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It was once believed that only a woman was “responsible” for childlessness in a couple. It is she who is to blame if there are still no children and no. The fact that the problem may be in the man too, began to talk not so long ago.
However, if pregnancy does not occur during the year with active attempts to conceive, the inscription “FREE” will appear on the woman’s medical card. Male reproductive health is still overlooked. So far, potential fathers have been given simple guidelines to keep fertility at the right level: wear loose underpants, avoid overheating and unhealthy foods, and get enough sleep. Recently, however, it has become clear that the problem is not only in the lifestyle of men. It can go much deeper.
Plague of the XXI century
Scientists are seriously concerned about the problem of male infertility.
Physician-reproductologist of the Center for Reproductive Health “CM-Clinic”.
“According to WHO data for 2018–2019, about 15–17% of married couples suffer from infertility worldwide. Among them, the male factor of infertility is about 50%. That is, it turns out 50 to 50 ”.
British scientists say that every tenth man experiences difficulties with conception, and one in five under the age of 35 has a low sperm count.
“Over the past 40 years, the sperm count in the ejaculate of the average European has more than halved,” according to a 2017 study published in the Human Reproduction Update. “In 1973, the average sperm count was 337,5 million; by 2011, it had dropped to 137,5 million.”
Doctor urologist-andrologist of the Center for Reproductive Health “CM-Clinic”.
“The main causes of male infertility are, first of all, infectious diseases. As a rule, in young couples who have no other problems, after appropriate correction, the spermogram indicators improve.
In addition to infections, there can be congenital causes, genetic factors. Genetic factors can be very diverse. Therefore, if we see in the spermogram a complete absence of spermatozoa or a sharp decrease in their concentration, we refer the patient for a genetic examination to a geneticist. “
Congenital infertility
Scientists believe that fertility problems start at the prenatal stage of development. Moreover, the genome, which is responsible for the reproductive function, is also involved in other aspects of human life. Therefore, if a man has problems with conception, then there are other health problems.
For example, a recent study published in the British Medical Journal claims that men who have difficulty conceiving have a higher risk of developing prostate and testicular cancer.
“Testicular cancer is an embryonic cancer, that is, it is ‘programmed’ at the stage of intrauterine development. But it does not manifest itself immediately, but when puberty begins, “says Alastair Sutcliffe, professor at University College London, one of the leading researchers in congenital male infertility.
The plastic world
Ecological problems, namely, chemical pollution of the environment, scientists are also inclined to blame for men’s troubles. Plastic is one of the biggest nightmares. More precisely, the phthalates contained in it. Studies have shown that if the mother’s blood in the first trimester was high in phthalates, then her son is likely to backfire with poor sperm quality. If the amount of phthalates exceeds the norm at 18–34 weeks of gestation, then boys are more likely to be born with small testicles, which also leads to a decrease in sperm quality.
Another pollutant that deprives men of offspring is perfluoroorganic compounds. They are called eternal because they survive for decades in water and soil. We come across them constantly – these compounds are used for the protective treatment of fabrics.
In addition, the painkillers that the mother took during pregnancy affect the fertility of the future man.
In particular, the fears of scientists were caused by ibuprofen and paracetamol. However, other medications should not be taken without consulting a gynecologist.
But folic acid, on the contrary, is able to protect the fetus from the harmful effects of the environment.
Tell me what you eat
“Prostatitis is getting younger all over the world. Even young men in their early 20s are diagnosed with this diagnosis. This is due to a sedentary lifestyle, bad habits, unhealthy diet and lack of vital microelements: zinc, chromium, manganese, ”says Valentina Aksenova, parasitologist, microelementologist, and research specialist at Optisult. She attributes microelementosis to one of the main causes of infertility in both men and women.
Lifestyle matters – many experts agree on this point.
“A healthy lifestyle, proper nutrition, the use of essential vitamins, promotion of healthy lifestyles in schools in terms of the onset of sexual activity, the correct use of contraception (the spread of infections plays an important role, especially at an early age) are all very important,” Olga Grudilova lists.
As it turned out, even genetically determined problems can be corrected by lifestyle correction – at least partially. 35-year-old Tony Suckling, speaking of his case, that he and his wife had been trying to conceive for four years. When the spermogram showed that he had too few spermatozoa, and even those were not viable, he was broken: he felt like he was not quite a man. In search of a solution to the problem, Tony decided to take up health: he gave up alcohol, take-away food, began to play sports and drink vitamins. Subsequent tests showed that none of this helped.
“We decided on ICSI, paid a lot of money, managed to fertilize two eggs, but not a single embryo took root. When we turned to another fertility specialist, the tests showed a high level of DNA fragmentation in the semen. This was the reason for the infertility, ”says Tony.
The doctor chose an individual therapy: he put both spouses on a gluten-free Mediterranean diet, Tony began to take a special complex of vitamins, fish oil. In addition, the couple stopped using plastic in everyday life. In the end, it was possible to conceive, but the pregnancy ended in miscarriage. But now the spouses have a chance for IVF – the quality of the sperm has improved significantly.
You can treat, you cannot treat
Let’s make a reservation right away – it is impossible to cure infertility with folk methods.
“Various herbal remedies, homeopathy, vitamins and so on, will not solve the problem. It is better to immediately consult a reproductive physician in order to choose the correct methods of diagnosis and treatment, “Olga Grudilova is sure.
As for diagnostics, the first thing that you have to go through is a spermogram. If everything is fine, you may not take it again. If abnormal, re-analysis is prescribed at intervals of 2-3 weeks.
“Then a man goes to an appointment with an andrologist, and it is better to come as a couple: it so happens that someone alone is to blame for infertility, and sometimes there is combined (male and female) infertility,” explains Aleksey Moiseenko. – If we see that we have persistent changes, we begin to examine the man further. First of all, we exclude STIs – this is shown by a smear. Then take the culture from the urethra, ultrasound of the male genital organs, both external and internal. These are mandatory procedures. “
Infertility treatment is prescribed depending on the diagnosis. Conservative methods are used when sperm quality is reduced. In case of infection, this is antibiotic therapy, if inflammation of the male genital organs (prostate, seminal vesicles, urethra, testicles), anti-inflammatory therapy is prescribed in combination with antibacterial drugs. If there are hormonal disorders, hormone therapy is needed.
But sometimes surgical intervention cannot be avoided.
“A very common cause of spermatogenesis is varicocele: a disease that is very often diagnosed in men of all ages. As a rule, in young children, surgical treatment is more effective and helps to restore spermatogenesis, ”says the expert andrologist.
Other diseases of the male genital organs are also surgically treated – cysts of the appendages, testicles, dropsy of the testicles, curvature of the penis, violation of ejaculation. After the correction, the couple is already able to conceive naturally.
“A separate item is the testicle biopsy. It is carried out both for the purpose of diagnosis (in the absence of sperm in the ejaculate) and for the use of sperm. If we find them, we either cryopreserve them for further use in the IVF program, or use them on the same day for fertilization, if there are ready-made eggs, ”adds Aleksey Moiseenko.