THE infertility is considered a disease that affects the reproductive system, found after a period of 12 months of unsuccessful pregnancy attempts, in which the couple had sex without using contraceptive methods. Currently, it is estimated that infertility affects 10% to 20% of couples of reproductive age in the world.
In 30% of couples who are unable to conceive, the man is solely responsible for the cause of infertility, with female causes associated with male causes occurring in 20% of cases.
THE varicocele , which consists of the abnormal dilation of the testicular veins, and the use of anabolic steroids are among the main causes of male infertility. The problem is also linked to the habit of leaving the notebook on the lap, which increases the temperature of the genital region, and the abusive consumption of alcoholic beverages.
Proper investigation of the causes can point to the origin of the problem and the possibility of reversing the situation. One of the first methods for evaluating a man’s reproductive capacity is the sperm analysis.
What is spermogram
The spermogram is the main test to evaluate infertility, being in most cases the first to be requested in the investigation of infertile men.
According to the Brazilian Society of Urology (SBU), about 80% of men with difficulty conceiving partners have low sperm concentration associated with decreased motility or altered morphology.
“The spermogram is a highly variable exam, for the same individual, on different collection days, so it is advisable to obtain two semen analyzes before offering an opinion on the patient’s condition. A period of abstinence of 2 or 3 days must be respected. Changes in the period of abstinence can invalidate comparisons between analyses”, says urologist Marcello Cocuzza.
The specialist explains that the collection of the exam must be carried out in a laboratory or reproduction clinic through masturbation. The sample must be collected in a special glass or plastic container with a wide opening, preventing material loss.
exam parameters
Biological proof of male infertility by spermogram is only possible in cases of complete absence of spermatozoa or complete absence of sperm motility.
Sperm test results vary from person to person.
Therefore, the World Health Organization (WHO) establishes parameters at intervals to determine the analysis of healthy or normal semen. Among the main indicators are:
- Seminal volume: from 1.5 to 7.6 ml
- Total sperm count: 39 to 928 million
- Sperm concentration: 15 to 259 million per ml
- Total motility: 40 to 81%
- Progressive motility: 32 to 75%
- Morphology (normal forms): 4 to 48%
“The interpretation of the values of the seminal parameters defined by the World Health Organization must be carried out with great care and attention. Reference values do not represent the average concentration of sperm in the general population, or minimum values required for spontaneous pregnancy. In addition, patients with seminal parameters outside the reference range of normality may be able to get their partners pregnant. Therefore, the spermogram should not be seen as a male fertility test”, warns physician Marcello Cocuzza.
The specialist recommends caution in the use of the spermogram for the diagnosis of male infertility.
“Men presenting the parameters within the suggested reference as normal, even so, may have difficulty getting their partners pregnant. Although the spermogram is intended to help doctors estimate the relative fertility of a given individual, seminal parameters definitely do not allow the definitive classification of patients as fertile or infertile”, he ponders.
Measures for the treatment of male infertility must be defined by the doctor after evaluating the causes of the problem. In the case of infections, the solution may be treatment from medications. If the source is hormonal dysregulation, stabilization may be necessary.
Source: CNN Brasil
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