INFERTILITY IN MEN (The DR AJ series)

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Some village communities have secrets only known by elders of that village and they are not for open discussions. The elders usually know which infertile man got his “cousin” to impregnate his wife. On that day “Man” would tell “cousin” that he is going away for a week to go and sort out some problems and that “cousin” should remain looking after “wife". The wife would submit and 9 months later a baby is born who looks like the cousin and no-one in the clan dare say anything because the elders know that the Man is infertile. Somehow that held communities and families together and life went on. I am not saying that this was ok but it happened. Infertility in men was a taboo back then in an african setting.

As time went on, a man who is infertile would always blame it on the wife to an extent that he would divorce the wife or take a second wife. Men simply find it hard to come to terms with the fact that they are the ones who can't bare children.

Nowadays the modern man takes his wife and visit their doctor for tests to see who can't bare children and is not an issue.
Infertility is failure by man or woman or both to achieve pregnancy in at least one year of not using protection while engaging in regular sex.

90% of men's infertility is due to the quantity and quality of the sperm. The sperm count is low, sperms are to weak to race up to the egg and fertilize it. The shape and structure might be abnormal as well. When a couple can't have children, there is a 20% chance that its the man who is infertile. A man can be infertile without any symptoms. He can enjoy sex with good erection and ejaculation is normal and copious. It's just that he is firing blanks.

Causes of infertility:
A) SPERM PRODUCTION (quantity and quality). The failure of testes to descend at birth, twisting of testes in the scrotum (Torsion), so called silent infections such as chlamydia and gonorrhoea , varicose veins of the testes, radiation damage, some chemicals and medicines, physical trauma to the balls and to some extent genetic causes all can contribute to poor quality and quantity of sperms.

B) ERECTION & EJACULATION PROBLEMS. Infrequent intercourse, failure to ejaculate, premature ejaculation, damage to nerves during prostate surgery, erectile dysfunction ( ED) some side effects of medications some diseases eg diabetes, high blood pressure and spinal cord injuries can contribute to a man failing to father a child.

C) BLOCKAGE OF SPERM TRANSPORT. Auto immune problems are on the rise. This is from nowhere one's immune system decides that the testes (or any part for that matter) are foreign to the body and starts attacking them. This is where sperms are are manufactured. Sexually transmitted diseases are responsible for blocking the tubes that transport sperms.

D) HORMONAL PROBLEMS. If you use anabolic steroids in the gym there is a chance that some time you might become infertile. Man love these steroids to build muscles.

E) INJURY TO THE BALLS
Which men are then at risks of becoming infertile even though they have fathered a child before? Smokers and drinkers. As men age there could be decrease in genetic quality and therefore sperms won't move as fast to meet the egg. Treat STDs promptly and finish the prescribed medication. A man with varicose veins in the spermatic cord is also at risk.

Diagnosis
Semen analysis in the lab. Semen is placed under a microscope to evaluate motility, shape and number of sperms in a given volume. Blood tests for hormone levels, chromosomal testing, imaging tests to look for structural problems

Treatment
Treat underlying medical problems. Surgery to correct any obstruction
In Vitro Fertilization (IVF). This is an expensive treatment and it only has a 25% success rate. This is done by surgically removing eggs from a woman. A man then ejaculates into a container and straight away the two are mixed in test tube ( hence the name test tube babies). After a few days when the embryo has formed, the woman is called back into theatre and the embryo implanted into the uterus. The woman has strict bed rest in hospital for several days.

Some men who have poor erection (ED) explore some tablets like viagra .... please always consult your doctor on that one because it's not a drug for people with High Blood pressure and heart problems. Did you know that viagra was meant to treat heart problems but the side effects of that was that it ended up dilating the veins in the penis hence an erection achieved??. So careful guys. There have been a number of deaths during sex because man would have taken viagra and they die of heart attack.

Dr AJ