What is it?
A couple is defined as infertile after at least 12 months of unprotected intercourse not resulting in the birth of a child. Approximately 15% of couples have difficulty having a baby, and in half of these cases male infertility plays major role. Fertility is a complex process: in order to become pregnant, the man must produce a sufficient quantity of spermatozoids, but above all they must be sufficiently healthy and mobile to reach and fertilize the female egg.
Causes and risk factors
There can be several causes of male infertility:
- varicocele: dilation of the testicular veins can lead to abnormal heating of the testicle, resulting in qualitative and/or quantitative alterations of the sperm;
- infections: some infections, especially sexually transmitted infections (chlamydia, gonorrhea, etc.) can affect the health of the spermatozoids;
- retrograde ejaculation: in this case the sperm is no longer emitted during ejaculation, but returns to the bladder and is expelled at the first urination; it can be due to diabetes, spinal lesions, drugs and bladder or prostate surgery;
- anti-sperm antibodies;
- tumors and their radio and chemotherapy treatments;
- cryptorchidism: the condition where the testicles do not descend into the scrotum at birth;
- hormonal disorders; -defects of the ducts that carry spermatozoids;
- chromosomal defects: i.e. Klinefelter syndrome, Kallman syndrome, Kartaganer syndrome;
- celiac disease;
- certain drugs: i.e., prolonged use of steroids, some antifungals, chemotherapies;
- industrial chemicals: prolonged exposure to benzene, xylene, toluene, pesticides;
- overheating of the testicles: i.e. sitting for a long time, wearing too tight clothing;
- alcohol, drugs and cigarette smoking;
- prolonged use of cycles and motorcycles
Which are the symptoms?
How is it diagnosed?
How is it treated?
Microsurgical inguinal ligation of spermatic veins: a technique that involves ligation of the small veins of the testicle without touching the artery and lymphatic vessels.
Scleroembolization: a substance is injected that induces an inflammatory reaction and heals the dilated veins of the testis so that they become occluded. It may be performed retrograde or anterograde.
Anterograde route (most frequent): a substance is injected into a small vein close to the testicle that induces an inflammatory reaction in the direction of venous flow and with a maneuver it blocks for a moment the venous return causing the narrowing of the vein.
Retrograde route: the same substance is injected in the opposite direction to the blood flow.
Seminal route reconstructions: microsurgical procedure involving reconstruction of the deferent ducts.
Where do we treat it?
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