Diagnosis of infertility in men: a complete examination scheme
Every married couple sooner or later thinks about the continuation of the family.Active sexual life without contraception, usually ends with the onset of pregnancy.But sometimes, conception does not happen, even after a year or two.In this case, a married couple is recommended to undergo a survey.If earlier, in the absence of children accused of a woman, today 40% of cases are attributed to male infertility.Table of contents: Causes of male infertility Complete scheme for examining men for infertility diagnosis
Causes of male infertility
Diagnostic methods allow you to determine what caused male infertility and prescribe effective therapy.
The main causes of infertility in men:
- congenital pathology;
- genetic disorders;
- venereal and infectious diseases;
- pathology of the genital organs;
- hydrocephalus of the canal and testis;
- diabetes mellitus;
- trauma to the pelvic and genital organs;
- complication after an operation for inguinal hernia;
- bad habits;
- exposure to harmful substances.
Important! Infertility affects the quality of seminal fluid, the amount and mobility of spermatozoa.
An examination of male reproductive health is performed by an andrologist.
Complete chart of men's examination for infertility diagnosis
As a rule, a male health examination begins with an andrologist consultation that collects an anamnesis, finds out complaints and conducts an examination of the patient.At this stage, diagnose possible violations, assess the functional and anatomical state of the organs of the reproductive system.The primary or secondary infertility is determined.
In men who do not have children, is defined as the primary infertility of .
Secondary infertility is diagnosed in men who already have children.It develops throughout life due to some reasons.
The further survey scheme is arranged depending on the results obtained.Appoint additional procedures and tests.
In general, the examination is performed according to the following scheme:
- Spermogram. Allows you to evaluate the quality of sperm.Further diagnosis depends on the results of this analysis.To get reliable data, a man three days before the deposit must refrain from going to the bath, intimate life and drinking alcohol.The material is taken in a medical facility by masturbation.
- MA R-test. Confirms or excludes immunological infertility in men.Sperm withdrawal is carried out in the same way as for spermogram.
- Ultrasound and dopplerometry of the scrotal organs. Survey of appendages and testicles, blood supply of these organs allows to confirm or exclude surgical, physiological or inflammatory pathologies.
- TRUSION of the prostate and seminal vesicles. With this survey, the structure of the prostate is examined, which allows to exclude or confirm the presence of chronic or acute inflammation.
Additional investigations are performed to clarify the diagnosis, which are performed according to the following scheme:
- hormonal background. Take a blood test for the hormones responsible for the course of spermatogenesis and male libido.The analysis is passed on an empty stomach.Blood sampling is carried out from 9 to 10 am;
- genetic examination. Appoints a physician if pathospermia is detected;
- PCR diagnostics of STDs. Eliminates or confirms the presence of a sexually transmitted infection that affects the conception process.Before passing the test, it is forbidden to urinate for two hours.A smear is taken from the urethra;
- is the secret of the prostate. Analysis allows you to exclude or confirm inflammation of the prostate.Before the study, it is necessary to abstain from sexual acts for three days;
- biochemistry of the ejaculate. The analysis is aimed at studying the seminal plasma.The result shows the work of seminal vesicles, epididymis and prostate gland;
- ROS. Determination of the level of free radicals.Hyperproduction of reactive oxygen species( free radicals, ozone, hydrogen peroxide) is one of the causes of ROS fertility, which reduces the motility of spermatozoa and reduces their ability to fertilize.As a result, their membrane is damaged.Moreover, chromosome DNA is damaged, which leads to the development of apoptosis of spermatozoa;
- Electro-microscopic method for studying spermatozoa. A complete study of spermatozoa, which can detect pathology of the internal structure and contents of the seminal plasma;Acrosomal reaction.
- . The chemical reaction that occurs on the sperm head at the time of contact with the egg allows it to penetrate it.Such a reaction occurs only in healthy spermatozoa;
- sperm seeding. Assign with hanged level of leukocytes or detection of bacteria;
- study of the Kruger morphology. Usually performed together with a spermogram.However, sometimes a detailed analysis of the spermogram is required, which includes sperm analysis, an MRA test and a Kruger morphology;
- HLA. Assign if the woman can not bear the child.The study determines the compatibility antigens of the spouses tissues.Venous blood is taken for analysis;
- definition of oncomarkers. Study is prescribed for suspected cancer;
- Kurzrock-Miller test. Postcoital test, which allows to identify the immunological conflict in a pair at the level of the cervix;
- PSA. The study is administered to all men after 45 years;
- trial of Shuvarsky. Compatibility test of partners.Determine the number of viable spermatozoa in the cervix after some time after coition;
- testicular biopsy. Assign with azoospermia.Allows you to put an accurate diagnosis and adjust the method of infertility treatment in men;
- laboratory testing. Assigned according to the indications.Urine sowing, blood and urine tests, biochemical blood test.
Important! Each method for diagnosing the cause of infertility has serious indications for research and is conducted only by experienced specialists.
Most cases of infertility in men successfully treatable.The main thing is to undergo a comprehensive examination and begin treatment.
Radevich Igor Tadeushevich, a sexually pathological andrologist of the 1st category