Following are some of the most common causes of Male infertility.
Azoospermia : Is the medical condition of a male not having any measurable level of sperm in his semen. It is associated with very low levels of fertility or even sterility, but many forms are amenable to medical treatment. In humans, azoospermia affects about 1% of the male population and may be seen in up to 20% of male infertility situations.
Classification : Azoospermia can be classified into three major types as listed. Many conditions listed may also cause various degrees of oligospermia rather than azoospermia.
Pretesticular azoospermia : Pretesticular azospermia is characterized by inadequate stimulation of otherwise normal testicles and genital tract. Typically, follicle-stimulating hormone (FSH) levels are low (hypogonadotropic) commensurate with inadequate stimulation of the testes to produce sperm. Examples include hypopituitarism (for various causes), hyperprolactinemia, and exogenous FSH suppression bytestosterone. Chemotherapy may suppress spermatogenesis. Pretesticular azoospermia is seen in about 2% of azoospermia.
Testicular azoospermia : In this situation the testes are abnormal, atrophic, or absent, and sperm production severely disturbed to absent. FSH levels tend to be elevated (hypergonadotropic) as the feedback loop is interrupted. The condition is seen in 49-93% of men with azoospermia.Testicular failure includes absence of failure production as well as low production and maturation arrest during the process of spermatogenesis.
Causes for testicular failure include congenital issues such as in certain genetic conditions (e.g. Klinefelter syndrome), some cases of cryptorchidism or Sertoli cell-only syndrome as well as acquired conditions by infection (orchitis), surgery (trauma, cancer), radiation,or other causes. Mast cells releasing inflammatory mediators appear to directly suppress sperm motility in a potentially reversible manner, and may be a common pathophysiological mechanism for many causes leading to inflammation. Generally, men with unexplained hypergonadotropic azoospermia need to undergo a chromosomal evaluation.
Posttesticular azoospermia : In posttesticular azoospermia sperm are produced but not ejaculated, a condition that affects 7-51% of azoospermic men.The main cause is a physical obstruction (obstructive azoospermia) of the posttesticular genital tracts. The most common reason is a vasectomy done to induce contraceptive sterility.Other obstructions can be congenital (example agenesis of the vas deferens as seen in certain cases of cystic fibrosis) or acquired, such as ejaculatory duct obstruction for instance by infection.
Ejaculatory disorders include retrograde ejaculation and anejaculation; in these conditions sperm are produced but not expelled.
AYURVEDIC TREATMENT: There is no satisfactory treatment of azoospermia in allopathic treatment system hence ayurvedic treatment is most preferred treatment for this condition. The treatment involves both medicinal treatment as well as panchkarma treatment for the same. Medicinal Treatment: Various herbs are known for their effects in increasing the sperm count of the patients e.g. Musli sufed, Munjatak, Makkhan, Ashwagandha, Shatavari, etc. Along with the herbs there are various classical combinations which are very helpful for treating this condition like Makardhwaj wati, Suwarna Siddha Makardhwaj, Shilajeet Adi wati, etc.
Ayurvedic Panchkarma therapies:: A special panchkarma procedure known as Uttar basti is very helpful for this condition, Uttar basti should be given under the supervision of a trained ayurvedic doctor only.
Oligospermia : Oligozoospermia, refers to semen with a low concentration of sperm and is a common finding in male infertility. Often semen with a decreased sperm concentration may also show significant abnormalities in sperm morphology and motility (technically "oligoasthenoteratozoospermia.
Diagnosis: The diagnosis of oligospermia is based on one low count in a semen analysis performed on two occasions. For many decades sperm concentrations of less than 20 million sperm/ml were considered low or oligospermic, recently, however, the WHO reassessed sperm criteria and established a lower reference point, less than 15 million sperm/ml, consistent with the 5th percentile for fertile men.Sperm concentrations fluctuate and oligospermia may be temporary or permanent.
Causes:
Pre-testicular factors refer to conditions that impede adequate support of the testes and include situations of poor hormonal support and poor general health including: � Hypogonadism due to various causes
� Drugs, alcohol, smoking
� Strenuous riding (bicycle riding,[5] horseback riding)
� Medications, including androgen.
Testicular factors:
Testicular factors refer to conditions where the testes produces semen of poor quality despite adequate hormonal support and include:
� Age
� Genetic defects on the Y chromosome
� Y chromosome microdeletions
� Abnormal set of chromosome
� Klinefelter syndrome
� Neoplasm, e.g. seminoma
� Cryptorchidism
� Varicocele (14% in one study)
� Trauma
� Hydrocele
� Mumps
� Malaria
� Defects in USP26 in some cases
Mast cells releasing inflammatory mediators appear to directly suppress sperm motility in a potentially reversible manner, and may be a common pathophysiological mechanism for several of the above mentioned factors.
Post-testicular causes:
Post-testicular factors decrease male fertility due to conditions that affect the male genital system after testicular sperm production and include defects of the genital tract as well as problems inejaculation:
� Vas deferens obstruction
� Lack of Vas deferens, often related to genetic markers for Cystic Fibrosis
� Infection, e.g. prostatitis
� Ejaculatory duct obstruction
Idiopathic oligospermia (oligoasthe-noteratozoospermia)
In about 30 % of infertile men no causative factor is found for their decrease in sperm concentration or quality by common clinical, instrumental, or laboratory means, and the condition is termed "idiopathic" (unexplained). A number of factors may be involved in the genesis of this condition, including age, infectious agents ( such as Chlamydia trachomatis), Y chromosome microdeletions, mitochondrial changes, environmental pollutants, and "subtle" hormonal changes.
TREATMENT: TREATMENT OF OLIGOSPERMIA IS VERY MUCH SIMILAR TO AZOOSPERMIA. The only difference is that lesser number of medications are required as compared to azoospermia. The results are very quick to come. At the same time panchkarma treatment is often not required.
LOSS OF LIBIDO : As is the case with women, lack of desire in men can be of either physical or psychological origin.
Physical causes :TREATMENT: In Ayurveda, libido is directly dependent upon the amount of �Shukara Dhatu� in our body. Ayurveda believes the body to be made up of seven dhatus. Rasa, Rakata, Mansam, Medam, Aasti, Maaja, Shukaram. It is believed that the diet we take is acted upon by the digestive fire of our body and Aahar Rasam is formed from the useful part of our food while the waste is thrown out of our body as the stool. Now this Aahar Rasam is acted upon by various types of metabolic fires leading to the formation of Rasa Dhatu and from there onwards upto Shukara Dhatu Respectively. If the amount of Shukra Dhatu decreases in the body due to Anuloma Kshayam( i.e. due to improper nutrition or due to disturbances in the metabolism of the body) or due to Pratiloma Kshayam (due to excessive masturbation or due to excessive indulgence in intercourse) then there occurs a loss of libido. Hence to improve the libido, we require to check this decrease in amount of Shukra Dhatu of the body. Various herbs as well as metallic preprations are helpful in improving the amount of shukra dhatu in the body and thus help to improve the libido.
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