A large percentage of abnormal sperm, however, may reduce the number of sperm with fertilizing potential. Other factors examined during a semen analysis include the viscosity and the volume. Semen, ejaculated as a liquid, almost immediately assumes a jellylike consistency and then liquefies again within 30 to 40 minutes.
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If the ejaculate does not liquefy, sperm may have problems entering the cervix. Therefore, in a semen analysis the thickness viscosity of the semen is examined at an interval after ejaculation when full liquefaction should have occurred. The volume of an ejaculate varies normally from 1 to 5 milliliters: there are about five milliliters in a teaspoon. If the volume of fluid is low, the sperm may not reach the cervix. Without the alkaline environment of adequate seminal fluid, the acidity of the vagina may immobilize the unprotected sperm.
While evaluating sperm morphology, the technician may discover a large number of white blood cells, possibly an indication of inflammation, infection, or both.
The specific bacterium or other microorganism may be determined by special techniques of culture or antibody testing. If an infection is present, therapy with antibiotics and perhaps other treatments may improve fertility potential. Thousands of sperm could fit on the period as the end of this sentence. Other Tests Additional tests can evaluate sperm function. The postcoital test PCT measures the ability of sperm to live and swim in the partner's cervical mucus. The procedure is performed during the days just before, or at the time of ovulation. This is the only time in the menstrual cycle when the mucus is clear, colorless, watery, abundant, and stretchable.
These are prime conditions for sperm passage. The cervical mucus sample is taken during a routine pelvic exam about two to 12 hours after intercourse, and it is examined under a microscope. Because the accuracy of a PCT depends on correct timing, more than one test may be necessary. A PCT can suggest problems with the quality of sperm or cervical mucus, or the presence of antibodies to sperm. In another test, sperm are put with a sample of cervical mucus other than the partner's to see how well they swim in mucus. The swimming ability of sperm in cervical mucus is an important indicator of a man's fertility.
In a sperm penetration assay SPA , also known as the hamster egg penetration test, a number of eggs from a female hamster are exposed in the laboratory to human sperm. The eggs are treated so that normal human sperm can attach to and penetrate the egg. This test can reveal sperm that are unable to undergo the physiologic changes necessary for fertilization.
Therefore, it may be performed after other studies have failed to reveal a cause of persisting infertility. Sperm antibody tests can be done to determine if a man's system harbors substances that cause his sperm to clump together, lose motility or lose the ability to fertilize an egg. Figure 3: Sperm leave the testicles and spend from 3- 12 days passing through the epididymis.
The two vas deferens transport sperm through the ejaculatory ducts to the urethra. At ejaculation the seminal vesicles, prostate gland and Cowper's glands add fluid to the sperm. Figure 4. Sperm production is regulated by hormonal messages exchanged between the brain and testicles. Questions asked during the history focus on the reproductive system. Information of particular importance includes the length of time the couple has been trying to become pregnant and the results of previous evaluations or treatments for infertility. The doctor will want to know of any past problems such as urinary tract infections, pain or swelling in the testicles, or genital surgery.
Since drugs can affect the reproductive system, especially its hormonal equilibrium, the doctor may ask about the use of prescription drugs and other drugs such as alcohol, tobacco, marijuana or cocaine. The patient may also be questioned about his sexual history, including the frequency of intercourse, pain with ejaculation, and the use of lubricants during intercourse. During the physical examination, the doctor will search for evidence of infection past or present and for a varicocele, conditions that are discussed later in this booklet.
One such example is testicle disease, which can result in azoospermia or the complete absence of sperm in the semen. This condition is found in a small fraction of infertile men. In most cases the cause of the disease is unknown, although it sometimes results from an infection in the seminiferous tubules. For example, the mumps virus, if contracted after puberty can affect both testicles and destroy the cells that make sperm.
When the tubules are not severely damaged, testicle disease may simply reduce the sperm count or motility. The condition causes no reduction in testosterone and thus sexual function is normal. Hormone deficiencies are a relatively rare cause of low sperm output, but men who do have hormone deficiencies often can be helped by prescription drugs.
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If blood tests show a low level of pituitary hormones, the doctor may prescribe medications to replace or increase the output of these hormones. Blood test results can be used to guide treatment. Unfortunately, for most men with a low sperm count or low motility, the cause is unknown and the chance of success is low with hormone therapy.
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These veins pose no threat to their health and usually cause no discomfort or other problem. A possible explanation for this is that sperm production is hindered by an abnormally high temperature within the testicles. Occluding or tying off these veins will improve sperm quality in some men, and this is believed to improve their chances for conception.
Other conditions can render a man infertile. An obstruction of the duct system may block the outflow of sperm. Infection, including sexually-transmitted disease, injury or surgery, can scar the delicate tubules of the epididymis or obstruct the vas deferens. Or, the vas deferens may have been severed in a vasectomy. If the obstruction is complete on both sides for any of these reasons, the ejaculate will contain no sperm even though the seminiferous tubules are in perfect working order.
Surgical techniques are available to restore the free flow of sperm from the testes through the duct systems. The likelihood of success depends to a great extent upon the cause of the obstruction and length of time it has been present.
Many doctors will try to clear an infection with antibiotics or other treatments in hopes of improving fertility potential. Infections in the epididymis, seminal vesicles or prostate gland may cause little or no symptoms, although they may cause infertility. Gone are the days when doctors assumed that all infertility problems involved only the woman.
A couple's smartest move when faced with male infertility is to investigate all aspects of the problem—its causes and possible solutions—guided by a qualified physician.
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A variety of factors can limit or eliminate a man's fertility—infection, hormonal imbalance, injury, varicoceles, even psychological and emotional problems. Today's specialists have several ways to identify these problems. Working together, the patient and doctor can approach a common goal: conception.
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Mientras atraviesan esta masa espiralada de tubos, los espermatozoides ganan movilidad y habilidad para fertilizar. El paciente puede adquirir la muestra en su casa y llevarla al laboratorio para examinarlo en 1 hora.
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Mientras la transporta, es importante mantener el semen cerca de la temperatura corporal. Generalmente el semen normal contiene al menos 20 millones de espermatozoides en cada mililitro. Alrededor de la mitad de los espermatozoides en un semen normal tiene cabezas ovaladas y colas levemente curvas. Sin el ambiente alcalino del fluido seminal adecuado, la acidez de la vagina inmoviliza a los espermatozoides desprotegidos.
Figura 2. Los espermatozoides maduros pueden verse en el microscopio. Estas son las condiciones primarias para el paso de los espermatozoides. Un PCT sugiere problemas en la calidad del esperma o del moco cervical, o la presencia de anticuerpos que rechazan el esperma.
La habilidad natatoria de los espermatozoides dentro de este, es un indicador importante de la fertilidad masculina. Figura 3. Figura 4. Las preguntas realizadas durante la historia se centran en el sistema reproductor. Uno de dichos ejemplos es la enfermedad testicular, la que resulta en una azoospermia o la ausencia completa de espermatozoides en el semen. Estas venas no son una amenaza para su salud y generalmente no causan malestar u otros problemas.