Male infertility

Infertility is diagnosed when a couple has spent a year or more trying to get pregnant without reaching this goal.

Approximately 15-20% of the general population suffers from infertility disorders.

There is a tendency to think that fertility problems are to a greater extent in women, however, approximately 50% of cases derive from pathological factors in men.

The reasons why a man may suffer from infertility can be, in most cases, diagnosed and treatable. Some examples can be infections in the genital tract, use of drugs, being exposed to fertilizers, high environmental temperatures, among others that put male fertility at risk; however, the most dangerous but also difficult to detect are reactive oxygen species ( ROS) or free radicals.

The study of the male’s fertile potential is determined by direct spermatobioscopy or seminogram.

This study requires obtaining a semen sample that is deposited in a sterile vial and is evaluated by a professional in the andrology area. There are parameters that determine if a semen sample is normal or has some pathology that may imply infertility; this study is based on parameters agreed by experts from the World Health Organization (WHO).

These parameters broadly are:

  • Macroscopic and microscopic evaluation of the sample.

  • Evaluation of viscosity, coloration, odor, pH among others.

  • Volume of the semen sample.

  • Sperm concentration per milliliter of ejaculate.

  • Progressive, in situ or null motility of spermatozoa.

  • Cellular debris.

  • Identification of other cell types such as leukocytes, epithelial cells, among others.

Despite the fact that free radicals are produced naturally as a habitual result of normal cellular metabolism, especially in situations of inflammation, they can damage cells in their genetic material, sometimes manifesting in biochemical pregnancies or abortions.

However, the human body is capable of repairing some of the damage caused by this type of situation, and through food, the body acquires a significant amount of antioxidants that help us minimize the negative effect of free radicals.

We can resort to antioxidant complexes in cases where fertility problems are suspected due to excessive oxidative stress. Some recommended complexes to improve sperm quality are melatonin, astaxanthin, DHA, vitamins A, C, E, among others.

The treatment of a semen sample (depending on the diagnosis) can be done with techniques such as washing with density gradients or Motile Sperm Recovery (REM), which is a treatment similar to sperm capacitation in a natural way that allows us to obtain the best sperm. for a low complexity treatment such as artificial insemination (AI).

When semen samples are below normal parameters, highly complex assisted reproduction techniques are used: in vitro fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI). Where the adequate conditions are provided so that a semen sample with a low concentration can fertilize one or more ovules in the case of IVF; or a spermatozoon is taken for each egg and injected directly into the cytoplasm of the same (ICSI).

Always on the vanguard.

There are new techniques such as PICSI (it is a physiological ICSI) which allows us to select the sperm that come from low sperm counts and determine which are the most suitable. The best spermatozoa bind to the hyaluronic acid in a petri dish that simulates the oocyte’s zona pellucida and are capable of fertilization. Subsequently, they are microinjected into the ovules and with this we reduce sperm DNA fragmentation and fewer sperm exposed to ROS.

“This type of study determines the fertile potential of the man and therefore can diagnose and guide what type of treatment can be adapted to the needs of each couple”

Biol. Luis Machorro
Biol. Luis Machorro
IVF and Andrology Laboratory

Vitrification of eggs and embryos at the Mexican Institute of Infertility.

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