Infertility affects 15% of all couples (an estimated 2.4 million) in their reproductive years. As a result, one in eight couples will struggle with infertility regardless of whether the diagnosis is primary or secondary. Despite 40% of infertility causes attributed to the male and 30% due to both the male and female, most men are reluctant to appreciate the high prevalence of their contribution. This distribution of etiologies maintains across cultural and ethnic boundaries.
The simplest evaluation of a male is the semen analysis (SA). Sperm density (greater than 20 million/mL), motility (greater than 50%), and morphology (greater than 30%) an integral screen of sperm fertilization potential. A persistently abnormal SA on two occasions obtained one month apart, particularly if severely low, warrants a genital examination by an experienced male reproductive specialist. Most male infertility physicians today are urologists with additional years of specialized training in the field. An abnormal SA may be the first sign of significant pathology and may be life threatening in 2% of cases. Laparoscopy Surgeries in Jaipur
The diagnosis of infertility may not only indicate a problem with the husband but also may put the health of his offspring at risk. With a growing understanding about the genetics behind male infertility, a genetic cause may exist in up to 20% of patients.
The primary goal of the evaluation is to determine the cause of the problem and to exclude life threatening pathology. To accomplish these goals all husbands will require at least a history, physical examination, hormonal testing in addition to the semen analyses. Other studies may be indicated but usually occur after the core evaluation. Male Infertility in Jaipur
The secondary goal of the male evaluation is to determine if the infertility is treatable. The leading causes of male infertility are varicocele (42%), idiopathic (23%), obstruction (14%) and cryptorchidism (3%).
Once a diagnosis is made a discussion ensues regarding treatment options. Today more options exist that were previously unavailable. Despite severe male factor infertility, pregnancy may still be achieved. The other unique feature of infertility treatment is the shared nature of the decision making process between the physician and the couple. Not only must the status of the wife be factored into the treatment decision but the couple's psychological, ethical and financial concerns as well. It is imperative during the male evaluation that the wife have completed her evaluation and that an open dialogue exists between the treating physicians of both the husband and the wife.
A couple experiencing infertility should not underestimate the significance of the problems that can exist in the male. These problems may be the sole or contributing reason for the couple's failure to conceive and are best identified by a male infertility specialist. Care and attention in looking for and identifying disease processes in both the man and woman will prevent missed opportunity for a potential cure and give the couple the timeliest and most efficient pathway to start or expand their family.
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