The second check up

During the visit the results of the tests are viewed, and a diagnosis is made.

The diagnosis of male infertility

Once the diagnosis is made, it is possible to evaluate the indicated therapy for each specific problem. Above all the possible therapy to be prescribed is evaluated.  In the case that this might not produce good results, it is a good idea to evaluate a MAP (Medically Assisted Procreation or Assisted Reproduction) technique.  The technique of Assisted Reproduction that will be adopted at the end varies depending on the conditions with which the patient presents; generally, simple ovarian stimulation is performed, artificial insemination in the presence of a mild deficit of sperm, in vitro fertilisation in case of a higher deficit, and the microinjection of spermatozoa into the ovule or the extraction of the sperm from the testicle in the case of more  serious spermatic abnormalities till azoospermia.

Abnormalities of the sperm.  When the parameters resulting from the spermiogram are different from the norm, the following conditions may be present:

• oligospermia: reduction of the total number of spermatozoa
• oligoasthenospermia: reduction of the number and the motility of the spermatozoa
• oligoasthenoteratospermia: reduction of the number, the motility and the presence of abnormal forms in the spermatozoa
• azoospermia: total absence of spermatozoa

Varicocele.  Is a dilation of the veins that surround the spermatic funiculi.  This condition is at the base of one of the most frequent causes of a deficit in the formation of  mobile spermatozoa.  The cause of this dilation is unknown, but it seems to be linked to constitutional and genetic factors.  Excessive heat can accentuate this sort of damage.

Infections.  These are very frequent.  Many are the germs involved.  Often they are sexually transmitted and the inflammation involves the prostate or the seminal vesicles, without the patient even being aware of  it.  Sometimes even viruses like the parotitis virus (mumps) can cause major infections of the testicles (orchitis)

Hormonal deficit.  These represent a modest percentage of infertility diagnoses.  Often a hormonal deficit of the pituitary gland occurs (the gland in the brain that produces the hormones FSH and LH) which then affects the formation of the spermatozoa.

Other causes.  Trauma of the testicles or lack of decent of the scrotal sack (cryptorchidism)  from the abdomen, chromosomal abnormalities and toxic factors present in the air like the by products of work processes or some pharmacological substances (like in oncology) can be causes of male infertility.