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- $Unique_ID{BRK00632}
- $Pretitle{}
- $Title{Infertility Tests}
- $Subject{fertility testes sperm sex cryptorchidism Mumps orchitis inflammation
- semen azoospermia varicocele infertility infertile fertile sterile sterility}
- $Volume{K-15}
- $Log{}
-
- Copyright (c) 1991-92,1993 Tribune Media Services, Inc.
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- Infertility Tests
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- QUESTION: We have tried unsuccessfully to have a child for 3 years now. I
- have gone through all the tests, and now my husband realizes that he too must
- be tested. What are the chances that the problem may be with him and how will
- they discover it?
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-
- ANSWER: Infertility affects 15% of marriages, and studies estimate that a
- "male factor" is responsible in one-third of these cases. Through careful,
- sympathetic evaluation, the underlying causes can often be pinpointed and
- corrected, leading to successful pregnancy for many of these couples.
- First, the doctor must gather a complete sexual history of the couple,
- noting any factors that may affect or inhibit pregnancy, such as the frequency
- of sex and its timing in relation to the menstrual cycle. Lubricants, douches
- or other substances used in conjunction with sex may have a spermicidal effect
- and be preventing the sperm from reaching the uterus.
- One factor that reduces fertility in the male is cryptorchidism--in
- childhood, the failure of one or both of the testes to descend into the
- scrotum. If this condition remains uncorrected past the age of 5,
- irreversible changes take place in the testes which reduce their fertility.
- Mumps orchitis, an inflammation of the testes, also negatively affects their
- reproductive ability; if both are infected, sterility may result.
- Miscellaneous infections, emotional or physical stress, certain
- medications and even the treatment of hernias can impair fertility. To get
- the complete picture, it is necessary for the doctor to examine the genitals,
- with an eye towards any physical abnormalities in the structure of the penis
- or the scrotum.
- Analysis of the semen itself yields the most important data regarding
- fertility. Since semen takes 75 days to develop, at least two samples should
- be taken at two to three-week intervals. The various characteristics of semen
- (volume, shape and their degree of movement) can vary tremendously between
- samples. Semen volume in an ejaculation is usually between one and a half and
- five milliliters, while the density of spermatozoa present should be above 20
- million per milliliter. Their degree of movement, or motility, should be
- active in at least 60% of sperm observed under a microscope within two to
- three hours of the sample being taken.
- Oval sperm heads are considered normal in such an evaluation; large,
- small, tapering, duplicated and amorphous heads may also be present. Fertile
- semen contains 10% abnormal, and between 60 and 70% normal forms.
- These tests may reveal the presence of azoospermia--a deformation in the
- testes preventing the creation of healthy sperm; while patients testing
- abnormal in all these characteristics are likely to have varicocele--a
- collection of dilated veins in the spermatic cord, the most responsive to
- surgery.
- Hormones are less likely to play a role in infertility, but can be tested
- if semen analysis fails to yield answers. A biopsy of testicular tissue is
- reserved for isolated cases.
- In unraveling these questions, emotional support from the spouse and
- physician is critical in resolving the psychological and physical stress
- resulting from infertility.
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- The material contained here is "FOR INFORMATION ONLY" and should not replace
- the counsel and advice of your personal physician. Promptly consulting your
- doctor is the best path to a quick and successful resolution of any medical
- problem.
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