Causes of infertility in men and women: a technique for treating varicocele

Infertility is a woman's inability to get pregnant. It affects about 5,3 million people in the Russian Federation. Infertility affects both men and women equally. In most cases, infertility is treated with medication or surgery. Improvements in fertility treatments have made it possible for many women to become pregnant. These advanced new technologies include in vitro fertilization, sperm injection and other similar procedures.

Causes of infertility in men and women

The causes of infertility. The normal process of fertilization requires interaction between the female and male reproductive systems. A sperm fertilizes an egg, usually in the fallopian tubes. Then the embryo is implanted in the uterus for further development. Infertility occurs when something is disturbed in this pattern. The problem may be in the woman, in the man, or even with both of them. The actual causes of infertility may not be detected at all, as the problem may be in the egg, sperm, or inability of the embryo to implant.

  • Pelvic inflammatory disease. Sexually transmitted diseases such as gonorrhea and chlamydia can be associated with pelvic inflammatory disease and cause severe damage to the fallopian tubes. It is worth donating blood for analysis of sexually transmitted diseases (STDs).
  • Endometriosis affects women of reproductive age. The disease causes pelvic pain and infertility. Endometrial tissue grows outside the uterus and damages the ovaries and fallopian tubes. This disease is diagnosed during laparoscopy.
  • Ecological and environmental factors. Negative environmental factors can cause problems with sperm production in men. Exposure to lead, heavy metals, and pesticides has also been associated with male infertility. Many other factors, such as excessive heat, microwave radiation, ultrasound, are controversial, as it has not been proven that they can actually cause infertility.
  • Smoking tobacco, marijuana, drug use. Smoking can cause infertility in men and women. Animal experiments have shown that nicotine blocks sperm production and reduces the size of male testicles. In women, changes in the uterine mucosa are observed, which affects the movement of sperm to the egg.
    Smoking marijuana disrupts the ovulation cycle (release of the egg) in women. In men, sperm count and sperm quality decrease. Heroin and cocaine have similar effects, increasing the risk of HIV infection associated with risky sexual behavior.
    In women, exposure to alcohol can lead to serious consequences for the fetus. However, chronic alcoholism associated with impaired ovulation obviously discourages fertility. Alcohol use in men affects testosterone synthesis and sperm concentration. Alcoholism also negatively affects sexual reactions and leads to impotence, lack of erection.
  • Physical activity and exercises. Of course, a healthy lifestyle should be promoted as part of normal activities. However, too much exercise can also be dangerous. In women, this can lead to a violation of ovulation, in men, to a low sperm count.
  • Wrong diets associated with rapid weight loss or weight gain.
  • Obesity affects infertility only when a woman's weight reaches an extreme limit.
  • Weight loss with anorexia creates menstrual and thyroid problems, thereby disrupting normal ovulation.
  • Age. The likelihood of a woman becoming pregnant decreases in the fifth decade of her life between the ages of 40-50. In men, testosterone levels decline dramatically with age.

Healthy couples younger than 30 years old and not using contraceptive methods of contraception have 25-30% chances of achieving pregnancy every month. Peak fertility in women occurs at the beginning of the third decade of life. A woman over the age of 35 years and especially after the age of 40 years, is likely to get pregnant about 10% every month.

Low testosterone levels - how is this related to poor erections?

The male sex hormone is called testosterone. It is produced in the testes. Testosterone levels are important for the normal sexual development and functioning of men. During puberty, it contributes to the development of male traits in boys, such as body and facial hair, muscle mass, and the development of additional sexual characteristics.

Testosterone levels decline with age, so it is considered normal for older men when testosterone levels are low.

Blood tests in some young men show low testosterone. In this case, we are talking about testosterone deficiency. The American Urology Association estimates that this is a testosterone deficiency below 300 nanograms per deciliter in two consecutive tests done in the morning on an empty stomach. It is difficult to say how many men in the population have low testosterone levels, although general data show that about 2 out of 100 men in the male population are affected.

Testosterone deficiency is more common in men with diabetes or overweight. One study found that about 30% of overweight men have low testosterone levels, compared to 6,4% of normal weight men.

In some men, low testosterone can be caused by accidental damage to the testicles, removal of the testicles due to cancer, chemotherapy or radiation therapy, pituitary disease, infections, or autoimmune diseases. In general, if your testicles produce less testosterone than normal, your blood levels will drop. Many of these men age rapidly or have conditions such as obesity, metabolic syndrome, which includes high blood pressure, high blood sugar, high cholesterol, or taking antipsychotics.

Testosterone deficiency symptoms

There are many signs and symptoms of testosterone deficiency. Specific symptoms are those that are more likely or directly related to the condition, for example: lack of sex drive, decreased erectile function, hair loss.

The American Urological Association recommends that clinicians perform testosterone deficiency screening tests in men with unexplained anemia, bone loss, diabetes, and before chemotherapy or testicular radiation.

Symptoms of Testosterone Deficiency in Men by Years

One of the main methods of dealing with this condition is testosterone therapy. In some cases, such as Klinefelter's syndrome or testicular surgery, trauma, infection, or other similar problems, it is highly recommended. Although the use of this type of therapy in men with testosterone deficiency caused, for example, by age, diabetes, infections and other similar conditions, is undesirable due to the side effects. According to a number of clinical studies, some men on testosterone therapy have been found to have a high risk of heart disease and stroke.

Patients with any of these symptoms may even request testosterone therapy without testing. This action is useless and definitely not in their favor. The total testosterone level should always be checked before starting therapy. There are usually several different ways of administering testosterone: through the skin (transdermal), by injection, through the mouth (oral), or through the nose (intranasally). It is important to know that there is no evidence that testosterone therapy is associated with prostate cancer, nor is there conclusive evidence to support the relationship between venous clot formation and testosterone therapy.

Remember that each organism is unique and each organism responds differently to treatment. Regular monitoring of testosterone levels will be required, and laboratory tests are recommended every 6-12 months.

Method of treating infertility in men and women

Infertility is treated with traditional treatments. For example, drug addiction treatment can help return normal ovulation. For men, the most common cause of infertility is semen problems. Either sperm is produced in small quantities or not at all. Sperm cells can change or die before they reach the egg. In this case, it is recommended Amarok drug... Chickenpox is a dilatation of the plexus vein of the testicular sperm and is a factor often associated with male infertility (in 40% of cases) as it can cause significant hormonal imbalances that negatively affect spermatogenesis.

Surgical varicose veins (varicocelectomy) is a relatively simple operation that is performed quite often in the treatment of infertility. Despite the fact that urologists believe that this type of surgery strongly affects male fertility, numerous studies have shown that surgical treatment of varicocele significantly reduces the likelihood that a partner will become pregnant. There are also opinions that the results of these studies were affected by the fact that specialists in this field did not report the latest methods of urological treatment.

Some studies show that such treatments are good in combination with assisted reproductive methods, especially in vitro fertilization (IUI). Nevertheless, the global and long-term benefits of infertility remain controversial, and new research is needed to achieve a safe and unanimously accepted outcome. One thing is certain: the surgical treatment of varicocele does not give impressive results when it comes to small dilation of the veins (1 or 2 degree).

Treatments for varicocele

The following are the most effective treatments for varicocele:

  1. Varicocelectomy - This is a standard surgical procedure for primary varicocele. It consists of alloying and dividing dilated and curved veins. This is an effective method that requires minimal intervention from the surgeon for the patient. Recovery occurs relatively quickly (within 6 days, full recovery can be achieved in 3 weeks). This method solves about 90% of varicoceles.
  2. Laparoscopic treatment of varicocele - includes minimal incisions (usually less than 3 cm). Although the procedure itself is more time-consuming, the patient recovers much faster compared to conventional surgery. It should be noted that this method has a higher risk of complications than the traditional approach.
  3. Transvocal selective varicocele embolization is a non-surgical treatment for varicocele that appears to be very effective and less painful than other procedures. This method of treatment is most often applied to young boys.

How is the treatment? The doctor introduces a catheter into the femoral vein through a small incision and embolizes the affected veins (sperm). The procedure lasts 15-45 minutes and is performed under local anesthesia. There are studies suggesting that the likelihood of varicocele recurrence is 10%. After the procedure (if it did not help), patients are treated with the classical surgical method. This type of embolization is not yet widely used; there are cases when this procedure is contraindicated.

The most common cause of infertility in women is ovulation disorder. Other causes of female infertility include tubal blockage. This is possible when a woman has inflammatory diseases of the pelvic organs or fibroids. Congenital malformations of the uterus and uterine fibroids can cause repeated miscarriages. Recommended use of herbal gathering seraphim to accelerate the onset of pregnancy.

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Dmitry Novitsyuk

Urologist Novitsyuk Dmitry Fedorovich for 20 years has been engaged in the diagnosis, treatment and prevention of diseases of the genitourinary system.