As the Baby Boomers edge into seniority, we’ve noted that many men and women in the younger generation have placed a greater focus on developing careers. Extended educations and following a career track have had the effect of delaying families for a much longer time than prior generations did. What happens when a couple finally decides that it’s time to conceive a child? For one thing, it may no longer be easy or even feasible for conception to take place. Infertility is now becoming a major problem for those in the 30 to 45-year-old group. It’s estimated that about 25% of these couples are affected, bringing heartache and guilt with the suspected infertility.
We’ve already talked about many of the problems associated with failure to conceive. But some problems are specific to men, and that’s what this section is all about. Male sperm cells’ morphology refers to the percentage of sperm that appear normal under a microscope. The sperms’ motility is the way the cells swim. Progressive motility means that the sperm cells swim in a straight line, non-progressive motility means that the sperm swim in circles, and total motility means that the sperm move in many directions at once.
Another measure of the health of sperm cells is their concentration or the amount of sperm in millions present in the ejaculatory fluid.
Men are probably more likely than women to come into contact with pollutants such as cigarette smoke, pesticides, solvents, gasoline and many others. Some research suggests that exposure to a variety of toxic substances, including some found in cigarettes, can damage sperm and/ or lower one’s sperm count. Sperm imperfections are to be expected, given the sheer volume of sperm in one ejaculation. But imperfections seem to occur at a higher rate in men who have been exposed to certain toxins, drugs, alcohol and radiation.
Physical and mental exertion, as well as stress have the potential to lower a man’s sperm count, as can smoking and excessive drinking. A group of drugs or substances either ingested or present in the environment that adversely affect sperm production are known as gonadoloxins. With steroids having hit the news recently with a resounding thud, one should probably deduce that these drugs can affect not just the sperm cells but many other mental and physical aspects of a person’s health Here’s a startling statistic: nearly 7% of 12th grade use or have used anabolic steroids to build muscle mass and improve athletic performance. Use of these male hormones suppresses the testes’ ability to make testosterone. The result is that the level of testosterone within the testes can bring about complete absence of sperm cells, a condition known as azoospermia.
Another thing about steroids…and there’s a lot…is that steroids cause a persistent depression of the hypothalamus and the pituitary glands. The damage may be irreversible even when the steroids are stopped. The testicles need pituitary hormones to be stimulated to create sperm cells. So, guys, taking steroids for body building, by mouth or injection, or just trying to “bulk up” a little bit can damage the body’s ability to make normal sperm cells…to the extent that sperm production ceases altogether.
If the male half of a couple wonders about his fertility, he should have a hormonal profile done to rule out serious medical conditions, give more information on his sperm production, and reveal whether hormonal treatment is indicated. A condition known as testicular failure is a general term for the inability of the testicle to produce adequate numbers of mature sperm. There are several reasons for this condition:
· The testicle may lack the cells that divide to become sperm (“Sertoli Cell-Only Syndrome”).
· There may be an inability of the sperm to complete their development Outpatient (“maturation arrest”).
· Sperm may be produced in such low numbers that very few can successfully navigate through the duct system and into the fluid to be ejaculated.
· Men can develop antibodies (commonly called an allergic reaction) to their own sperm. There are many reasons why this may happen – and sometimes no explanation makes sense – but this condition makes it more difficult for the sperm to penetrate the woman’s cervical mucous and make its way into the uterus. The entire fertilization process is made much more difficult. The treatment may very likely be injection of the sperm directly into the egg (ICSI).
· Rarely, there may be a problem with the ejaculatory ducts that carry sperm from the seminal vesicles, where sperm are stored, to the urethra, from which they’re ejaculated. Sometimes the ducts are plugged, or they may be missing altogether. Nonetheless, new procedures can be used to bring about conception through harvesting the sperm.
· If the seminal fluid is very thick, the sperm may have difficulty moving through it. In these cases, the semen can be processed to separate the moving sperm from the fluid and debris; the sperm separated out in this way can be placed into the uterus with a small catheter for an intrauterine insemination (IUI).
· Hydroceles and varicoceles are relatively common disorders affecting the man’s reproductive tract. A hydrocele is a pear-shaped cyst in the groin. A varicocele is a tangle of varicose veins surrounding a testicle. These conditions occur in 10% to 15% of all adult men – of those, 20% to 40% have related fertility problems. Outpatient surgery is commonly used to correct these problems.
· Men may experience infections of the reproductive tract, including the prostate, the epididymis, and the testes. Post-puberty viral infections of the testes may cause significant damage and irreversible infertility.
· Signs such as excessive white blood cells or bacteria (more than 1 million per cubic centimeter) in a semen specimen require testing for asymptomatic STD’s. Antibiotics may alleviate this problem.
