Infertility effects one in every six couples who are trying to conceive. In at least half of all cases of infertility a male factor is a major or contributing cause. This means that about 10% of all men in Nigeria who are attempting to conceive suffer from infertility.Historically, infertility has been considered a women’s disease. It is only within the last fifty years that the importance of the male factor contribution to infertility has been recognized. The mistaken notion that infertility is associated with impotence or decreased masculinity may contribute to this fear. The good news is that the rapid research advances in the area of male reproduction have brought about dramatic changes in the ability to both diagnose and treat male infertility. The majority of couples suffering from infertility can now be helped to conceive a child on their own.

The most common identifiable cause of infertility in men is varicocele. This is a condition of enlarged veins in the scrotum that causes abnormalities in the temperature regulation of the testis. Enzymes that are responsible for both sperm and hormone (testosterone) production have an optimal temperature at which they operate most effectively. If this temperature is elevated by even one degree, sperm and testosterone production are adversely effected.The evidence for the negative effect of varicocele on testicular function in male fertility is now overwhelming. What is less certain, however, is the effect of repairing the varicocele on restoring testicular function.
Results showed the pregnancy rate in couples where men with varicoceles underwent surgery was three times higher than when men did not undergo surgery.
The second major cause of infertility in men is blockages or obstructions of the male reproductive tract. This is particularly true for men with zero sperm count, a condition called “azoospermia.” Men with zero sperm count can be divided into two broad groups:
men who have an obstruction problem or blockage, meaning they are making sperm, but the sperm can’t get out, or
men who have a production problem, meaning they are not making sperm, a condition called “non-obstructive ” azoospermia’’.Blockage can also be caused by a urinary tract infection or by the sexually transmitted diseases such as staphylococcus, chlamydia and gonorrhea. Bacteria can infect the tiny duct called the “epididymis,” which is essentially a swimming school for sperm before they are able to swim to fertilize an egg. Infection of the epididymis can cause scarring and blockage, inhibiting the sperm from leaving the duct to fertilize an egg.
[C] HYPOGONADISM(Low testosterone or Low T)
This is a medical term for a defect of the gonads that results in the underproduction of testosterone. Late-onset hypogonadism (LOH), Andropause or Androgen Decline in the Aging Male (A.D.A.M), is a syndrome caused by a decline in gonadal production of testosterone in males that occurs with aging. This “male menopause” can also cause hypogonadism. However, it occurs for certain men and not for the others.
Effects of low testosterone in men may include: (not all are present in any single individual)
Poor libido(Low sexual desire)
Fatigue always tired
Muscle loss/atrophy
Erectile Dysfunction
Increasing abdominal fat
Glucose intolerance (early diabetes)
High Cholesterol /Lipid
Poor sleep
Difficulty concentrating
Memory Loss-difficulty in choosing words in language
Psychological and relationship problems
Increase size of chest
Hot flashes
Decrease in growth of, or loss of, beard and body hair
Loss of bone mass (osteoporosis)
Shrinking of the penis and testicles
Decrease in firmness of testicles
Frequent urination (polyuria) without infection/waking at night to urinate
Achy muscles
Night sweats
Dry Skin and/or cracking nails

Low sperm count (Oligozoospermia) is one of the main causes of male infertility. It is considered that a man has low sperm count when he has less than 20 million spermatozoa per one ml of ejaculate.
A great number of medical conditions as well as many biologic and environmental factors can cause low sperm count temporarily or permanently.

Here are some of the possible causes of low sperm count:
Problems with sperm production – such problems can be genetic (for example Klinefelter’s syndrome) or based on a hormonal disorder
Testicular injury and disease – injuries that affect the testicles may affect sperm production and cause low sperm count
Malnutrition and nutrient deficiencies – deficiency of some nutrients (for example Zinc, Selenium, vitamin C, etc.) may also lead to low sperm count
Overheating – excessive heat from saunas, hot tubs, etc. may decrease sperm production and lower sperm count
Smoking – smoking cigarettes may impair male fertility since it is known to reduce sperm count and sperm lifespan
Drugs – the use of cocaine and heavy marijuana is known to reduce sperm count by 50%
Excessive alcohol consumption – alcohol is toxic to sperm and may reduce sperm count and quality
Prescribed medications – many prescription medications are known to reduce sperm count and decrease fertility
Environmental toxins, radiation and heavy metals – a number of environmental factors, such as exposure to toxins or chemicals, can reduce sperm count either by affecting testicular function directly or by affecting the hormone system
Obesity – many studies find association between low sperm count and obesity in men
Stress and excessive physical or mental exertion – these can cause some hormonal changes in the body that can affect sperm count and fertility
Varicocele – it is not clear how exactly this condition causes infertility in men
Bicycling – blood vessels and nerves may be damaged due to the pressure from the bike seat
[E] Sperm that are abnormally shaped or that don’t move correctly
[F] Undescended testicle
[G] Sometimes the cause of male infertility cannot be identified. In these cases, there may be an underlying genetic problem.

This is a very simple and important test and should be done early in the evaluation process. Sometimes the test should be done 2, or even 3 times to get an accurate reflection of the numbers and their variation over time.
For most infertile men, the semen analysis is the only test which needs to be done – after all, the only job of a man is to provide sperm to fertilise the egg ! For men with a low sperm count, there is need to do any other tests, such as blood tests for measuring the levels of key reproductive hormones, such as prolactin, FSH, LH and testosterone.
For men with azoospermia ( zero sperm count), additional blood tests may be useful . The serum FSH (follicle-stimulating hormone) level test is a useful one for assessing testicular function. If the reason for the azoospermia is testicular failure, then this is reflected in a raised FSH level. This is because, in these patients, the testis also fails to produce a hormone called inhibin (which normally suppresses FSH levels to their normal range). A high FSH level is usually diagnostic of primary testicular failure, a condition in which the seminiferous tubules in the testes do not produce sperm normally, because they are damaged.
The use of ultrasonography has become an important component in the evaluation and treatment of male reproductive tract disorders. From the use of color flow Doppler ultrasonography for the assessment of varicoceles to transrectal ultrasonography combined with seminal vesiculography for the evaluation of ejaculatory duct obstruction, ultrasonography has practical clinical applications. The recent advances in diagnostic transrectal ultrasonography for ejaculatory duct obstruction.

Often preventing infertility is much easier and better than treating it! What can you do to reduce the risk of being infertile ? The biggest preventable danger to male fertility is due to uncontrolled sexually transmitted diseases (STDs) such as syphilis, gonorrhea and chlamydia which can cause irreparable damage to the reproductive tract . Another important preventable cause of testicular damage in men is uncorrected undescended testes. Undescended testes should be surgically treated at an early age to prevent damage – preferably before the age of 2 years. This requires educating mothers of young boys; and doctors as well. It may also be a good idea to immunise boys against mumps in childhood, thus preventing the ravage which mumps can cause to the testes in later life.
Drugs – including alcohol, cocaine and marijuana – are all poisons. They can reduce sex drive; damage sperm production; and interfere with ovulation – and sometimes this damage is irreparable. Smoking tobacco also affects reproductive function – by depleting egg production; increasing the risk of PID; and lowering sperm counts. Often, the adverse effect is temporary, so that when these are stopped, the harmful effects on reproductive function are likely to be reversed. However, since abstinence is easier than moderation, the best option is not to smoke, drink or use drugs!
Occupational hazards can also decrease sperm counts. Many toxic drugs – including radiation, radioactive materials, anesthetic gases, and industrial chemicals such as lead, the pesticide DBCP and the pharmaceutical solvent ethylene oxide can reduce fertility by imparing sperm production. Intense exposure to heat in the workplace (for example, long-distance truck drivers exposed to engine heat; and men working in furnaces or in bakeries) can cause long-term and even permanent impairment of sperm production. You should be aware of these hazards and may need to control your exposure if fertility is a concern.
Interestingly, many researchers have observed that sperm counts the world over are declining. Whether this is due to exposure to toxic chemicals such as dioxins ( formed as a result of environmental pollution) , which cause disruption of the endocrine system; or to the stresses of modern day life remains unclear.
What can you do to improve your sperm count ?
Stop smoking, drinking or abusing drugs. Most doctors will advise that you take vitamins ( such as Vitamin E, Vitamin C); and others prescribe antioxidants and selenium, though the effect of these on male fertility is still a contentious issue. Traditional advise included taking cold water showers and wearing loose underwear, to help keep the testicular temperature low and “ sperm friendly “, but the results can be unpredictable. Certain drugs ( for example, salazopyrine which is used for treating ulcerative colitis) can suppress sperm counts, so if you are taking prescription medicines, ask your doctor about what their effect on sperm counts is. One simple way of increasing your chances of getting your wife pregnant is to have sex frequently – the more the sperm you deposit, the better your chances of hitting the jackpot !

Treatment for infertility should first address any underlying medical condition that may be contributing to fertility problems. Drug therapy may be used to treat hypogonadism and other hormonally related conditions. Surgery is used to repair varicoceles and correct any obstructions in the reproductive tract.
If fertility issues remain unresolved, intrauterine insemination (also called artificial insemination) and assisted reproductive technologies such as in vitro fertilization should be considered.

JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria, offer comprehensive infertility screening tests for both couples like Transvaginal Scan for uterine and ovarian functions,Ovulation/follicular tracking, HSG to evaluate the fallopian tubes, blood tests for hormone check, semen analysis etc. We also offer a simple assisted reproductive procedure like INTRAUTERINE INSEMINATION [IUI].

For accurate assessment of your fertility situation, contact us at JOAS MEDICAL DIAGNOSTIX, Ikotun Lagos Nigeria.
For FREE Consultation and FREE Counseling. Also for Quality and Accurate Medical Diagnostic Tests Contact

We are located at
JOAS HOUSE, 2, Okesuna Street,
Opposite The Synagogue Church Busstop,
Bolorunpelu, Ikotun, Lagos
Postcode: 100265

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