Why infertility may appear in men: causes and types. Do women issue certificates of infertility?

A woman can become pregnant with IVF if quality sperm is used for such a procedure.

Therefore, a man participating in in vitro fertilization must pass an analysis to identify the ability to conceive - a spermogram.

With normal rates, the chances of successful fertilization increase significantly. The doctor is responsible for decoding the examination results. But it is also useful for a man to know the norms of spermogram, possible deviations and methods of improving the quality of the ejaculate.

Indications for the study of ejaculate

A spermogram is understood as a visual, microscopic, physicochemical, quantitative and qualitative study of the ejaculate of a man of reproductive age. It is the most accurate analysis to assess the quality of semen. Sperm are examined using special equipment in the laboratory.

Indications for a spermogram are:

sperm cryopreservation is planned;
a married couple cannot conceive a child throughout the year with regular intimate relationships without protection;
the man is going to become a sperm donor;
a preventive examination of the reproductive system is performed;
there are diseases transmitted through sexual contact;
preparation for the IVF procedure is in progress;
there is a suspicion of impaired fertility due to infectious pathologies, varicocele, genital trauma;
pregnancy planning is being carried out, and the man wants to be examined;
revealed a hormonal imbalance.

Delivery and transcript of analysis

Material for semen analysis is obtained by masturbation. The sampling is carried out in the laboratory (in a room specially designed for this).

You can collect the biological fluid at home and immediately take it for research. The spermogram results are handed out to the patient or doctor the next day after the delivery of the material.

They are drawn up in the prescribed form: the conclusion indicates a list of indicators, their actual and standard values. In Russia, there are no standards approved at the federal level, which prescribe how to take a spermogram and interpret the result.

Therefore, at the stage of receiving ejaculate, laboratories have different requirements for men. There are some differences in regulatory values.

To decipher the spermogram, the doctor pays attention to the following parameters:

ejaculate volume;
liquefaction time (depends on the viscosity of the liquid);
acidity;
spermagglutination;
colour;
concentration of leukocytes;
sperm motility (determined by assessing sperm categories A, B, C and D);
red blood cell level;
structure, shape of sperm;
the presence of mucus, blood;
the presence of antisperm antibodies.

An increased content of leukocytes, erythrocytes, the presence of mucus indicates an inflammatory process. Blood in the ejaculate appears with injury and some diseases of the urethra.

Insufficient sperm count may indicate infertility. Antisperm antibodies prevent sperm from fertilizing eggs.

How to Prepare for Analysis to Get Good Results?

It happens that a spermogram taken twice in a row shows different values. This is because sperm quality is influenced by different factors. To get a reliable result, a man should prepare for the examination in a certain way.

Preparation rules:

refrain from sexual intercourse and masturbation for 4 to 7 days. During this time, the ejaculate accumulates the same amount of spermatozoa that a man usually has;
do not take alcoholic beverages 7-8 days before the examination (alcohol has a bad effect on sperm motility);
do not smoke for three days before the diagnosis (nicotine reduces the concentration and motility of sperm);
do not visit the bathhouse, sauna, do not swim in hot water for several days before the procedure (high temperature reduces the mobility and concentration of sperm).

What spermogram is considered normal?

The guidelines for the interpretation of spermogram results are WHO recommendations. The healthcare organization regularly reviews the reference values.

At the moment, the standards given in the fifth edition of WHO from 2010 apply. But not all Russian laboratories are guided by such recommendations.

Normal semen is grayish-white or grayish-yellow in color. Some food products (carrots, beets), vitamin A can affect the shade. The optimum acidity level varies from 7.2 to 7.8. The liquefaction time is 10-60 minutes.

Spermatozoa are considered normal as oval cells with mobile tails. During the assessment of morphology according to Kruger, the laboratory assistant detects a defect in the head, changes in the neck. The content of immature germ cells is allowed up to 2%.

Pathological forms may be present in a man in small quantities. Normally, sperm adhesion is not detected.

A milliliter of ejaculate contains 20 to 120 million sperm. The total sperm count is 40-600 million. The optimal number of sperm capable of fertilization is not less than 15%.

A healthy man should have so many motile sperm in the ejaculate: category A - about 25%, B - 25%, C and D - no more than 20%. Leukocytes are normally present in the amount of 3-4 pieces in the field of view. There should be no red blood cells.

A slight presence of mucus is allowed. If the spermogram indices correspond to the standard values, then the chances of conceiving a child increase.

Table of norms by age

The quality and quantity of semen changes with age. Already from the age of 35, ejaculate begins to be produced in a smaller volume, the number of mature spermatozoa decreases. This is due to the extinction of the male reproductive function.

The table of spermogram norms by age is shown below:

Research by French scientists has shown that men aged 30 to 35 have a fertility rate of 13.6%. The fertilization success at 45 years old is 9.3%.

Reasons for deviation of sperm motility in men from the norm

Almost 50% of men have abnormalities in the spermogram. A small volume of ejaculate, an insufficient number of sperm, and their reduced mobility can interfere with fertilization.

Reasons for a decrease in sperm count:

endocrine pathologies (hypothyroidism, impaired hypothalamic-pituitary regulation);
diseases of the genitourinary sphere (orchitis, cryptorchidism, varicocele, prostatitis);
traumatic injuries of the genitals;
heat;
klinefelter's syndrome;
chronic poisoning by lead, carbon dioxide, mercury;
starvation;
hot climate;
exposure to certain medications (sleeping pills, steroids, antibiotics);
chlamydia;
frequent ejaculation;
mycoplasmosis;
wearing tight underwear.

The complete absence of sperm (azoospermia) occurs when:

congenital anomalies;
exposure to toxins (chemicals, drugs, alcohol, radiation);
inflammatory process in the genitourinary sphere;
hormonal disruption;
diseases of an infectious (non-infectious) nature.

Sperm motility can be reduced for the following reasons:

stress;
overwork;
taking antibacterial drugs;
sedentary lifestyle of a man;
avitaminosis;
smoking;
frequent use of lubricants;
alcohol abuse;
the influence of ionizing (electromagnetic) radiation.

What to do with poor performance?

If a man received a bad semen analysis result, he should make an appointment with an andrologist and undergo a series of additional examinations. If during the diagnosis no pathological processes were identified, then it is worth revising the lifestyle.

You can increase sperm motility by following these rules:

quitting smoking, alcohol;
elimination of stress;
playing sports;
wearing loose underwear;
balanced diet;
taking vitamin complexes.

To stop inflammation, which is accompanied by low motility of sperm, an increased level of leukocytes, the drugs Spermaktin, Tribestan, Androdoz, Speman are used.

Suppositories "Prostopin" for the treatment of prostatitis

Suppositories for the treatment of prostatitis have a wide range of drugs, they contain active substances that relieve pain, relieve inflammation and promote a speedy recovery. Candles containing natural ingredients are beneficial for the body. They do not have a toxic effect on the body, and the phytopreparation does not give side reactions to organ systems.

Contraindicated in people with allergic reactions to all bee products

General characteristics of the suppository "Prostopin"

Suppositories Prostopin are a dosage form intended for administration into the rectal cavity. Since the constituent components are most often presented as oils and fats, they are quickly absorbed and evenly distributed along the rectal wall. Since the medication does not pass through the digestive tube, it does not lose its healing properties, passing through the metabolism in the liver, and the maximum amount of active substances enters the bloodstream. The absorption of the substance occurs due to the location in the ampulla of the rectum of the system of hemorrhoidal veins. The upper veins, by the blood stream, carry active substances into the portal vein system and pass through the liver and enter the inferior vena cava. The middle and lower veins, bypassing the liver, deliver the medicine to the inferior vena cava system.

Benefits of rectal administration of the drug:

If it is impossible to administer the substance orally (vomiting of various genesis, esophageal pathology, edema of internal organs);
The structure of the substance is not influenced by the digestive enzymes of the gastrointestinal tract.

Disadvantages:

Psychological factor. Most males refuse to use the drug, as they experience discomfort when administered;
Irritant effect;
In the absence of preparation, before the administration of the drug, the dose will not be constant. This is due to a decrease in the absorbing surface of the mucous membrane due to the presence of feces in the intestine.

Natural composition of the drug

The medicine is made from bee products. After processing the components, they acquire properties more accessible for absorption, thereby better affecting the diseased organ.

Royal jelly (100 mg in one suppository) is the discharge of the maxillary glands of bees, which provides food for the larvae and the uterus. The secret has antimicrobial, antifungal, anti-inflammatory effect. It also stimulates the immune system to fight against pathogenic microflora and stress.
Honey (120 mg) normalizes metabolism, has a bactericidal and antiseptic effect. Honey is also recommended to be taken as a prophylaxis for viral infections.
Propolis (310 mg) is a natural antibiotic.
Perga (150 mg) has a tonic effect for the whole organism, an immunostimulant, increases potency.
Pollen (80 mg) activates and accelerates the regeneration of damaged tissues.

Prostopin also has anti-carcinogenic, analgesic effects.

Indications for use

Prostopin is used not only for prostatitis; it is also used in the complex therapy of anal fissures, hemorrhoids, erectile dysfunction, inflammation of the spermatic cord, and prostate adenoma. In the complex therapy, Prostopin is prescribed for infertility, due to the lethargy of sperm.

Release form

Suppositories from yellow-brown to greenish cone-shaped, with a characteristic odor. Produced in a plate of 5 candles in a package, resembling cells.

Storage conditions

Store the medicinal product out of the reach of children at a temperature of 3-7 ºС.

Interaction with other medicinal products

There are no clinically registered cases of incompatibility with other drugs.

Overdose

Overdose cases were not recorded.

Contraindications

Due to the fact that the drug contains exclusively natural ingredients, people with hypersensitivity to the constituents of the drug immediately develop an allergic reaction.

Before using the medicine, consult your doctor and read the instructions for use.

Application rules and dosages

To obtain the desired result, the drug must be used once a day before bedtime, injected into the rectum to a depth of 10 cm. Before using the drug, it is necessary to empty the intestines on your own or make a cleansing enema. The course of treatment is 2-4 weeks, if necessary, re-therapy is prescribed.

Prostopin for inflammation of the prostate gland

Regular use of the drug for exacerbation of prostatitis eliminates pain in the groin and urethra, facilitates urination, relieves swelling. It has a beneficial effect on the quality of the sperm produced, improves potency and erection. When used for prophylaxis, it prolongs remission, promotes the regeneration of damaged tissues.

It is also prescribed for the complex treatment of hemorrhoids. Relieves pain, swelling, normalizes blood circulation.

The diagnosis of "Infertility" can be a death sentence for any person. Many are afraid of him and do everything in their power so that he does not appear on their outpatient records. Men and women beat the doorsteps of all possible clinics, stand in long lines to the famous luminaries of science, pass a bunch of tests, endure painful procedures, and the long-awaited pregnancy never comes.

For other men, the situation is completely opposite: they can have a child without any effort and not even one. They do not bother with the issue of contraception, and for this reason, an unplanned pregnancy can occur.

Offended women go to court to award child support. On the Internet, you can find a large number of requests from men who want to avoid this fate and convince the court of their infertility.

For this, men are looking for doctors who can issue a certificate confirming their state of health. It will contain the following information:

Name of the patient;
Full name of the doctor and his specialty;
test results;
diagnosis;
date of issue of the certificate.

Which doctor issues

Internet users are advised to contact a urologist or geneticist for such a document. Practice shows that this does not solve the problem, because the judge will most likely require additional research on the man's fertility. It is a pity that today men are afraid to take responsibility for their actions to help their children grow up, but prefer to hide behind “phony” papers.

Also, some men complain that such a document was demanded from them when obtaining permission to adopt a child. Experts say that in this situation there is no need for this certificate, because families without this diagnosis can take care of the child. For more accurate information on this issue, it is worth contacting lawyers who will help to resolve the issue from a legal point of view.

If a young woman, after a year of a happy family life in love and harmony, cannot conceive in any way, she begins to seriously worry about infertility. Therefore, she shares her doubts and fears with her friends, relatives, relatives. This is, of course, a good solution, but purely psychological. To find out the cause, and, if necessary, undergo treatment, you need to see a doctor.

According to medical statistics, in our country the average number of infertile couples is 10-15%. Infertility: When to Diagnose? If pregnancy does not occur in any way, how much time after the start of regular sex life should I see a doctor? Let's look for answers to these questions:

Infertility certificate or when a disappointing diagnosis is made?

Most often, infertility is diagnosed after 12 months of regular sexual activity of the spouses, provided that both have no health problems, are of reproductive age, and the average frequency of sexual intercourse is at least 2-3 times a week, without the use of contraceptives.

If all of these conditions are met, usually the probability of conception in the first 3 months is 30%. In the next 7 months - 60%. And in the next 2 months, the probability of conception is 10%. That is, 12 months of regular sexual activity should fully ensure the onset of pregnancy by 100%.

If this does not happen, you need to see a doctor, undergo the necessary examination, and take tests. Moreover, both spouses need to do this. The fact is that very often infectious diseases are the reason for the inability to get pregnant. They are found during the examination. With timely treatment, this cause of infertility is eliminated.

It is also necessary to note such an important factor that significantly affects the possibility of getting pregnant, as a woman's childbearing age. More recently, the optimal age for pregnancy has been between 18 and 25. But at present, this age is considered to be 20-35 years. A physically healthy thirty-year-old woman has a 20% chance of becoming pregnant in one menstrual cycle. Provided that sex is regular. By the age of 40, this probability decreases to 5%.

Of course, various chronic gynecological diseases not treated in time, as well as congenital structural features of the female body, can lead to female infertility. There are also many reasons for male infertility. Most diseases that prevent pregnancy can be successfully treated, especially at the initial stage of development. Therefore, you need to see a doctor as soon as possible.

Infertility treatment

An experienced doctor should carry out the diagnosis. In addition, it is imperative to find out which spouse has problems with conception. If, for some reason, infertility cannot be cured, remember - life is not over and this problem can still be solved. Only spouses need to do this together, together. You can find a way out of this seemingly hopeless situation.

How to get rid of infertility?

Sperm donation

This is the best option for male infertility. It can be very difficult for a man to decide on this, because he will know all his life that his child is not his own. But to preserve the family, most infertile men agree to donate. If the decision is made, be responsible for the donor search.

There is another form of donation. It is used for female infertility, when female cells are not produced or their function is lost. In this case, a healthy egg is taken from a donor woman. The doctor then connects her to her husband's sperm. Then transplanted into the uterine cavity of the wife. In this case, at the onset of pregnancy, the woman endures and gives birth on her own and on time.

Surrogate mother

This method should not be discounted either. If a woman is infertile and it is known for sure that she cannot give birth on her own, you can find a surrogate mother. The doctor will fertilize her egg with her husband's sperm, after which the woman will carry and give birth to a child, whom you can pick up. If this method is chosen, you need to be very responsible in choosing a surrogate mother. She should already have children of her own, and she should also be physically and mentally healthy.

Adopting a baby

Remember that adopting a small person is a very serious and responsible step. Therefore, before doing it, discuss this opportunity with your family, weigh all the pros and cons, pros and cons. Each child is a person that requires attention, care, and most importantly - he needs to be loved. The adopted baby should become truly dear to you. You must understand that you are fully responsible for him - for the necessary treatment, training, education.

If you are ready for this, hurry to the guardianship authorities, take from a specialist a list of documents that need to be collected for adoption.

It is best to adopt a newborn baby refusal from the hospital. Unfortunately, there are a lot of such abandoned children. But you can adopt an older child by visiting an orphanage. But in this case, certain difficulties may arise, because a child of 3-5 years old may simply not accept a new mom and dad. Whereas a newborn may not know all his life that his parents are adoptive.

How to come to terms with infertility and is it worth it?

In conclusion, I want to add that if infertility is diagnosed, there is no need to despair. Remember that life does not end there and there is always an acceptable way out for you. The fact is that real medicine is not perfect, and it can be achieved endlessly. But that's not the point. The human brain, whoever created it, is perfect. So in many cases, you need to start changing your idea in your head about your position. You have to imagine every day that you are healthy and can have children, and even that you already have them, have just been born. Imagine the whole process of the birth of life, the birth of a child. All these thoughts should be joyful. Eliminate all negativity, bad habits from your world. Engage in health promotion and keep imagining what you want in your head. Do not sweep aside amulets, icons and other symbols that strengthen the belief that you are healthy and can do everything ... And you really can, because your brain will make you healthy!

Offended women go to court to award child support. On the Internet, you can find a large number of requests from men who want to avoid this fate and convince the court of their infertility.

For this, men are looking for doctors who can issue a certificate confirming their state of health. It will contain the following information:

Name of the patient;
Full name of the doctor and his specialty;
test results;
diagnosis;
date of issue of the certificate.

Which doctor issues

Men are worried when planning children against the background of chronic prostatitis. They think that their illness will prevent them from conceiving a baby. This is true, but only in a small percentage. Prostatitis is considered a complex process that does not directly affect the ability to conceive.

Difficulty conceiving

Many couples are sure that chronic prostatitis will prevent a baby from being born. Although it is possible, it is dangerous. With the development of the disease against the background of infection, a woman can "take" bacteria to her. In this case, the danger lies in the infection of the partner. If conception succeeds, then it will be more difficult for a pregnant woman to treat foreign organisms. This is worth remembering.

In the chronic stage of prostatitis during an exacerbation, there may be problems with conception. The reason for this is the lack of desire to make love. In addition, the man will experience painful spasms during ejaculation. Sometimes there is a rapid "eruption", but does not affect the conception itself. It is important to treat prostatitis as soon as you realize that it is it. If the disease has gone further, sperm may deteriorate, as a result of which the sperm will become flaccid and cannot reach the desired point.

The prostate has an important function - it produces juice. It is found in the semen and controls the activity of the sperm. With prostatitis, the number and labor force of "seminal agents" is reduced, and this significantly reduces the percentage of conception. But nevertheless, prostatitis and infertility cannot be put closely together, since indirect causes affect conception. An inflamed prostate is not a prohibition on planning a baby.

The danger of prostatitis is that its process may not be felt by a man. He will be noticed when the disease is already at an advanced stage.

Is there a connection

Many men with infertility and chronic prostatitis are diagnosed with secondary infertility. Conception itself is dangerous only for a woman due to the presence of an infection in a man. Of course, most men cannot have children with this pathology. This process is hindered by such moments as:

bacteria;
viral agents;
mushrooms;
coli from the intestines, fixed in the flora.

Given the fact that chronic prostatitis is a concomitant factor in the inability to conceive a child, it is still possible to carry out the conceived (conception). The chances will be less, but they will be. It is imperative for an inflamed prostate to undergo examinations before planning a pregnancy. Self-medication in this case is inappropriate, but control by a doctor is important.

In the female population, after the 35 mark, the ability to become pregnant begins to decline. The male population is not puzzled by this, since they are not threatened. They can conceive a new life even in old age. With modern medicine and special equipment, it is safe to say that prostatitis and child planning are compatible.

Planning conception

You need to start the planning process with a visit to your doctor. This could be a urologist or andrologist. A woman also does not hurt to check her "performance". The man will need to donate sperm for analysis. The specialist will check the results and evaluate the seed. Only after this sperm test will the doctor tell about the prognosis. After receiving an interpretation of the tests, you need to go to the urologist. With a negative spermogram and unwanted inflammation, tests for the state of hormones, ultrasound and an assessment of the secretion are prescribed.

With prostatitis and infertility, the chances are reduced, so if you want to conceive a baby, you need to be careful about your health. For any form of prostatitis, treatment should be started immediately. You also need to revise your diet, eliminate harmful effects, give up nicotine and alcohol addiction. All these actions together will improve the test performance and help your partner get pregnant.

general information

Even if with inflammation of the gland with potency and desire everything will be in order, a specialist can give no more than 5% for natural conception. This is a very small figure that is difficult to raise. If we talk about treating a chronic type of disease, you can increase the chances of conception. While you shouldn't console yourself with that, it's much more complicated. All tests can be in a relatively "good" norm, but the condition of the sperm will be poor. The doctor will prescribe vitamins, although they will not directly help make the baby, they will support the immune system in order to maximally protect the man from new infections. Ideally, for chronic prostatitis to allow you to become pregnant, you need to follow all the recommendations of the doctors.

If a man who has chronic prostatitis wants healthy offspring, he should eat a balanced diet that will exclude fatty and spicy foods. You also need to undergo a full course of treatment and examination. Only after comprehensive measures can we confidently say about the opportunity to replenish the family.

Male infertility will be discussed in this video:

11 rules for preparing for the MAP test and how to decipher the results

When conducting such an in-depth semen analysis as the MAP test, decoding can immediately answer the question of the cause of male infertility. In healthy guys, sperm are separated from contact with blood cells by a special barrier. For a number of reasons (trauma, inflammation, infection), its violation occurs, after which the immune system begins to attack the germ cells. Sperm damaged by antibodies cannot fertilize. Therefore, to find out the causes of infertility, doctors recommend that patients not only take a spermogram, but also do a mar-test.

All spermatozoa that form in the testes in men already have an altered genetic makeup. This is due to the fact that the primary germ cell divides in half at once, so that each has 23 chromosomes. Normal cells in the human body contain a set of 46 chromosomes. That is why sperm cells are atypical, foreign, subject to destruction for the body's immune system. To prevent this from happening, nature came up with a special barrier, it is called hematotesticular, because it separates the blood vessels and spermatic cords in the testicles. Thanks to this protection, immune blood cells do not penetrate into the testicles and sperm in healthy men do not attack.

Certain circumstances can damage the barrier, for example:

mechanical trauma to the genitals;
postoperative complications;
sexually transmitted infections (especially chlamydia);
childhood diseases (mumps);
inflammatory diseases of the testicles (orchitis).

If the testicles are deprived of protection, then immunity begins to work inside them. This means the production of antibodies against the body's own germ cells. As a result of an immunological reaction, sperm cells are damaged and are deprived of the opportunity to fertilize eggs. All these changes in sperm cells are shown by the mar-test. It is usually done in parallel with the study of spermogram, since it cannot give complete information about all the properties of a biological material. The need for clarifying analyzes arises when all spermogram indicators in a man are normal, and the couple cannot conceive a child.

The Mar-test is a deep examination of the semen, on the basis of which the patient can be diagnosed with immunological infertility.

This analysis is of great importance for assessing the fertile function of the stronger sex, since it allows to reveal the presence of germ cells with good motor activity, but unsuitable for conception.

In accordance with the latest recommendations of the World Health Organization, the Mar-test must be carried out simultaneously with the spermogram in order to get a complete picture of the patient's reproductive capacity.

This research is of two types:

Direct testing. For analysis, ejaculate is taken from a man or the mucous contents of the cervical canal from his partner. The number of glued spermatozoa with antibodies on the surface is determined in the material.
Indirect way. It consists in determining by ELISA the titer of antibodies against sperm in the blood serum.

Who is the Mar-test indicated for:

men whose spouses cannot get pregnant for no other reason;
urologist's patients treated for STIs (chlamydia or other infections);
clients of family planning and reproductive medicine centers - in the preparatory period before the IVF procedure;
persons who have undergone serious operations on the organs of the genitourinary tract;
men who have not revealed changes according to the results of the spermogram, but conception still does not occur;
patients who have an agglutination or other pathology of sperm in the analysis of semen.

Contraindications for the Mar-test are the following violations identified in the semen analysis:

oligospermia (the amount of ejaculate is less than 1.5 ml);
azoospermia and oligozoospermia (absence or insufficient number of sperm);
cryptozoospermia - reduced content of male germ cells in 1 ml of sperm;
necrozoospermia - most of the spermatozoa found in biological material are dead.

The MAP test and semen analysis are usually done in parallel. Both tests are done from the same semen sample, so there is no need to re-receive ejaculate. The biological material is collected in a special sterile container through masturbation in a secluded office in the clinic. Houses can also be assembled, but on condition that the container with ejaculate is delivered to the laboratory within 40-50 minutes. Otherwise, male germ cells risk dying or dramatically changing their morphology, which will adversely affect the research results. Sperm should never be collected in advance and stored in the refrigerator. Until delivery to the clinical laboratory, containers with semen must be kept in an environment close to the temperature of the human body.

In order to correctly collect and hand over biological material to physicians, during the preparation for the examination, you should adhere to some simple rules:

The test is best done after a few days of rest, especially if a man's labor activity is associated with contact with chemicals, fertilizers, toxins.
For 5-7 days before collecting ejaculate, complete sexual abstinence is recommended.
You need to stop drinking alcoholic beverages in a week.
For 3 months, you should stop taking drugs.
For 2 weeks, do not visit the steam rooms in the baths.
Withstand at least half a month after treatment with antibiotics and other drugs.
The study will have to be postponed for six months after a course of hormonal drugs.
In the case of acute infectious and inflammatory diseases, it is necessary to wait for complete recovery and not take a spermogram for another 10 days after it.
The day before the test, it is necessary to limit heavy physical activity and exclude psycho-emotional experiences, as well as the use of fatty and spicy foods.
Sleep well on the eve of the study.
It is forbidden to smoke 4 hours before collection of ejaculate.

For fertility assessment, preference is given to the direct method of conducting the Mar-test. For this, blood cells or synthetic particles are added to the semen, on which antibodies from the IgA or IgG classes have been applied. Then everything is mixed with Igg antiserum. Spermatozoa with attached antibodies adhere to the injected cells. The percentage of the obtained complexes to normal sperm is calculated. At the same time, according to the photo, you can determine the place of attachment of antibodies on the germ cells. The most unfavorable prognostic criterion is the attachment to the head.

Usually, you can get a spermogram and a Mar-test with indicators in the form of a table already on this or on the second day after the analysis. For greater reliability, the doctor may recommend re-conducting in 15-20 days.

What the resulting analysis can mean is a mystery to the layman. Spermogram and MAP test are interpreted by qualified specialists.

What indicators of the analysis of ejaculate are considered normal:

semen color - white-gray;
quantity - more than 1.5 ml;
pH - 7.2 and higher;
viscosity - 0-3;
agglutination - 0-4;
liquefaction time - up to 60 minutes;
the number of sperm in 1 ml - over 15 million;
general mobility - more than 40%;
cells with normal morphology - from 80%;
leukocytes - less than 1 million in 1 ml;
mucus - no;
spermatogenesis cells (immature) - up to 4 million in 1 ml.

In the first case, the chances for the onset of natural fertilization are great, since there are free motile sperm in the semen. In the second case, more than ½ of the male sex cells are damaged by antibodies, which indicates his immunological infertility. This can only mean that the only possible method of conception is artificial insemination. The higher the percentage, the less chance of paternity. The lower from 50%, the better.

However, doctors consider such a gradation of results to be rather rough, therefore, several steps are distinguished. The ideal state is the 0 percent Mar-test, which means that there is no immunological reaction in the body against its own sperm. This is the norm.

What options for the Mar test can be:

The analysis showed from 0 to 10% of sperm affected by antibodies. This case is regarded as an error and assumes that the MAP test should be repeated in 2-3 weeks.
With rates above 10% but below 50%, the situation is not hopeless. It is necessary to find out what a man has with health and lifestyle in order to remove negative factors. In addition, there are modern drugs that make the Mar-test as low as possible.
Indicators significantly higher than 50% do not respond to conservative treatment. You can only "wash" the spermatozoa received from a man and prepare them for artificial insemination.

Antibodies detected during the study can be of several types:

IgA - they are responsible for the formation of local immunity and are produced by cells of the mucous membranes;
IgG - are constantly present in the human body after an infection or as a result of an immunological reaction;
IgM - are the first indicator of the immune response, do not persist for long and are determined by laboratory tests only within 2 weeks after formation.

How to correctly read the received data on immunoglobulins? The effect of different types of antibodies on genetic material is different, with the difference that IgG changes the composition of sperm. They increase the viscosity of the ejaculate, increase the white blood cell count, and also lower the acidity. This happens most often in men who have suffered an infectious inflammation of the genitourinary organs in the form of prostatitis, vesiculitis or orchitis. IgA reduces the quality of germ cells, since they affect morphology.

Most often, when examining spermatozoa, combinations of different antibodies are found on them, which is an undoubted sign of immunological infertility.

There are many reasons for getting poor analysis. Infertility can be the result of dozens of diseases and pathological conditions that can provoke an autoimmune reaction in a man's body.

The most common ones are:

varicose veins of the spermatic cord (varicocele);
cryptorchidism (absence of testicles in the scrotum due to their undescendedness);
obstruction of the vas deferens;
testicular neoplasms;
chronic inflammation (prostatitis, orchitis, vesiculitis);
sexually transmitted diseases;
genital trauma;
complications after surgery, biopsy;
consequences of vasoresection - sometimes the patient decides to reverse the operation, but it is no longer possible to become a father in a natural way.

To lower your Mar test scores, you must first find out the exact reason why the test came back positive. To do this, the doctor asks the patient about living and working conditions, about the nature of food and lifestyle. Sometimes, to improve the spermogram, it is enough to make a correction in the usual way of life.

If pregnancy does not occur in the next 9 months, then the man is recommended to undergo additional examination.

These may include the following studies:

tests for hormone levels;
blood tests for all sexually transmitted infections;
Ultrasound of the pelvic organs;
CT or MRI;
phlebography to assess blood supply, etc. at the discretion of the doctor.

The results of a complete examination are necessary to clarify the diagnosis and choose treatment tactics.

If an infection is detected, courses of antibacterial agents are carried out.

If there are no bacteria, then the following methods are applied:

Corticosteroid hormones (prednisone) are prescribed in short courses. In each case, the dose and duration of treatment are determined individually. These drugs inhibit the production of antibodies, but cause side effects, so you cannot self-medicate.
Plasmapheresis - purification of the blood from immune complexes and antisperm antibodies, sessions are carried out until the indicators normalize.
Antihistamines - can be used in some cases with an unfavorable allergic background in the body.

The absence of natural pregnancy after the treatment and the disappointing results of repeated studies for antisperm antibodies are direct indications for

fertilization by one of the modern methods (ICSI, IVF). In this case, the most decent spermatozoa are selected from the sperm, they are "washed" from antibodies in special solutions and used for the conception procedure.

When you receive a positive Mar test, you should not despair, this is not a sentence. You need to get tested, find a good doctor and follow his recommendations. In addition to drugs, you need a healthy diet, rejection of all addictions and the right psychological attitude.

Many private and public clinics offer MAP testing services. The procedure is paid, the cost varies from 1000 to 2500 rubles, depending on the region, the level of the medical institution.

Some laboratories offer rapid analysis. Accelerated testing usually costs 300 or 400 rubles more.

The mar-test is a specific laboratory test that is often used when examining men who see a doctor for infertility. This study is usually carried out simultaneously with a spermogram from the same material.

Thanks to this method, today specialists have the opportunity not only to diagnose the fact of infertility, but to find out the cause of the development of the disease. This is necessary to select the correct management of a patient with a positive MAP test.

This analysis can be prescribed by a specialist andrologist, urologist, reproductologist. The situation is not always critical. In some cases, conservative drug therapy and normalization of the lifestyle help. If a couple does not have a chance of natural conception, then modern methods of artificial insemination will come to the rescue.

Varicocele and pregnancy: one interferes with the other

Varicocele is a vascular lesion of the plexus plexus within the spermatic cord. We can say that this pathology is something like varicose veins, which often worries pregnant women.

Only in men this varicose veins are in the scrotum.

Varicocele may affect sperm quality by increasing testicular temperature - this is one of the theories prevailing in modern medicine.

Varicocele and pregnancy: is there a relationship? This disease was detected:

in 40% of infertile men;
in 20% of all men from the total population of the Earth, in the vast majority of patients, spermogram showed normal sperm quality.

The main evidence to support the hypothesis of a relationship between varicocele and pregnancy is animal testing by partial ligation of the renal vein in a dog (Al-Juburi et al., 1979). This method was later used to create varicoceles in non-human primates and rats.

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The researchers found that unilateral varicocele had a two-way effect on testicular blood temperature, blood flow, and histology. These consequences were eliminated after treatment. Thus, it has been shown that varicocele has a direct adverse effect on testicular function in animals, and this can be corrected by surgery.

Urologists, after diagnosing grade 2 or grade 3 varicocele, often suggest surgery. However, varicocele correction may not always improve sperm quality and return it to normal. Recovery after surgical treatment of varicocele takes up to a week, sports loads should be given no earlier than a month later, and pregnancy planning should begin in 3 months.

Those who intend to plan a pregnancy in the coming year should be examined in order to timely identify varicocele and other factors that impede conception and childbirth.

Will there be pregnancy after varicocele surgery: studies related to pregnancy after varicocele

The Dutch researchers wanted to find out if the chances of pregnancy are increased after varicocele surgery.

Ten randomized controlled trials were conducted. They were attended by a total of 900 men who could not conceive children. The reason for the low birth rate was unclear.
Most of the men had poor quality semen.

The research results showed:

32 out of 100 women become pregnant after their partner's varicocele was treated. In other words, pregnancy after varicocele surgery does not always occur.
16 out of 100 women became pregnant within a year, even though their partner had no treatment for varicocele.

These numbers are averages and are taken from various studies.

Questions that men diagnosed with varicocele often ask doctors:

How long does it take to get pregnant after varicocele surgery? It may take 3 to 6 months for a husband's sperm count to improve. After this period, the wife may become pregnant.
Can you get pregnant with varicocele? It is possible, especially if the varicocele is in its early stages. Male fertility depends on the number of sperm in the ejaculate, their motility, the content of leukocytes, erythrocytes, normal forms of sperm and other parameters. Preferred candidates for varicocele surgery are men with a low sperm count (15-20 million per ml). A woman should also be examined by a gynecologist before her partner undergoes surgery.

Any varicocele surgery can have side effects. In patient reviews, there are references to bruising, infections, dropsy of the testicle, and damage to the blood vessels.

Pregnancy with varicocele in a man: the role of varicocelectomy

Varicocelectomy (varicocele surgery) is an unpleasant step in a man's life, and not everyone decides on it, knowing that no doctor will give a 100% guarantee of the result (pregnancy and childbirth in a woman). The role of the procedure in improving male reproductive function with signs of varicocele has been discussed in medicine for a long time.

Some studies show improved fertility after varicocele surgery, while others show no link between varicocele and conception. In search of an answer, the Clinic for Reproductive Medicine in Cleveland undertook a meta-analysis of the data in the medical literature.

Surgical excision of the spermatic cord veins in infertile patients with palpable varicose testicular lesions and at least one “unhealthy” sperm parameter improves the chances of spontaneous pregnancy.

With varicocele in men, varicocelectomy is a much more effective help for health than vitamins, medications or advice from experts from forums under the motto "we treat at home." That is why urologists, like a mantra, repeat to patients "with the problem of varicocele, only surgery will help."

Varicocele and alternative treatments for male fertility

Varicocele is a common disorder of veins at the site of the plexus plexus in the scrotum. Distinguish between primary and secondary varicocele.

The first is characterized by the absence of valves in the testicular vein or congenital weakness of the venous wall.
The development of the secondary occurs due to pathological processes that disrupt the outflow of blood from the testicle.

Diagnosis of varicocele is based on a combination of a medical examination of the patient and anamnesis. To confirm the diagnosis of infertility, you need to make a spermogram. Only palpable varicocele is likely to be associated with infertility. Most studies show improvement in sperm quality (15 to 15 percent) and fertility after treating a person with varicocele.

Intrauterine fertilization (IMO), and in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) are the most common options for treating varicocele and infertility in men. The choice of the appropriate option depends on:

whether a woman has indications or contraindications for IVF;
pain and other unpleasant symptoms due to varicocele at the time available for conception.

Varicocelectomy is in most cases a potentially more cost-effective option for infertile varicocele compared to IVF + ICSI. The goal of varicocele surgery is to prevent reflux (the flow of blood in the opposite direction to normal flow). Once the affected vein has been tied or filled with special items, blood can no longer flow back into the testicle. And the function of the bandaged vein will be taken over by healthy ones.

The presence of varicocele can lead to a progressive decrease in sperm parameters and impairment of spermatogenesis - the process of maturation of sperm in the testicle.

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