Evaluation of male infertility

Infertility is the inability of married couples to get pregnant despite using a contraceptive method for 1 year and despite their regular cohabitation. A normal couple has a 20-25% chance of conceiving within a month, 75% within 6 months, and 85-90% within 1 year. Most of them are seen as a result of sexual intercourse on the day of ovulation or 6 days before ovulation. Infertility is a problem that affects about 15% of married couples.

In the infertility problem of couples, only male-related factors are about 20%, and the problem in men in about 30-40% of couples is added to the problem in women; In 50-60% of couples who have difficulties in conceiving, it is revealed that a problem in the man partly contributes to the problem of infertility. Although most of the problems in men can be understood from examination and sperm analysis, some situations may require special tests. 5-35% of untreated infertile couples can have children in the future by having sexual intercourse alone without any supportive treatment.

Whatever the cause, overcoming infertility is not easy. Many infertile men feel incomplete and unhappy. Some think that he has lost his manhood. These feelings are normal and the way to overcome them is to communicate with other people. Infertile couples should support each other to overcome these problems. It should not be forgotten that 90% of infertility causes can be treated and there are many treatment options.

As a result of the treatments, most men can solve their problems and enable them to have children with normal sexual intercourse. It is a common erroneous practice to switch to female infertility treatments without the man’s being examined by a urologist and his spermiogram performed in a specialized laboratory is evaluated by an experienced urologist. In addition, sperm test is requested from the spouses of women who go to the obstetrician and this is evaluated. This is an incorrect approach. It would be wrong to evaluate male infertility by only looking at the sperm test. It should be noted that in some cases, male infertility may be the first sign of an underlying and life-threatening serious disease.

Examinations:

After the history and physical examination, male tests should be performed. Evaluation in terms of male infertility should be done at least two or three spermiograms evaluated in the WHO (World Health Organization) criteria, with an interview with a urologist at the first stage and by giving sperm correctly. Semen Analysis should be done after 2-5 days of sexual abstinence. If done at longer intervals, the number of dead sperm increases. If it is done in a shorter time, it will affect the sperm count.

Normal spermiogram has the following values:

The volume ………………… should be between 2-6 ml.

Color: Opaque, grayish and becomes yellowish with increasing abstinence period.

pH:………………………………..7.2 to 7.8

Leukocyte…………………………1*1,000,000 should be less than.

Liquefaction: ………… should be 10-20 minutes.

Concentration……….20 million /ml (Total must be more than 40 million/ml)

Motility…fast forward movement should be above 25%, fast forward and slow forward movement should be above 50%.

Morphology…….30% according to WHO ………14% according to Kruger’s Criteria.

Forward motion should be ………….>%2.

spermiogram; It is the most important test in the evaluation of infertile men. Apart from azoospermia, semen analysis does not provide a clear distinction between infertility and infertility. As the quality of sperm parameters decreases, the chance of pregnancy decreases, but it does not completely end. If a problem is detected in the examination or sperm test as a result of the first evaluations, detailed examinations will be started. These can be more detailed tests with sperm, hormone analysis, ultrasonography and some other radiological and genetic tests.

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