Usually premature ejaculation is not a cause of male infertility. Male infertility is decided by semen analysis ,comprising of azoo spermia, oligo zoospermia, reduced motility of sperms and presence of abnormal sperms. Infection in testes, seminal vesicles and prostate can affect sperm quality. . Obstruction in the path of semen can cause azoospermia. Varicocele is an important cause for male infertility. Need to check testicular status by scrotal sonography, testicular biopsy and hormonal studies ( thyroid, testosterone, prolactin) Clomiphene has a definite role in improving sperm count . Other drugs are in experimental stage. Lisinopril has been found to be moderately successful in one study . Intrauterine insemination, IVF, Intracytoplasmic sperm injections are options available . Life style modifications are important.
Besides Semen Analysis, U can do Serum Testosterone, FSH & LH. If testosterone levels are low, then U can do testosterone replacement therapy or Clomiphene Citrate (To increase GnRH). Other nutrients like Zinc, Lycopene, CoQ & other minerals & vitamins can be used. The drug of choice for PME is DAPOXETINE (30mg once daily). Other SSRIs like Fluoxetine or Paroxetine have been used by some centres.
My views are some times marital disharmony or emotional conflicts about intimacy,sexual relations,or parenting roles can directly affect endocrine function and such physiological processes as erection , ejaculation and ovulation. No evidence exists , however, for any simple ,causal relationship between stress. And infertility. The problem is further complicated when hormone therapy is used to treat the infertility , because the therapy may temporarily increase depression in some patients. Mood cognitive change can be changed pharmacy to treat disorder..hyperstimulate.. . Test are semen analysis...postcoital test...anti sperm antibodies... testicular biopsy... semen analysis for fructose. PME for squeezing technic...with depoxetine..with SsRi Paroxetine Clomipramine. Most important are Medical history... surgical history... sexual history... infertility history... social history... development history...
Apart from question ..You deserve to be appreciated for what knowledge you have about reproductive endocrinology involved in male infertility..... But Dr.Ajit what's the role of L-Carnitine/ Co- enzyme Q ????
What is the Standard Dose of Clomiphene Citrate in such cases? & What is the duration?
Ssri are the treatment of choice for pre mature ejaculation
tab rajprwtni vati phalghrit Raghavendra Nadargi kapal bharti anulom bilom 30min & agrriwith
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Friends yesterday I have discussed about the female infertilty on the demand of patients today I am discussing about Male infertility. Male infertility Reproduction (or making a baby) is a simple and natural experience for most couples. However, for some couples it is very difficult to conceive. A man’s fertility generally relies on the quantity and quality of his sperm. If the number of sperm a man ejaculates is low or if the sperm are of a poor quality, it will be difficult, and sometimes impossible, for him to cause a pregnancy. Male infertility is diagnosed when, after testing both partners, reproductive problems have been found in the male. How common is male infertility? Infertility is a widespread problem. For about one in five infertile couples the problem lies solely in the male partner. It is estimated that one in 20 men has some kind of fertility problem with low numbers of sperm in his ejaculate. However, only about one in every 100 men has no sperm in his ejaculate. What are the symptoms of male infertility? In most cases, there are no obvious signs of infertility. Intercourse, erections and ejaculation will usually happen without difficulty. The quantity and appearance of the ejaculated semen generally appears normal to the naked eye. Medical tests are needed to find out if a man is infertile. Causes of male infertility Male infertility is usually caused by problems that affect either sperm production or sperm transport. Through medical testing, the doctor may be able to find the cause of the problem. About two-thirds of infertile men have a problem with making sperm in the testes. Either low numbers of sperm are made and/or the sperm that are made do not work properly. Sperm transport problems are found in about one in every five infertile men, including men who have had a vasectomy but now wish to have more children. Blockages (often referred to as obstructions) in the tubes leading sperm away from the testes to the penis can cause a complete lack of sperm in the ejaculated semen. Other less common causes of infertility include: sexual problems that affect whether semen is able to enter the woman’s vagina for fertilisation to take place (one in 100 infertile couples); low levels of hormones made in the pituitary gland that act on the testes (one in 100 infertile men); and sperm antibodies (found in one in 16 infertile men). In most men sperm antibodies will not affect the chance of a pregnancy but in some men sperm antibodies reduce fertility. Known causes of male infertility Sperm production problems • Chromosomal or genetic causes • Undescended testes (failure of the testes to descend at birth) • Infections • Torsion (twisting of the testis in scrotum) • Varicocele (varicose veins of the testes) • Medicines and chemicals • Radiation damage • Unknown cause Blockage of sperm transport • Infections • Prostate-related problems • Absence of vas deferens • Vasectomy Sexual problems (erection and ejaculation problems) • Retrograde and premature ejaculation • Failure of ejaculation • Erectile dysfunction • Infrequent intercourse • Spinal cord injury • Prostate surgery • Damage to nerves • Some medicines Hormonal problems • Pituitary tumours • Congenital lack of LH/FSH (pituitary problem from birth) • Anabolic (androgenic) steroid abuse Sperm antibodies • Vasectomy • Injury or infection in the epididymis • Unknown cause The male reproductive system The male reproductive system is made up of the testes, a system of ducts (tubes) and other glands that open into the ducts. The brain plays an important part in the control of the male reproductive system. The pituitary gland and the hypothalamus, located at the base of the brain, control the production of male hormones and sperm. Luteinising hormone (LH) and follicle stimulating hormone (FSH) are the two important messenger hormones made by the pituitary gland that act on the testes. The brain connection Two messenger hormones act on the testes The testes (testis: singular) are a pair of egg-shaped glands that sit in the scrotum next to the base of the penis on the outside of the body. The testes make sperm and the male sex hormone testosterone. It takes about 70 days for sperm to become mature and able to fertilise an egg. When released from the testes, the sperm spend two to 10 days passing through the epididymis where they gain the vital ability to swim strongly (become ‘motile’), and to attach to and penetrate (get into) the egg. At orgasm, waves of muscle contractions transport the sperm, with a small amount of fluid, from the testes through to the vas deferens. The seminal vesicles and prostate contribute extra fluid to protect the sperm. This mixture of sperm and fluid (the semen) travels along the urethra to the tip of the penis where it is ejaculated (released). Homeopathic Medicines for Infertility in Men The top homeopathic medicines used for treating infertility in men are as follows: Homeopathic medicines for infertility in men with erectile dysfunction Agnus Castus is used when a man’s sexual desire and physical ability are reduced. The genitals stay relaxed, cold and flaccid. Caladium is used when infertility or impotency results because of mental depression. The genitals stay relaxed and weak erections are likely. Selenium is used for erectile dysfunction featured by slow and weak erections. Involuntary semen discharge may also be indicated as a symptom. Homeopathic medicines for infertility in men with low sperm count The homeopathic medicine X-Ray is very effective in treating low sperm count in men. Sperm count gets increased, enhancing both the quantity and quality of sperm. Homeopathic medicines for infertility in men with orchitis Conium is used for treating infertility in men, which occurs due to orchitis. The testicles get swollen, enlarged and hardened. Conium also helps patients with a history of suppressed sexual desire. Homeopathic Medicines For Infertility In Women The top homeopathic medicines for treating infertility in women are as follows: Homeopathic medicines for infertility because of acid vaginal charges Borax and Natrum Phos are effective homeopathic medicines used for treating infertility in women, which occurs because of acid vaginal charges. These medicines are prescribed when the vaginal discharges are destructive, acrid and sperm killing in nature. Borax is used when the discharge is like egg white, copious and warm. Natrum Phos is used in the case of acrid, creamy and honey coloured discharge. Homeopathic medicines for infertility because of prolonged and profuse periods Calcarea Carb and Aletris Farionosa are ideal homeopathic medicines which are used in case of prolonged and profuse menstrual periods, and in the case of periods appearing before the usual time. Experiencing early menses is likely. The patient may experience anemia, leucorrhea, fatigue, tiredness and weakness along with menorrhagia. Homeopathic treatment does not utilize the use of any kind of chemicals, and hence there are no side effects on the body. You should consult a homeopathic practitioner before starting to take homeopathic medicines for infertility.Dr. Rajesh Gupta8 Likes9 Answers
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ABC OF : MALE INFERTILITY. ( I ). MAY BE USEFUL. ** Reproduction (or making a baby) is a simple and natural experience for most couples. However, for some couples it is very difficult to conceive. ** A man’s fertility generally relies on the quantity and quality of his sperm. If the number of sperm a man ejaculates is low or if the sperm are of a poor quality, it will be difficult, and sometimes impossible, for him to cause a pregnancy. ** Male infertility is diagnosed when, after testing both partners, reproductive problems have been found in the male. KNOWN CAUSES OF MALE INFERTILITY :- 1. SPERM PRODUCTION PROBLEMS : • Chromosomal or genetic causes • Undescended testes (failure of the testes to descend at birth) • Infections • Torsion (twisting of the testis in scrotum) • Varicocele (varicose veins of the testes) • Medicines and chemicals • Radiation damage • Unknown cause 2. BLOCKAGE OF SPERM TRANSPORT : • Infections • Prostate-related problems • Absence of vas deferens • Vasectomy 3. SEXUAL PROBLEMS (ERECTION and EJACULATION problems) : • Retrograde and premature ejaculation • Failure of ejaculation • Erectile dysfunction • Infrequent intercourse • Spinal cord injury • Prostate surgery • Damage to nerves • Some medicines 4. HORMONAL PROBLEMS : • Pituitary tumours • Congenital lack of LH/FSH (pituitary problem from birth) • Anabolic (androgenic) steroid abuse 5. SPERM ANTIBODIES : • Vasectomy • Injury or infection in the epididymis • Unknown causeDr. Puranjoy Saha25 Likes23 Answers
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Friends today I am discussing about a serious problem known as Male infertility. Male InfertilityCauses Causes Not all cases of male infertility or azoospermia (no sperm in the ejaculate) are the same or should be treated in the same way. AZOOSPERMIA CAN BE DIVIDED INTO TWO BROAD CATEGORIES: Obstructive Azoospermia (OA):: OA means that sperm are being produced normally inside the testicle, but there is a blockage or obstruction in the reproductive tubing that is preventing the sperm from flowing to the outside world. Non-Obstructive Azoospermia (NOA): NOA means that the tubes are open, but there is a sperm production problem where either no sperm are produced at all or there is a very low level of sperm production. This level is often so low that the sperm never make it all the way out of the testicle and can only be found inside the testicle during surgery. Causes of Obstructive Azoospermia CAUSES OF OBSTRUCTIVE AZOOSPERMIA CAN BE GENETIC, CONGENITAL, OR ACQUIRED. Vasectomy: The most common cause of obstructive azoospermia, this surgical procedure interrupts the sperm ducts to stop the flow of sperm. Watch this video to learn more about vasectomy and vasectomy reversal. Infection: Obstructive azoospermia can also be caused by infections of the testicles, prostate, or reproductive tract such as epididymitis/orchitis, prostatitis, and venereal diseases such as Chlamydia. These can cause a blockage in the small tubules of the epididymis or the ejaculatory duct. Congenital Conditions: Some men are born missing a portion of the vas deferens that is essentially a genetic situation similar to a vasectomy. Other men are born with a cyst in the prostate that blocks the ejaculatory ducts. Surgical Complications: Surgical procedures performed on the urogenital organs or hernia repair can result in scarring that leads to a blockage. This is more common in pediatric patients because the reproductive tract is so small in children. Causes of Non-Obstructive Azoospermia Non-Obstructive azoospermia can be caused by abnormalities within the testicle or with reproductive hormones that control sperm production. The causes can be genetic, congenital or acquired. Some causes can be treated effectively and others can be bypassed to allow a man to father a child with IVF. Some men have a problem with the production of hypothalamic or pituitary hormones and this is treated by replacing the missing hormones in order to encourage sperm production. Genetic Causes: These include chromosomal abnormalities where the number of chromosomes is not as it should be (called aneuploidy) or parts of the chromosome arms break off and switch locations (called translocations). The most common chromosomal problem causing azoospermia in men is a situation where there is an extra X chromosome. This is called Klinefelter Syndrome. Another genetic cause of azoospermia is a deletion of some of the genes on the Y-chromosome. The Y-chromosome is responsible for giving men their “male” characteristics. When one or more of the genes on this chromosome that is responsible for sperm production are deleted, it can result in azoospermia. Genetic causes of azoospermia are not reversible but most men with genetic issues still produce small amounts of sperm within the testicles that can be used to father normal children. Varicocele: This reversible cause of NOA is characterized by varicose veins around the testicle. This condition is the most common cause of male infertility and is easily fixable. Most varicoceles only cause a minor lowering of sperm count but in some cases the varicocele results in azoospermia. You can learn more about varicocele and varicocele repair here. Hypospermatogenesis: This means that there is sperm production within the testicle but just at lower amounts than normal, and what would be required to see sperm on a routine semen analysis. This is the most common finding on biopsy. Maturation Arrest: In this situation there is a problem in the development of sperm during the maturation phase that causes the testicle to fill with only precursor sperm. This arrest in development can occur at an early or late stage of the sperm maturation process. There is close to a 50% chance of finding some mature usable sperm in this situation. Causes of Male Infertility & Azoospermia Sertoli-Cell Only Syndrome (SCO) or Germ Cell Aplasia (GCA): This is typically a worst-case-scenario cause of NOA. With SCO or GCA, the germ cells that divide and become sperm are missing from the testicle. But even in this situation 15-20% of men with SCO will have some low level of sperm production somewhere within the testicle. One of the most important things we have learned about the testicle in the last 20 years is that sperm production in the abnormal situation is not homogeneous, meaning it is not the same or constant in all areas of the testicle. So, while one area might have scarred tubules with SCO pattern, another area might have some germ cells and some mature sperm. This phenomenon has led to the development of microsurgical sperm extraction techniques that enable the reproductive surgeon to examine the inside of the testicles, specifically the seminiferous tubules, using a microscope. This means there is a greater chance of finding an area that has sperm, and a better chance of becoming a biological father. Testicular Cancer: Sometimes the first sign of testicular cancer or other tumors of the reproductive system is azoospermia or a very low sperm count. This is one of the most important reasons why a male reproductive specialist must examine someone with an abnormal sperm count. By detecting the tumor early, it could save a patient’s life. Medical Treatments: Chemotherapy and radiation therapy used to treat cancer are two types of medical treatment that can cause temporary azoospermia. Most men who undergo these treatments will have sperm production resume within two years following therapy, depending on the type of treatment received. Prescription Drugs: Among the biggest drug-related causes of NOA are testosterone and other anabolic steroids. These can cause sterilization and are a very common and usually reversible cause of azoospermia. Overwhelming Oxidative Stress causes sperm damage There are numerous causes of male infertility but no matter what the etiology, the final common pathway to sperm damage (DNA fragmentation) is through free radical peroxidation leading to overwhelming amounts of oxidative stress on the sperm. Ironically, oxidative stress is necessary for normal sperm function and sperm actually produce free radicals, but when more stress is generated than the system can compensate for, the body is unable to neutralize the toxins which ultimately injure the sperm cell membrane and the sperm DNA. This leads to functional impairment of the sperm cell and, ultimately, infertility. Best Homeopathic Medicines for Oligospermia Many homeopathic remedies have been known to cure Low sperm Count. Some of these are; Agnus Castus: Sexual melancholy. Fear of death. Sadness with impression of speedy death. Absentminded, forgetful, lack of courage. Illusion of smell-herrings, musk. Nervous depression and mental forebodings. Yellow discharge from urethra. No erections. Impotence. Parts cold, relaxed. Desire gone (Selen; Con; Sabal). Scanty emission without ejaculation. Loss of prostatic fluid on straining. Gleety discharge. Testicles, cold, swollen, hard, and painful. Anacardium Orientalis: Fixed ideas. Hallucinations; thinks he is possessed of two persons or wills. Anxiety when walking, as if pursued. Profound melancholy and hypochondriasis, with tendency to use violent language. Brain-fag. Impaired memory. Absent mindedness. Very easily offended. Malicious; seems bent on wickedness. Lack of confidence in himself or others. Suspicious (Hyos). Clairaudient, hears voices far away or of the dead. Senile dementia. Absence of all moral restraint. Voluptuous itching; increased desire; seminal emissions without dreams. Prostatic discharge during stool. Argentum Nitricum: The patient is intellectual strong, patient complaint of memory loss, along with disturbed sense of reasoning. Patient is involved in foolish task, with strange conclusions. Patient experience strange illusions and hallucinations. His mind is full of useless and troublesome thoughts specially at night time, which makes him very anxious. Due to anxiety patients keeps on walking.Melancholia.Weak of memory, It seems time passes very slowly. Dulness of head, mental confusion ; dizziness ; tendency to fall sideways. Caladium: Patient is unable to remember things, he is very forgetful with vague mind. Due to absentmindedness, he keep on searching different things. Concentration is very less due to which he is unable to put his ideas into speech. He has high desire for sex with relaxation of his organ. A state of total impotency. During intimacy there is urethral discharge. at times impotency is due to mental suppression. Severe itching on testcles. Conium Mac: Mental state is full of hysteria with the nervousness. Patient complaint of weakness of muscles with trembling. Patient has very high desire for sex, but due to impotency he is not able to perform. Patient complaints of semen loss during sleep with or without dreams. Ejaculation is very painful- as if cutting with a knife due to acrid semen. Swelling and hardness Lycopodium: There is great desire to be alone. Despondent. Mentally and physically patient is very tired with complaint of chronic fatigue, with great aversion to his work. He is very forgetful, with dread of public appearance. Great Sensitivity, patient cries even when thanked. It is one of the most used medicines for impotency. Genital organ are feeble due to low vitality. Patient marries to live a normal life, but after marriage he finds he is sexually impotent without erections or very weak and short erections as if he is not a man. There is history of gonorrhoeal discharge with warts on male genitals. Patient is not trustworthy; he is very suspicious and find fault in every task. Patient is very timid with low self-confidence.Dr. Rajesh Gupta5 Likes7 Answers
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PLEASE ADVISE FOR THIS PATIENT. This report shows low sperm motility. Any suggestions to increase it.Dr. Yash Chadha3 Likes6 Answers
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A couple wd primary infertility ..... All reports of wife is normal bt the husband is oligospermic... How to proceed it further....Ritu Yadav1 Like5 Answers