Diagnosis of male infertility - how to establish the cause of infertility

According to demographic studies conducted in different countries in the percentage of male causes of infertile marriages may be from 30% to 50%. Such a high percentage of male factor requires an integrated approach to establishing possible causes of infertility. Diagnosis of male infertility in most cases is not difficult and is conducted much easier when compared to the study of women.

Recommendations for using the diagnostic algorithm

No matter what was the history of reproductive function in men previously for diagnosis should be used specifically to develop a protocol or algorithm. This greatly facilitates the diagnostic procedures and helps to pinpoint the direct cause of infertility The causes of infertility - heredity and lifestyle . With the right collection of clinical history, complete examination of the genitourinary system, and mandatory analysis of the ejaculate to collect reliable information that allows you to establish the correct diagnosis and later assign the appropriate course of therapy. In the first place during the examination of a patient are general clinical methods. These include the right for primary survey (or medical history), general medical examination and consultation related professionals depending on the evidence (a doctor genetics, sex therapist and other specialists).

Physical examination and urogenital men include:

• assessment of physical status, that is, constitutional, sexual development of man, his body, the presence and degree of development of secondary sexual characteristics
• the state of the genitourinary system is estimated on the basis of palpation examination of the genitals (scrotum, testicles, epididymis). It is particularly important to assess the volume of the testicles, as proved a direct dependence of the size of the testicles and the quality of spermatogenesis
• emphasizes sexy, ejaculatory function. Signs of inadequate ejaculatory function is anejaculation, premature ejaculation and ejaculation ekstravaginalnaya

The main laboratory and instrumental diagnostic method is to study the semen. It is considered the most important method of assessing the functional activity of the gonads men. In addition to qualitative and quantitative evaluation of semen is carried out biochemical analysis of sperm that is informative in terms of studying the physiological characteristics of the properties of the seminal fluid. This allows you to assess the condition of spermatogenesis.

Additional methods for the study of male factor infertility

If there is a need to clarify the role of endocrine disorders in the genesis of infertility, it is necessary to conduct a survey male hormone. This includes determining the level of the central hormones, sex hormones, and thyroid hormones Thyroid hormones: mechanism of action and physiological effects . It is important to do blood sampling. Taking blood should be carried out only in the morning to 11 o'clock in the morning is strictly on an empty stomach and after abstinence for two days. Be sure to examine the blood levels of the male hormone testosterone. On the basis of this indicator can reveal whether the use of hormone therapy Hormone therapy - is it possible to fool nature?   (a circuit HRT), and subsequently monitor its effectiveness. In addition to the direct determination of the level of hormones used for the diagnosis of a variety of functional tests. This allows more detailed examination to identify violations at different levels of the male reproductive system, specify the level of destruction that is essential when choosing a treatment strategy.

Of great importance in the diagnostic term given to instrumental methods .  These include an ultrasound scan of the patient genitalia (prostate and seminal vesicles), which is important for the development and definition of the functional state of the data structures .  As an additional method you can use the method of Doppler and color mapping that will contribute to more accurate diagnosis .  If the causative factor of male infertility is considered insufficient at the level of the central structures of the brain, you should use the methods of beam diagnostics .  These include various diagnostic methods, as well as CTE and MRI (CT and MRI) .  The last two methods have become the method of choice for the law on patients due to their apparent advantages over the widely used X-ray examination .  The final stage is to conduct a testicular biopsy .  Among the methods of biopsy is considered to be the most informative open biopsy .

Marina Solovyov

Additional analyzes of the abnormal cervical smear

If a cervical smear shows abnormal results, your doctor may recommend a re-analysis. If the result of analysis revealed significant changes in cervical cells, conducted additional tests, including:

• Colposcopy - a detailed examination of the tissues of the vagina and cervix.
• Endocervical curettage Cervical canal - the path traversed by every person   - Taking for the analysis of cervical cells using a special curette.
• Biopsy - a procedure taking pieces of cervical tissue for microscopic examination.

What is colposcopy?

Colposcopy - a procedure that allows the cervix to investigate in detail the presence of abnormal cells. The procedure involves covering the cervix with a special solution, which upon reaction with all the anomalous field change color to white. Then these areas are studied using a colposcope - a medical instrument resembling a microscope. A small piece of tissue is taken for study in the laboratory.

Colposcopy procedure is painless, but the capture of tissue for analysis may be some bleeding and soreness. Cervical Biopsy involves taking a small piece of cervical tissue for microscopic examination using a special brush.

Cervical dysplasia

Pap smears can detect certain changes in the cells of the cervix. This condition is called dysplasia Dysplasia - what is it?   cervix or precancerous changes in the cells stage. Papillomavirus Papilloma - do not treat lightly   Human causes abnormal cell changes in most women. Quite a number of diseases, sexually transmitted diseases, can lead to cervical dysplasia - but not all of these diseases are associated with serious consequences for health and the risk of cervical cancer.

In most cases of cervical dysplasia affects women between the ages of 25 to 35 years, although the chance of dysplasia exists for all age groups. The number of factors, often causing cervical dysplasia include:

• Sex before the age of 18
• Pregnancy before the age of 16
• Sex with many partners
• The presence of other diseases
• Admission medications that suppress the immune system
• Smoking

Cervical dysplasia is usually not accompanied by noticeable symptoms. This disease does not necessarily mean the development of cervical cancer in the future, but if left untreated can lead to cancer. Because cervical cancer progresses slowly, regular inspection of the cervix to prevent the emergence and development of disease. Typically, progressive cervical dysplasia leads to cervical cancer, even after 10 or more years.

Treatment of cervical dysplasia

Diagnosis of cervical dysplasia at an early stage and allow proper treatment to cure almost all kinds of diseases. Without treatment, 30 to 50% of cases of dysplasia can lead to cervical cancer Cervical cancer: possible cure . The most common treatments for cervical dysplasia include:

• Loop electrosurgical removal - a procedure in which abnormal areas of cervical tissue is removed by passing through a thin wire loop electric discharge.
• The wedge biopsy - removal of a wedge-shaped sample of abnormal cells of the cervix.
• Cryotherapy - freezing procedure is abnormal areas of cervical tissue.
• Laser treatment - the procedure of destruction of abnormal cells using a directional laser beam.

Side effects and risks associated with the selected treatment for cervical dysplasia, discuss with your doctor before starting treatment. There is a small chance that the chosen method of treatment can affect pregnancy in the future.