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group_3_presentation_3_-_male_infertility [2018/11/30 20:34] vasavans [Symptoms] |
group_3_presentation_3_-_male_infertility [2018/11/30 23:09] (current) premachu |
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| The system of tubes in the testicles (seminiferous tubules) contain germ cells that are converted into sperm by hormones, including testosterone. During this process, the germ cells divide until they resemble tadpoles with a head and short tail. | The system of tubes in the testicles (seminiferous tubules) contain germ cells that are converted into sperm by hormones, including testosterone. During this process, the germ cells divide until they resemble tadpoles with a head and short tail. | ||
| - | <box width centre|> {{:sperm2.png?nolink&300|}}</box| Figure 1. The Process of Spermatogenesis. > | + | <box width centre|> {{ :sperm2.png?nolink&200 |}}</box| Figure 1. The Process of Spermatogenesis. > |
| The tails push the sperm into a tube behind testes called epididymis. For around 5 weeks, the sperm travels through the epididymis to complete their development. The sperm then moves to the vas deferens. When a man is stimulated or sexual activity, the sperm mixes with seminal fluid (whitish liquid produced by seminal vesicle and prostate gland, to form semen. Due to stimulation, the semen which contains up to 500 million sperm is pushed out of the penis through the urethra (Frothingham, n.d.). | The tails push the sperm into a tube behind testes called epididymis. For around 5 weeks, the sperm travels through the epididymis to complete their development. The sperm then moves to the vas deferens. When a man is stimulated or sexual activity, the sperm mixes with seminal fluid (whitish liquid produced by seminal vesicle and prostate gland, to form semen. Due to stimulation, the semen which contains up to 500 million sperm is pushed out of the penis through the urethra (Frothingham, n.d.). | ||
| - | <box width centre|> {{ :sperm_movement.png?nolink&400|}}</box| Figure 2. The Movement of Sperm in the Male Reproductive Tract. > | + | <box width centre|> {{ :sperm_movement.png?nolink&500 |}}</box| Figure 2. The Movement of Sperm in the Male Reproductive Tract. > |
| ====== Symptoms ====== | ====== Symptoms ====== | ||
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| * Small, firm testicles | * Small, firm testicles | ||
| * Lower than normal sperm count | * Lower than normal sperm count | ||
| + | (Mayo Clinic, n.d.). | ||
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| * Produced in low numbers | * Produced in low numbers | ||
| * Not produced at all | * Not produced at all | ||
| + | |||
| + | (Mayo Clinic, n.d.) | ||
| === Varicoceles === | === Varicoceles === | ||
| Varicoceles is when the scrotum has swollen veins. The sperm is blocked from proper growth because the blood is not able to be drained. This may be due to the blood flowing backwards from your belly into your scrotum. Since the testicles are too warm at that point, the sperm cannot be produced and results in low sperm count. Varicoceles is found in 16% of the male population. | Varicoceles is when the scrotum has swollen veins. The sperm is blocked from proper growth because the blood is not able to be drained. This may be due to the blood flowing backwards from your belly into your scrotum. Since the testicles are too warm at that point, the sperm cannot be produced and results in low sperm count. Varicoceles is found in 16% of the male population. | ||
| + | |||
| + | <box width centre|> {{ :39234986-varicocele.jpg?nolink&300 |}}</box| Figure 3. The difference between normal and dilated veins.> | ||
| === Retrograde Ejaculation === | === Retrograde Ejaculation === | ||
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| * Cancer | * Cancer | ||
| * Arthritis | * Arthritis | ||
| + | |||
| + | (Mayo Clinic, n.d.), (Eunice Kennedy Shriver National Institute of Child Health and Human Development, 2017) | ||
| ====== Environmental Causes ====== | ====== Environmental Causes ====== | ||
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| For example, male mechanics exposed to trichloroethylene (TCE), a chemical used as a degreasing agent, were found to have TCE and its by-products in their semen. A study conducted on mice found that TCE exposure led to reproductive tissue damage, suggesting that TCE is metabolized in the human reproductive tract and can adversely affect the normal development of sperm (Xu //et al//., 2004). | For example, male mechanics exposed to trichloroethylene (TCE), a chemical used as a degreasing agent, were found to have TCE and its by-products in their semen. A study conducted on mice found that TCE exposure led to reproductive tissue damage, suggesting that TCE is metabolized in the human reproductive tract and can adversely affect the normal development of sperm (Xu //et al//., 2004). | ||
| - | <box width centre|> {{ :tce.png?direct&200 |}}</box| Figure 2. Chemical structure of trichloroethylene (TCE).> | + | <box width centre|> {{ :tce.png?direct&200 |}}</box| Figure 4. Chemical structure of trichloroethylene (TCE).> |
| === Radiation or X-rays === | === Radiation or X-rays === | ||
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| === Hormonal Profile === | === Hormonal Profile === | ||
| To rule out of major health concerns, a hormonal profile can be conducted. This purpose of this test is to determine how effective your testicles are at making sperm. This involves looking at hormones such as follicle-stimulating hormone. | To rule out of major health concerns, a hormonal profile can be conducted. This purpose of this test is to determine how effective your testicles are at making sperm. This involves looking at hormones such as follicle-stimulating hormone. | ||
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| + | <box width centre|> {{ :basic-diagnostic-tests-to-tell-if-a-man-is-fertile-570x242.png?nolink&300 |}}</box| Figure 5. Methods of diagnostic testing for male infertility.> | ||
| ====== Prevalence ====== | ====== Prevalence ====== | ||
| The actual rates of male infertility are unknown and are shown based on self-report as well as rates calculated from current literature (Kumar & Singh, 2015). Global male infertility rates are different amongst races simply due to the fact that some developing countries underreport their male infertility. This is the case especially in African countries because if a man is unable to reproduce they are seen as inferior. It is believed that to compensate for this, polygamy is practiced in order to increase their likelihood of impregnating a woman (Agarwal et al., 2015). In North America its estimated that 4.5-6% of males are infertile; of all infertility cases, approximately 40-50% are due to male infertility (Kumar & Singh, 2015). This can be attributed to low sperm concentration, poor sperm motility or abnormal sperm or even a combination of these deficiencies (Agarwal et al., 2015). | The actual rates of male infertility are unknown and are shown based on self-report as well as rates calculated from current literature (Kumar & Singh, 2015). Global male infertility rates are different amongst races simply due to the fact that some developing countries underreport their male infertility. This is the case especially in African countries because if a man is unable to reproduce they are seen as inferior. It is believed that to compensate for this, polygamy is practiced in order to increase their likelihood of impregnating a woman (Agarwal et al., 2015). In North America its estimated that 4.5-6% of males are infertile; of all infertility cases, approximately 40-50% are due to male infertility (Kumar & Singh, 2015). This can be attributed to low sperm concentration, poor sperm motility or abnormal sperm or even a combination of these deficiencies (Agarwal et al., 2015). | ||
| - | {{ :12958_2015_32_fig2_html.jpg?nolink |}} | + | <box 65% round white centre|> {{ :12958_2015_32_fig2_html.jpg?nolink |}}</box| Figure 6. Out of the total infertility cases, estimated percentages due to males are reported.> |
| ====== Treatments ====== | ====== Treatments ====== | ||
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| === Transurethral Resection of the Ejaculatory Duct === | === Transurethral Resection of the Ejaculatory Duct === | ||
| Ejaculatory duct blockage can be treated surgically. A cystoscope is passed into the urethra and a small incision is made in the ejaculatory duct. This gets sperm into the semen in about 65 out of 100 men. But there can be problems. Blockages could come back. Incontinence and retrograde ejaculation from bladder damage are other possible but rare problems. Also, only 1 in 4 couples get pregnant naturally after this treatment (Urology Care Foundation, n.d.). | Ejaculatory duct blockage can be treated surgically. A cystoscope is passed into the urethra and a small incision is made in the ejaculatory duct. This gets sperm into the semen in about 65 out of 100 men. But there can be problems. Blockages could come back. Incontinence and retrograde ejaculation from bladder damage are other possible but rare problems. Also, only 1 in 4 couples get pregnant naturally after this treatment (Urology Care Foundation, n.d.). | ||
| - | <box width centre|> {{ :vasovasotomy.jpg?300 |}}</box| Figure 4. Vasoepididymostomy Procedure> | + | <box width centre|> {{ :vasovasotomy.jpg?300 |}}</box| Figure 7. Vasoepididymostomy Procedure> |
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| === Intracytoplasmic Sperm Injection (ICSI) === | === Intracytoplasmic Sperm Injection (ICSI) === | ||
| ICSI is a variation of IVF. It has revolutionized treatment of severe male infertility. A single sperm is injected into the egg with a tiny needle. Once the egg is fertilized, it's put in the female partner's uterus. It is used if you have very poor semen quality, or if you have no sperm in the semen caused by a block or testicular failure that can't be fixed. Sperm may also be taken from the testicles or epididymis by surgery for this method (Urology Care Foundation, n.d.). | ICSI is a variation of IVF. It has revolutionized treatment of severe male infertility. A single sperm is injected into the egg with a tiny needle. Once the egg is fertilized, it's put in the female partner's uterus. It is used if you have very poor semen quality, or if you have no sperm in the semen caused by a block or testicular failure that can't be fixed. Sperm may also be taken from the testicles or epididymis by surgery for this method (Urology Care Foundation, n.d.). | ||
| - | <box width centre|> {{ :icsi.jpg?300 |}}</box| Figure 5. ICSI Procedure> | + | <box width centre|> {{ :icsi.jpg?300 |}}</box| Figure 8. ICSI Procedure> |
| __**Sperm Retrieval for Assisted Reproductive Techniques**__ | __**Sperm Retrieval for Assisted Reproductive Techniques**__ | ||
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| - | {{ :nup_167548_0084.jpg?nolink&300 |}} | + | <box width centre|> {{ :nup_167548_0084.jpg?nolink&300 |}} </box| Figure 9. Jimmy Fallon on his show.> |
| + | |||
| + | ====== Final Remarks ====== | ||
| + | Male infertility is an extremely common cause of infertility. For many couples suffering from infertility, a semen analysis is one of the highest yield tests performed during a comprehensive fertility evaluation. The results of a semen analysis alone are often insufficient to determine an optimal treatment path, and further targeted testing may be required. However, with the proper assisted reproduction treatments, the majority of men suffering from sperm production abnormalities will have an excellent chance of becoming a father. | ||
| ====== References ====== | ====== References ====== | ||
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| Cabler, S., Agarwal, A., Flint, M., & Du Plessis, S. S. (2010). Obesity: modern man's fertility nemesis. Asian journal of andrology, 12(4), 480. | Cabler, S., Agarwal, A., Flint, M., & Du Plessis, S. S. (2010). Obesity: modern man's fertility nemesis. Asian journal of andrology, 12(4), 480. | ||
| + | |||
| + | Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2017). What are some possible causes of male infertility? Retrieved December 1, 2018, from http://www.nichd.nih.gov/health/topics/infertility/conditioninfo/causes/causes-male | ||
| Gude, D. (2012). Alcohol and fertility. Journal of human reproductive sciences, 5(2), 226. | Gude, D. (2012). Alcohol and fertility. Journal of human reproductive sciences, 5(2), 226. | ||
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| Xu, H., Tanphaichitr, N., Forkert, P. G., Anupriwan, A., Weerachatyanukul, W., Vincent, R., ... & Wade, M. G. (2004). Exposure to trichloroethylene and its metabolites causes impairment of sperm fertilizing ability in mice. Toxicological sciences, 82(2), 590-597. | Xu, H., Tanphaichitr, N., Forkert, P. G., Anupriwan, A., Weerachatyanukul, W., Vincent, R., ... & Wade, M. G. (2004). Exposure to trichloroethylene and its metabolites causes impairment of sperm fertilizing ability in mice. Toxicological sciences, 82(2), 590-597. | ||
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