Male infertility: what is it?

With this term we mean inability to achieve pregnancy after two years of unprotected sexual intercourse.
While at one time infertility was the total prerogative of the female sex, not considering the possibility of male participation, today we have become aware of how, as many as 30% of infertility in a couple, both for the male factor, also remembering that in couples, about 20%, will be infertile.

Why this happen?

There are many factors that can determine infertility in humans and we must remember how, unfortunately, a large contribution is coming from environmental pollution that can even modify the genetic program in the fetus thus creating an epigenetic reprogramming that will manifest itself later also in other dysmetabolic pathologies such as obesity, cardiovascular pathologies, tumors and infertility.

It must also be considered how environmental pollution can alter the stimulation of hormone receptors, thus modifying their final product both in terms of fertility and in the production of hormones such as, for example, testosterone.
These interfering molecules such as, for example, phthalates and bisphenols contained in plastics, take the name of endocrine disruptors.
Among the pathologies classically called into question we must not exclude varicocele, that is a dilation of the veins spermatics of the testicle; topic that we will deepen in a subsequent article.
Even untreated seminal tract infections can lead to severe oligoasthenzoospermia, a reduction in the number of movement and quality of spermatozoa.

An "uncontrolled" introduction of anabolic drugs can determine an altered spermatogenesis up to an sometimes irreversible infertility

Furthermore, let us not forget, among the causes, use and abuse of anabolic drugs and steroids that can create serious problems of spermatogenesis since, the suppression of the hypothalamus pituitary gonadal axis that occurs with the use of testosterone (and the its conversion into estrogen), creates an inhibition of the release of the so-called gonadotropins LH and FSH with the FSH responsible for stimulating spermatogenesis.
It follows, therefore, that the "uncontrolled" introduction of anabolic drugs can often determine in the athlete who uses them an altered spermatogenesis up to sometimes irreversible infertility.

What tests done?

The main test for the study of male fertility is the spermiogram that must be performed in compliance with the WHO 2010 guidelines, often associated with the determination of FSH testosterone LH as mentioned in the previous lines.
The spermiogram must be entrusted to the competent specialist, preferably an andrologist perfected in the physiopathology of human reproduction, to have a correct interpretation of the numerical data that isn't always as simple and intuitive as it might seem.
In any case, there are possibilities of recovery once the root cause has been identified.

Therapies and possible treatments

In cases of hormonal suppression, stimulatory therapies based on FSH and clomiphene (off label) can be attempted, which have the purpose of stimulating on the one hand the spermatogenic line of the testis and on the other the pituitary for the release of LH and FSH.
In the presence of varicocele of another degree, its surgical correction will be useful as necessary for the treatment and cure of infections of the seminal tract.
Currently, the increasingly justified use of nutraceuticals and molecules such as Ashwagandha and Cordyceps together with the classic liberators of nitric oxide, zinc and carnitine; indispensable for the mobility and "health" of the spermatozoon, its proving to be a concrete aid in the recovery of male fertility.

Arguments, clearly, specific and sectoral that will find space in the next articles, to be released on the blog, dedicated to andrology, fertility and anti-aging.

Bibliografy

Male infertility: an overview of causes and treatment options.
Leaver RB.Br J Nurs. 2016 Oct 13;25(18):S35-S40. doi: 10.12968/bjon.2016.25.18.S35.PMID: 27734725 Review.

Sexual dysfunction and male infertility.
Lotti F, Maggi M.Nat Rev Urol. 2018 May;15(5):287-307. doi: 10.1038/nrurol.2018.20. Epub 2018 Mar 13.PMID: 29532805 Review.

Testosterone and Male Infertility.
Ohlander SJ, Lindgren MC, Lipshultz LI.Urol Clin North Am. 2016 May;43(2):195-202. doi: 10.1016/j.ucl.2016.01.006. Epub 2016 Mar 19.PMID: 27132576 Review.

https://www.urologia-andrologia.net/steroidi-anabolizzanti-e-infertilita-maschile-tutto-e-recuperabile