Diagnosis of male infertility
When identifying signs of infertility in men, the first step to determine the causes of the pathological process is to seek advice from a urologist or andrologist. These specialists will be able to conduct a specialized examination and appoint the necessary examination.
- 1 Spermogram
- 2 Detection of immunological incompatibility
- 3 Ultrasound
- 4 Other studies
One of the most important studies in the program of diagnosing male infertility is a spermogram. This analysis makes it possible to evaluate the following parameters of the ejaculate:
- morphology or the structure of spermatozoa;
- sperm motility;
- number of spermatozoa.
The rule is to identify more than 20 million spermatozoa in 1 ml of ejaculate. In this case, most spermatozoa should have the correct structure and retained motor function. In the presence of deviations from these indicators, we can talk about the presence of a secretory form of male infertility.
Detection of immunological incompatibility
When analyzing the results of a spermogram, specialists can evaluate not only the anatomical and functional parameters of spermatozoa, but also the biochemical features of sperm. One of the important indicators of biochemistry of sperm is the presence of antisperm antibodies. These substances are able to enter the reproductive system of men from blood vessels when the hematotestick barrier is broken. Antisperm antibodies almost completely cover the surface of spermatozoa, and as a result the probability of conception is significantly reduced.
Another method of checking spouses for immunological compatibility is HLA-typing. This procedure consists in the study of antigens of the surface of leukocytes obtained from the venous blood of patients. Based on a set of these molecules, the individual HLA-phenotype of a person is determined. In this case, the more coincidences between the phenotypes of the spouses, the less likely the conception in a given couple. For example, if the immunological compatibility of the spouses is disrupted, the female body can perceive the fertilized egg as a modified cell of its own organism and try to destroy it.
Ultrasound examination( US)
When performing ultrasound examination of pelvic organs in a man, it is possible to detect abnormalities in the structure of the testicles, prostate gland, and testicular appendages. Thus, the detection of a pronounced narrowing of the diameter of the vas deferens can be a sign of obturation infertility. In addition, ultrasound is the method of choice for revealing pathological formations of the organs of the reproductive system. The
can be performed by various methods. The classical method of external examination is most often used, but in some cases transrectal ultrasound may also be used. This technique allows you to identify pathological processes in the prostate gland, as well as seminal vesicles. In addition, the technique of color Doppler mapping of the circulatory system of the genital organs is available.
Other studies of
The following techniques can also be used to diagnose male infertility:
- study of hormones - the most important is the determination of the activity of such hormones as testosterone, LH, FSH( see hormonal background in men);
- microbiological examination of the ejaculate - is performed in case of detection of a large number of leukocytes in the sperm;
- PCR and ELISA - these two methods of laboratory diagnosis allow to confirm or deny with high accuracy the presence of sexually transmitted infections in a patient;
- karyotyping - performed to check the genetic compatibility of the spouses. It is aimed at identifying chromosomal and genetic mutations;
- test of Kurzrock-Miller - is to assess the quality of cervical mucus of a woman and the sperm of a man after mixing them in the laboratory;
- postcoital test is similar to the Kurzrok-Miller test method, however, the mixing of biological fluids in this case is carried out in vivo during the sexual intercourse.
For qualitative diagnosis of male infertility, in addition to these studies, a consultation of a geneticist, immunologist, reproductive specialist and psychologist is required.
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