Data from the World Health Organization (WHO) indicate that 15% of the world population has problems getting pregnant naturally, a percentage that corresponds to approximately 80 million people. Marital infertility is characterized by the absence of pregnancy after 12 months of sexual intercourse without the use of contraceptive methods, and its causes may be linked to female and/or male infertility factors. It is common for couples to resort to human reproduction as a way to correct infertility.
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However, the correct thing is for this couple to identify and treat the causes of infertility and look for human reproduction only when all chances of conception in a natural way are exhausted. In the case of male infertility, andrology is able to identify the causes and propose treatment to restore it.
When to look for an andrologist who specializes in human reproduction?
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After a year of trying to get pregnant, the couple must seek help from a specialist in human reproduction, responsible for conducting a thorough investigation to determine the aspects that are damaging fertility. This assessment should involve, in addition to a gynecologist, an andrologist — who specifically takes care of men's health — so that it is possible to carry out a complete survey of female and male problems.
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According to the article "A unique view on male infertility around the globe", infertility affects about 15% of couples worldwide, totaling 48.5 million. Men are considered to be solely responsible for 20-30% of infertility cases and contribute to 50% of cases overall.
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In this way, understand that male causes have as much impact on fertility as female causes. Therefore, at this stage of investigation, the andrologist specialized in human reproduction will perform physical examinations and request laboratory tests. Are they:
Weight and height assessment;
Verification of the location, volume and consistency of the testicles;
Analysis of the integrity of the epididymis and vas deferens;
Identification of possible infections or diseases such as varicocele;
Hormonal levels;
Seminal analyses.
The results obtained will allow the specialist to point out the best strategies for the restoration of natural fertility, whenever possible.
MALE INFERTILITY
Male infertility can have several causes. Some of them are:
Genetic problems.
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These are not the only conditions that contribute to the diagnosis of male infertility. A study carried out by the Institute of Advanced Studies at the University of São Paulo (IEA-USP), revealed that environmental pollution is one of the external factors that most affect male fertility. Therefore, patients who live in São Paulo, for example, are more likely to develop infertility than those who live in more wooded cities. Sedentary lifestyle, smoking, poor diet, alcoholism and the use of illicit drugs are also directly related to the causes of infertility.
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To investigate the factors of infertility, a man must perform all semen analysis tests, which include: DNA fragmentation test, sperm function test, biochemical semen analysis; semen microbiology; anti-sperm antibody test; sperm-oocyte interaction test; ultrastructural evaluation of sperm and azoospermia diagnostic tests.
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The conduct of human reproduction treatment will directly depend on the identified causes of infertility, always with the main objective of restoring and preserving the natural fertility of man. If there is hormonal dysregulation, for example, it will be necessary to regulate the body so that it is healthy and functional.
WHAT ARE THE TREATMENTS FOR MALE INFERTILITY?
The medical protocol adopted in cases of male infertility will depend on the cause that triggered the condition. In general, the medical procedures adopted are:
Microsurgical vasectomy reversal;
Clearance of ejaculatory ducts (in cases of obstructive azoospermias);
Drug treatment with antibiotics for 14 to 21 days, in cases of infection;
Antioxidant treatment;
Specialized treatment with hormones;
Pre-chemotherapy or radiotherapy semen freezing in cancer patients;
Microsurgical correction of varicocele;
Changing habits and lifestyle.
ANDROLOGY IN ASSISTED REPRODUCTION
Andrology is a subspecialty of urology that specifically diagnoses and treats conditions related to the human reproductive system. The andrologist physician is able to study the clinical history of patients, as well as order specific tests to identify the causes of male infertility and determine the best methods to overcome the situation.
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In 87% of cases, it is possible to make an accurate diagnosis — and two thirds of these problems can be resolved with therapeutic methods that restore reproductive capacity. In the remaining third, a treatment of human Reproduction assisted may be necessary.
FERTILITY PRESERVATION
Studies show that infections are the second most important cause of male infertility, and many of them can be resolved simply with the use of antibiotics. The use of anti-inflammatory drugs and drugs against gastritis can also compromise the production of sperm and, consequently, the reproductive capacity of men.
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Because of these possibilities, it is recommended that males be followed up by an andrologist since puberty - just as women regularly consult a gynecologist.
This is a health care that favors the preservation of fertility and the general health of men at all stages of their life.
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Patients who have been diagnosed with cancer and who will undergo treatment with chemotherapy and radiotherapy should opt for cryopreservation. The indication also occurs to men who will undergo immunosuppressive therapy, and the most effective way to preserve fertility is opting for semen freezing before starting any of the mentioned protocols.
SECOND OPINION
The investigation of male infertility, in general, is quite objective and focuses on the main causes that generally lead to marital infertility. It is important, however, that the analysis is always made with a focus on the man and the woman - and not just in one of the parts.
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In the case of men who are having difficulty getting their partners pregnant, the main tests performed are: the spermogram, which includes sperm function tests (already mentioned above), in addition to hormonal tests for men and ultrasound, for example.
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In the case of women, ovulation is commonly evaluated and a study of the tubes is carried out to check for possible obstructions. When necessary, complementary and more advanced exams can be requested for both.
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Therefore, although the couple certainly has the right to seek a second opinion whenever it is their wish, this is a more suitable measure for cases in which it was not possible to precisely point out the cause of infertility.
REPEAT ABORTION
Scientific evidence indicates that sperm quality can directly influence the occurrence of miscarriages. A study published in the scientific journal Clinical Chemistry in January 2019 and carried out by Imperial College London, university in England, evaluated semen samples from 50 UK men, in which their respective partners had suffered at least 3 repeated spontaneous abortions .
In the research, the sperm of individuals in this group had considerable amounts of fragmented DNA, especially compared to samples from men with partners who had a normal pregnancy. The DNA carries the genetic material and it is essential that it is intact during the fertilization process in order to form a genetically normal embryo.
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These results show even more the importance of always keeping your health up to date and properly accompanied by an andrologist, a physician who dedicates his studies to men's health. This medical specialty is able to restore male fertility as naturally as possible.
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The function of andrology is precisely to minimize the use of human reproduction techniques, always opting for the restoration of fertility in a natural way, as well as the health of this man.