September 23th, 2010

The inability to become pregnant after one year of vaginal intercourse without birth control.

Primary Infertility Never had children

Secondary Infertility Has had children in the past but is now

unable to

Infertility affects roughly 10-15% of couples in the reproductive age.

33% of the time it is due to problems with the woman

33% of the time it is due to problems with the male

33% of the time it is unknown

Quick, easy tests Medical history and examination Ejaculated sperm are evaluated

The sperm is checked for several factors Sperm count between 20 to 100 million per mL is

normal Movement – 50% should be motile 1 hour

after ejaculation Morphology -Maturity and shape (quality) Volume – 1 teaspoon us sufficient Acidity – should be slightly acidic

If sperm are deemed as abnormal he will see a specialist and experience more tests Hormonal blood tests Imaging tests Testicular biopsy Anti-sperm antibody tests Human / Hamster / cow, egg / cervical

mucus test

The most common cause for male infertility is a problem with the sperm Either low sperm

count or sperm with poor quality.

Sperm with poor quality cannot move rapidly enough or in the right direction, or may be abnormally shaped.

Some conditions that may contribute to sperm problems include: Under-developed testes-usually arising

after a mumps infection, a hernia surgery, an injury or birth defect.

Swollen veins in the scrotum. Undescended testes-a problem often

present from birth in which the testes remain in the body cavity. Normally they descend into the scrotum before birth.

Infections, such as gonorrhea or tuberculosis, that block the ducts through which the sperm travel.

Exposure to metals such as leads, or chemicals such as pesticides.

Certain medications, example: corticosteroids and chemotherapy drugs

Injury to the testicles – Blunt trauma, penetrating, and degloving injuries.

Chronic prostate infections

Autoimmunity, in which antibodies or cells of the man's immune system attack sperm cells, mistaking them for toxic invaders. The antibodies attach themselves to the sperm and may cause them to stick together, or may stop them from penetrating the cervical mucus or the egg.

What causes male autoimmunity? Male autoimmunity can develop after

vasectomy.

In retrograde ejaculation the muscles of the urethra do not force the sperm out. Instead, the sperm travel backward into the bladder.

Causes of retrograde ejaculation include: Drugs such as tranquilizers or high blood

pressure medicines. Diseases such as diabetes or multiple

sclerosis. Neck, bladder or prostate surgery. Spinal cord injury.

Sexual difficulties such as impotence, premature ejaculation, or painful intercourse.

Genetic defects or structural problems Hormonal problems (rare) may be present

from birth or can develop from brain or pituitary gland tumours or radiation treatment.

STI’s - It has not been 100% proven that they can in men.

Hormones - occasionally effective

Antibiotics - These may help treat sexually transmitted diseases and other infections.

Corticosteroids - These drugs can aid men who make antibodies to reject their own sperm, but they may also have serious side-effects after long use.

Viagra - The medication improves blood flow to the penis, resulting in an erection. Studies have revealed that 70 percent of men who used Viagra improved their ability to maintain an erection.

Varicose (or swollen) veins in the man's scrotum, helping to restore proper sperm movement.

An obstruction in the man's reproductive organs, including the epididymis, vas deferens and ejaculatory duct. These blockages can halt the sperm's passage or prevent it from mixing with semen.

1. What is infertility? K (1)2. How is a male discovered to be infertile? K

(1)3. What are three causes of weak sperm? K (1)4. Why would a low sperm count or weak

sperm cause infertility? I (1) 5. Explain what happens in a retrograde

ejaculation. I (3)6. Do you think retrograde ejaculation could be

corrected? If so, explain what they would do? K (1) I(1)