What is the probability of infertility after mumps in men?

Epidemic parotitis or, in common parlance, "mumps" is a viral infection that affects the glandular tissues of the body. Most often it is clinically manifested by inflammation of the parotid salivary glands, the edema of which creates the characteristic shape of the face that gave the name of the disease. Parotitis is dangerous for complications, such as pancreatitis, serous meningitis, thyroiditis, mastitis( both in girls and boys).One of the relatively frequent complications in men is orchitis, which can lead to infertility.

What is the "pig"

Fortunately, the mumps epidemics have passed by universal vaccination: after the vaccination was included in the calendar in 1981, the incidence decreased 600 times. Unfortunately, postvaccinal immunity lasts about 20 years on average.

The causative agent is paramyxovirus, transmitted by airborne droplets, only people get sick. Susceptibility to it in non-vaccinated and not affected reaches 100%.The incubation period is from a week to 25 days, an average of 18-20 days. Boys and men get sick on average twice as often as girls and women. In pre-vaccination times, there were cases when parititis literally "mowed" the operating armies.

The disease begins acutely, the temperature reaches 38-40 degrees. On the first day, in the majority of patients, a characteristic lesion of the parotid salivary glands arises, which is manifested by pain in this area, by noise in the ears. Often other salivary glands are involved in the process: submandibular and sublingual. The face swells and becomes round. Edema is maximal for 2-3 days, then it begins to subside, but this process in adults lasts up to 2 weeks( in children, on average, a week).The symptoms of intoxication are expressed: weakness, headache, drowsiness, muscle pain.

Orchitis develops on the 6-9th day of the disease on the background of a diminishing inflammation of the salivary glands. The temperature rises again, the headache returns, vomiting occurs.

More often( 75-80%) one testicle is affected. It drastically swells( the skin is stretched, shines), becomes cyanotic, there is a pronounced soreness. Occasionally, the viral orchitis passes into an abscess of the testicle - if a bacterial infection joins. This condition requires urgent surgery.

Treatment of mumps

Specific, that is, aimed at destroying the pathogen, treatment of mumps does not exist. In an uncomplicated process, therapy is limited to anti-inflammatory and detoxifying agents.

In the case of orchitis,

• uses hormonal anti-inflammatory drugs( prednisolone) to quickly remove swelling, preventing complete death of the testicle;
• Novocaine blockade of the spermatic cord - for the same purpose;
• cytostatics - to prevent the development of antisperm antibodies;
• as an auxiliary method, facilitating the condition with orchitis, is prescribed wearing a scrotal suspension.

Why can infertility develop after mumps?

Orchitis caused by the mumps virus often ends with a different atrophy of testicular tissues, including spermatogenic epithelium. There are several reasons for this:

1. Tissue swelling provokes ischemia( impaired blood supply) due to their squeezing.
2. The virus affects the walls of small vessels, which leads to their thrombosis.
3. Another reason is a violation of the hematotestick barrier, which causes an autoimmune reaction. Proteins of spermatogenic epithelium, which is finally formed after puberty, are "unfamiliar" to the immune system. Usually they do not penetrate into the blood - for this there is a hematotestick barrier. Inflammation damages it, which can cause the appearance of antisperm antibodies.

What is the probability of infertility after a transferred mumps?

It is believed that infertility after the transferred orchitis occurs only after bilateral inflammation. Nevertheless, this is about a quarter of all cases of male infertility. According to the spermogram, such men show oligozoospermia or azoospermia, from qualitative changes - asthenozoospermia and teratozoospermia.

Is infertility treated after mumps?

In case of developed infertility, most often it is necessary to use auxiliary reproductive technologies( IVF, ICSI).

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