperm production. Failed sperm production is often the result of:

• Hormonal Abnormalities : Sometimes your body may not produce enough of certain hormones involved in the sperm-making process, causing azoospermia. Hormonal imbalances caused by anabolic steroid use or particular disorders, like Cushing’s Syndrome, can contribute to azoospermia.

• Cryptorchidism : Cryptorchidism, or undescended testicles, is a condition in which your testes have not descended properly. It is generally corrected in childhood, however, if it isn’t corrected, your testicles will be unable to produce sperm properly.

• Vascular Trauma : Trauma to the testes or to the blood vessels within the testes can also prevent your body from producing sperm. Varicocele causes veins in the testes to enlarge and become swollen. As a result, blood pools in the testes, impairing sperm production.

4) Reduced sperm (Asthenozoospermia Motility)

Asthenozoospermia, also known as low sperm motility, refers to disease that the motility of sperm in the forward movement is less than 50% or sperm in fast forward movement is less than 25%. The biggest worry of the patients with asthenozoospermia is infertility, which is mainly caused by the low sperm motility. The sperm can't effectively reach the tubal ampulla and also can't fertilize the egg and create a single totipotent cell. There are many factors that can cause asthenozoospermrmia. Such as reproductive tract infections, non-liquefaction of semen, varicocele, endocrine and other physical and chemical factors of drugs and radial. Asthenozoospermia can lead to male infertility. And nonliquefaction of semen which considered as the main reason that causes asthenozoopermia, should be attached importance to.

Infertility that is caused by asthenozoopermia is mainly because the non-liquefaction of semen limits the movement of the sperm, which make the sperm can't fuse with the egg within the best time. Fertilization is a complex and orderly process. In this process, sperms must pass through from the vagina, to the cervical, uterine, fallopian tube, until to the tubal ampulla where the sperm can fertilize the egg. During this period, sperms can not be delayed too much time, for the egg can only survive 48 hours, the sperm must meet and fuse with the egg. If the egg can't meet the sperm and become the fertilized egg after it is discharged, it dies naturally after 48 hours to 72 hours. Sperm motility of patients with asthenozoopermia is low, so once patients lost the chance of fertilization, they must wait 1 month after another mature egg discharges when fertilization is possible.

Sperms that left from the body normally are limited before the semen fluid liquefies. Once the semen fluid liquefies, sperm shows good motility. The reason why the activity of sperms is limited when nonliquefaction of semen appears mainly lies in the seminal plasma. In the non-liquefaction seminal plasma, we can see thin fibrin reticularly with each other, which lows the motility of the sperm, then leads to asthenozoopermia. Like people swimming in the river, if there's no obstacle in the river, they could swim very fast. However, if there are many aquatic in it, they would likely to be entangled winding plants, then the speed is greatly reduced. The common cause of nonliquefaction of semen is the lack of fibrinolytic enzymes and trace elements(magnesium, zinc, etc), etc, which is caused by vesiculitis and prostatitis. Fibrinolytic enzyme is not enough discharged, fibrin in the seminal plasma can not effectively be destroyed, nonliquefaction of semen, then leads to asthenozoospermia.

5) Blood In Semen (Hemaospermia)

What is blood in the semen?

The presence of blood in the semen (ejaculate) is also called hematospermia. Hematospermia is not always noticed; therefore, it is difficult to make estimates of its incidence.

What are the causes of blood in the semen?

Blood in semen can be caused by many conditions affecting the male genitourinary system. Areas affected may include the bladder, urethra, the testicles, the tubes that distribute semen from the testicles (known as the seminal vesicles), the epididymis (a segment of the spermatic ducts that serves to store, mature, and transport sperm), and the prostate gland.

Blood in the semen is most commonly a result of a prostate gland biopsy. More than 80% of men who undergo a prostate biopsy may have some blood in their semen that persists for three to four weeks. Likewise, vasectomy can lead to bloody semen for about one week after the procedure.

In men with hematospermia who have not had a recent prostate biopsy or vasectomy, a number of benign and malignant conditions of the male genital system may be the cause. In many situations, no definitive cause is found.

The following conditions have been reported in association with hematospermia:

• Benign or malignant tumors of the prostate, bladder, testes, or seminal vesicles

• Infections including, but not limited to, chlamydia, herpes, cytomegalovirus, and trichomoniasis

• Inflammation of the prostate (prostatitis), epididymis (epididymitis), or urethra (urethritis)

• Calculi (stones similar to kidney stones) in the seminal vesicles or prostate

• Polyps in the urethra

• Ejaculation duct obstructions

• Metastatic cancers (that have spread from other sites in the body) located in the genitourinary system

• Cysts, hemorrhage, or other abnormalities in the seminal vesicles

Dr. BEERINDER SINGH YOGI
Elder Son of
Khandani Vaid Harbhajan Singh Yogi

 



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