Sperm problems

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Sperm problems are a common cause of infertility. At the latest, when the woman was found no cause of infertility, the man should be investigated. Fertility studies in men are relatively simple.Standard valuesThe most common disorder of male fertility is an insufficient production of normal, well-motile sperm. The normal quality of male sperm contains more than 20 million sperm per milliliter of semen. Of these, 35 percent should be of normal shape and 50 percent be flexible. If these values ​​are not reached, the man's fertility is limited.A table with the standard values ​​can be found here.Years after-effectsAn andrological examination of the man begins with a detailed medical history. For the urologist / andrologist is it important to know whether the man ever had a sexually transmitted disease or a urinary tract infection, mumps and other childhood diseases have been present, as these conditions may also adversely affect the reproductive years later. Effects of environmental toxins, chemotherapy, accidents, and previous surgery can also have influence on sperm quality such as frequent visits to the sauna and regular alcohol and cigarette consumption.Long ripening processThe maturation of sperm takes several weeks. Because the process is highly sensitive and depends on many factors, it may well be that the sperm tests at different times, both qualitatively and quantitatively differ significantly. The most important study to assess the man's fertility is the microscopic examination of the ejaculate.After an accident or due to organic defects, it may be that although sperm are formed, but that the same transport is not guaranteed optimal. For special forms of male sterility of azoospermia (absence of live sperm in the ejaculate), seeds may be obtained directly from the epididymis (MESA) or directly by biopsy from the testicular tissue (TESE) (see the production of sperm).OAT syndromeAs OAT syndrome (oligo-astheno-teratozoospermia syndrome) is defined as a disorder of fertility, which is the most common cause of reduced fertility (ie, infertility) in men.What causes the OAT syndrome can have?There are many possible causes in men, which can lead to disruption of fertility:

    
disturbed formation of sperm, because the testes in the scrotum instead of the body are

    
The testicles have become little (Hodenhypoplasie)

    
Varicocele (varicocele)

    
after a testicle injury or testicle infection

    
hormonal disorders (hypothyroidism, endocrine tumors of the adrenal cortex)

    
Relocation of the seminal tract (caused for example by inflammation of the epididymis, prostate, or urethra)What makes the OAT syndrome?The OAT syndrome is characterized in that the lower sperm count (= oligo), reduced mobility (= astheno) and an increased incidence of malformations (terato =) have.As the OAT syndrome is the treatment?First, if possible, the cause is eliminated. This is especially true for inguinal testes or varicocele. Additionally, certain hormones (such as FSH, LH or testosterone) and sperm are examined. You may also be examined, the testes (testicles through a biopsy).The result of all treatments has been disappointing.Disorders of sperm transportInterference with sperm transport may be the reason for infertility. A man then produced a sufficient number of seeds though, they come not in the woman's body, because the sperm ducts are blocked.Possible CausesUrinary tract infections or pelvis can spread to the epididymis or the vas deferens and causing them so much that the sperm can no longer be forwarded. It may be formed by cysts (Funikulozele, spermatocele). More rarely cause injuries, for example, by hernia surgery, or congenital malformations, to an occlusion of the vas deferens and thus to azoospermia (absence of sperm in the ejaculate).Inflammation of the seminal tract unnoticed run for most men and are often caused by chlamydia. The classic cause of gonorrhea and syphilis are becoming more rare.TherapyCongenital and inflammation or injury caused by closures of the seminal tract can be opened in about half of those affected by a microsurgical operation again and thus restore the man's fertility surgery.In the event that the seminal tract can be restored, there has been some time the possibility of sperm directly from the testicular tissue (TESE = Testicular Spermatozoenextraktion) or epididymal tissue (MESA = microsurgical epididymal Spermatozoenaspiration) to win.Immunological problems (sperm)One cause of infertility in men may be immunological problems. In some cases, a man makes antibodies that attack its own sperm. Antibodies are substances with which defends the body against foreign substances such as bacteria or viruses (immune system). This reasonable reaction itself leads when you derailed, including infertility.Such a problem can occur because of injury or infection and disease can be detected by the presence of white blood cells in semen. Inflammation of the seminal tract are often caused by chlamydia. The urologist will try for an immunological sterility to reduce antibody formation by cortisone administration.Semen analysis - deviations from the WHO standardSpermThe deviations from "normal semen" such as the WHO (World Health Organization) has defined it, can have very different shapes.Normozoospermie
normal semen analysisAmount
2-5ml ejaculate (about one-half to one full teaspoon)Acidity
pH 7.2 - 8.0Liquefaction
in 10-30 minNumber of sperm cells / ml
20-150 million sperm / mlMobility
50% or moreForm
30% or more normal formsInflammation
only isolated inflammatory cellsStick
no abnormal adhesion of sperm with each other.Aspermia
no ejaculationMulti Semie (polysemy)
> 6ml ejaculationParvisemia (hyposmia)
<2 ml of ejaculateCryptozoospermia
<1 million sperm per milliliter (only a few sperm)Hyperzoospermie
> 150 million sperm per milliliterOligozoospermia
<20 million sperm per milliliterPolyzoospermie
> 200 million sperm per milliliter (as relative Polyzoospermie at Parvisemia)Asthenozoospermia
<50% progressively motile sperm or<25% rapid progressive spermTeratozoospermia
<30% of spermatozoa with normal morphology (too many malformed sperm)Nekrozoospermie
no sperm mobility, in EOSIN test all deadLeukospermie
Inflammation, most prostateOligo-astheno-terato-zoosperms
(OAT syndrome) - a combination of low numbers, poor motility and sperm of many forms of error.Spermatozoenzahl <20 million / mlAzoospermia
no sperm in the ejaculate

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