Top Ten Causes of Male Infertility
Medical studies indicate that infertility is attributed equally to men and women, with each contributing approximately one-third of the cases. The remaining third involves instances where both parties show abnormalities. Below are the top ten causes of male infertility.
1. Testicular Abnormalities
Testicular abnormalities can occur in three scenarios: cryptorchidism not only leads to infertility but can also provoke malignancies; damage to germ cell development from adverse environmental factors during fetal stages; and early testicular injuries that may stem from birth-related trauma.
2. Chromosomal Abnormalities
Conditions such as intersex disorders and abnormalities in the reproductive system can significantly impact fertility.
3. Postnatal Testicular Injury
Surgeries like hernia repairs, fluid collection operations, and orchidopexy potentially damage the vessels supplying the testicles, leading to involution of the testes.
4. Hydrocele
This condition can compress the blood circulation of the testes, causing infections or atrophy, with an incidence rate of 16% to 19% post-puberty.
5. Gravitational Impact
Excessive weight bearing in men may reduce spermatogenesis within the testes, contributing to infertility.
6. Psychological Factors
Men experiencing high stress levels may encounter erectile dysfunction, leading to infertility.
7. Blood Supply Issues
Patients with arteriosclerosis or diabetes often suffer from small artery diseases affecting the testes, thus impairing sperm production.
8. Influence of Drugs and Chemicals
Substances such as nicotine, alcohol, and opiates can negatively affect sperm generation. Medications like anticonvulsants have a direct impact on spermatogenesis.
9. Environmental Factors
Men working in excessively hot environments, wearing tight underwear, or engaging in intensive smoking and drinking may experience fertility issues due to environmental stressors.
10. Infections of the Reproductive Organs
Infections caused by bacteria, viruses, or protozoa can directly damage the testes, seriously undermining sperm production and decreasing sperm motility. For example, mumps orchitis can occur in 20% of boys before puberty, potentially resulting in infertility.
Case Study
Consider the case of Mr. Jiang, who reported difficulties with ejaculation after marriage. Upon examination, he discovered that his long foreskin hindered friction and stimulation during intercourse. Following a circumcision, he felt some improvement but still could not achieve ejaculation during sex. Despite having experienced nocturnal emissions in the past, he wondered why he now struggled to replicate that experience.
Understanding the Mechanics of Ejaculation
Ejaculation is a reflexive process initiated by nerve signals leading to contractions in the testes and associated structures. The sperm travel through the vas deferens, culminating in the expulsion of semen through the urethra. The process comprises rhythmic contractions with the first segment primarily consisting of fluid from the prostate, which generally holds sperm of higher quality and concentration compared to the second segment from the seminal vesicles.
Importance of Segmented Ejaculation in Treating Male Infertility
The technique of segmented ejaculation holds significant clinical value in treating male infertility. If a patient has a low sperm count or motility, implementing this method during the woman's ovulation period can enhance the chances of conception. After the first segment of semen is expelled, withdrawing may help preserve the concentrated, high-quality sperm in the vaginal canal.
Challenges of Long Foreskin on Ejaculation
While long foreskin may be a primary cause of difficulty in ejaculation, the role of the partner should not be overlooked. During the initial stages of marriage, a partner's shyness or passivity can result in insufficient sexual stimulation, ultimately affecting ejaculation.
Tackling Psychological Factors Impeding Ejaculation
Psycho-emotional issues are significantly linked to ejaculation difficulties, especially when these difficulties are secondary. Addressing the inhibition of the central nervous system and seeking sexual counseling can be beneficial. Building confidence and employing effective techniques during intercourse can potentially overcome the challenges faced.
Medical Solutions
Certain medications may assist in alleviating ejaculation issues. For instance, Levodopa can stimulate the cerebral cortex, while ephedrine taken before intercourse can enhance muscle strength and central nervous system activity, facilitating ejaculation. However, these medications are contraindicated for patients with hypertension or coronary artery disease.