Male Factor Infertility
Possible reasons for male factor infertility include the presence of inflammation, genetic defects, trauma, obstruction of vas deferens, hormonal disorders, immunological parameters and lifestyle habits. These factors can cause alternations of sperm parameters (number, motility and morphology of spermatozoa) and could be the cause of subfertility.
The most common conditions that could cause weakness of sperm function or inability to produce sperm include:
The presence of varicocele, could affect the normal temperature of the testis and thus the function of the cells involved in the production of spermatozoa.
Treatment with chemotherapy, even if the target tumor is not related with the men's reproductive system, can have devastating results in the production healthy spermatozoa.
Medical history of contagious diseases such as gonorrhoea, chlamydia, viral infections such as mumps and inflammations of the prostate, the urethra and epididymis, it is possible to influence the production of sperm.
The serious trauma of the testis can also be a potential factor of male subfertility.
The presence of anti-sperm antibodies could lead to agglutination of spermatozoa and decrease their motility.
The basic parameters which are widely used for the evaluation of malesperm are the volume of ejaculated semen, the number, the motility and the morphology of spermatozoa contained in the semen.
According to the criteria of World Health Organisation (WHO) sperm capable to fertilize is considered the one with volume ≥ 2,0ml, concentration of spermatozoa ≥ 20 million per ml, total progressive motility ≥50% or rapid progressive motility ≥ 25%. Sperm morphology (size and proportions of the head, middle section, and presence of cytoplasmic droplet) is evaluated according to strict criteria with desired normal forms of at least 14%.
When the number of spermatozoa is lower than expected, the condition is characterized as oligospermia, the total absence of spermatozoa is characterised as azoospermia while the presence of spermatozoa with progressive motility lower than 50%, as asthenospermia.
Men with azoospermia
Azoospermia is the absence of spermatozoa in the semen and it is distinguished in obstructive and non-obstructive. In obstructive azoospermia, the spermatozoa are normally produced in the test is but are not present in the ejaculated semen because of the obstruction. Men suffering from obstructive azoospermia ejaculate normally, but the ejaculated semen contains seminal fluid without spermatozoa. In non-obstructive azoospermia, the testis does not produce any spermatozoa. The lack of production or the minimal production of spermatozoa suggests testicular failure.