I hope you have been well, and I'm glad you are back for another visit with your Uncle Ike, and our madcap adventures through the world of Male Factor Infertility ("MFI") and the related Ginsu ninja samurai swords of emotional slashingness.
I thought, since so MANY of my Twitter followers responded on this issue, I decide to talk a little on the up close and personal causes of MFI. I'm sure you want to know if you are "average", "above average" or have "above average odds" for correcting your MFI and moving forward, especially when MFI is the only diagnosis you have as a couple.
First, the sources of my information comes from a) Mayo Clinic; b)Stanford University; c)University of Iowa; d) personal experience at (hard for a Va Tech Hokie to say) University of Virginia School of Medicine. Secondly, your personal experience will vary, because you are an individual. You will need a thorough but barely intrusive physically exam to determine most causes and treatments for your swimmers. Lastly, the actual list of causes of MFI reads like the ingredients list for your favorite Bath and Body Works products, so you need someone besides a funny, good-looking Uncle to give you advice. Seek the good stuff and find a specialist that will respect the woman, the man, and the man parts.
Okay, the most likely cause of problems is overheating. The likely cause is plumbing, caused by swollen or enlarged veins in the scrotum, called a varicocele. Unlike the tighty whities that boxers can help (yes, it is real!) these varicoceles can be surgically treated. You see, unlike ovaries, the testes need to be a little cooler than body temperature and the swimmers need that, too. Too warm, and the sperm producing tissue is damaged, or the sperm quality is damaged.
Next on the list is chemical problems. Swimmers, like drivers, don't drive well under the influence, and the following list from University of Iowa ought to kick you in the nuts:
- Anabolic steroids
- Antihypertensives
- Allopurinol
- Erythromycin
- Chemotherapy
- Cimetidine
- Colchicine
- Cyclosporine
- Dilantin
- Gentamycin
- Nitrofurantoin
- Tetracycline
Injury. Big problem. Kick, punch, fall, you name it, it hurt! But it may have caused you damage that either lowers sperm production or blocks the tubules for the sperm to travel out to the prostate. Even more likely is tortion - the twisting of the testes and the related vascular and connective tissue that can very quickly damage or destroy healthy, mature sperm producing cells and related tissues. So the grabbing & twisting can be catastrophic to reproduction. Be GENTLE!Diseases, infections and birth defects like undescended testes (called chryptochordism - they stay in the body cavity rather than descend into the scrotal sac during fetal development) also have a toll on MFI. Surgical injury or damage in the groin area can also limit fertility.
Finally, the last major category we will cover is hormonal deficiency or imbalance. Stanford University has the following disorders, which, while rare, are still common enough to mention for our purposes.
The following is a list of hormonal disorders which can disrupt male infertility:
Hyperprolactinemia: Elevated prolactin--a hormone associated with nursing mothers, is found in 10 to 40 percent of infertile males. Mild elevation of prolactin levels produces no symptoms, but greater elevations of the hormone reduces sperm production, reduces libido and may cause impotence. This condition responds well to the drug Parlodel (bromocriptine).
Hypothyroidism: Low thyroid hormone levels--can cause poor semen quality, poor testicular function and may disturb libido. May be caused by a diet high in iodine. Reducing iodine intake or beginning thyroid hormone replacement therapy can elevate sperm count. This condition is found in only 1 percent of infertile men.
Congenital Adrenal Hyperplasia: Occurs when the pituitary is suppressed by increased levels of adrenal androgens. Symptoms include low sperm count, an increased number of immature sperm cells, and low sperm cell motility. Is treated with cortisone replacement therapy. This condition is found in only 1 percent of infertile men.
Hypogonadotropic Hypopituitarism: Low pituitary gland output of LH and FSH. This condition arrests sperm development and causes the progressive loss of germ cells from the testes and causes the seminiferous tubules and Leydig (testosterone producing) cells to deteriorate. May be treated with the drug Serophene. However, if all germ cells are destroyed before treatment commences, the male may be permanently infertile.
Panhypopituitafism: Complete pituitary gland failure--lowers growth hormone, thyroid-stimulating hormone, and LH and FSH levels. Symptoms include: lethargy, impotence, decreased libido, loss of secondary sex characteristics, and normal or undersized testicles. Supplementing the missing pituitary hormones may restore vigor and a hormone called hCG may stimulate testosterone and sperm production.
Now, with all this heavy stuff, you need to know that there are treatments. A few of these conditions may mean that you have to move to having assistance from doctors or a donor to father a child. But you need to take care of your health first, then on achieving the dream of children. Don't give up. I am here to give you hope!
