Infertility and Men

Sperm are made in the testicles.  They are then stored inside yards of "plumbing" called the epididymis, which lies on top of each testicle.  Sperm are nourished by semen, which is made by glands along the way.  When the magic moment arrives, about 150 million sperm are ejaculated in a half-teaspoon of semen through the penis.

When men are young and most likely to be fathering children, sperm numbers and semen quality and quantity should be at their peak.   As men get older, changes occur in the prostate and surrounding accessory glands which result in decreased semen volume over time.  This is normal as men age.

Although some people still think of fertility as a "woman's problem," up to half of all cases of infertility involve problems with the male partner.  A problem with the semen or sperm affects more than one-third of the couples who are unable to have children.  Infertility in a man may be the sole reason that a couple can't conceive, or it may simply add to the difficulties caused by infertility in his partner. 

30% of men are sub-fertile and at least 2% are totally infertile.  There are at least 2 million cases of male infertility reported in the USA each year.  Up to 25% of infertile men have abnormal or low sperm counts causing their infertility, for no identifiable reason. This is called idiopathic infertility.

Semen Analysis
Semen Analysis is usually one of the first tests done to help determine whether a man has a problem fathering a child (infertility).   Also it may be done to test the success of a vasectomy or reversal of vasectomy.

Semen Analysis measures the amount of semen a man produces and determines the number and quality of sperm in the semen sample.  The sample is usually collected through masturbation.  Semen Analysis can detect the following problems:

  • Azoospermia - No sperm are produced, or the sperm aren't appearing in the semen.

  • Oligiospermia - Few sperm are produced.

  • Problems with sperm motility - If sperm aren't moving normally, they are less likely to be capable of fertilizing an egg.

  • Problems with sperm morphology - Problems with the form and structure -- or morphology -- of the sperm may cause infertility.

Semen Analysis tests include:

  • Volume - This is a measure of how much semen is present in one ejaculation.  The normal range is 1.0 to 6.5 milliliters (ml) per ejaculation.

  • Liquefaction time - Semen is a thick gel at the time of ejaculation and normally becomes liquid within 20 minutes after ejaculation.  Liquefaction time is a measure of the time it takes for the semen to liquefy.  Normal time should be less than 60 minutes.  A longer liquefaction time may indicate an infection.

  • Sperm count - This is a count of the number of sperm present per ml of semen in one ejaculation.  The normal range is 20 to 150 million sperm per ml.  If a man has had a vasectomy, the count should be 0.

  • Sperm morphology - This is a measure of the percentage of sperm that have a normal shape.  Normally at least 70% of the sperm have normal shape and structure.

  • Sperm motility - This is a measure of the percentage of sperm that can move forward normally.  The number of sperm that show normal forward movement in a certain amount of semen can also be measured (motile density).  Normally 60% of the sperm (at least 8 million sperm per ml) should show normal forward movement.

  • pH - This is a measure of the acidity (low pH) or alkalinity (high pH) of the semen.  The normal range is 7.1 to 8.0.

  • White blood cell count - White blood cells are not normally present in semen.  A large number of white blood cells being present indicates an infection.

  • Fructose level - This is a measure of the amount of a sugar called fructose in the semen.  The fructose provides energy for the sperm.  Normally there are 300 milligrams (mg) of fructose per 100 ml of semen.  Less than this indicates a blockage of the seminal vesicles.

Varying degrees of infertility are associated with one or more of the above tests not being within normal range.

Blood Analysis
If Semen Analysis indicates a problem, then further testing may include Blood Analysis for the following:

  • Testosterone - Testosterone plays a role in sperm production.  Normal ranges for total testosterone are 270 to 1,080 ng/dL (men aged 20 to 39), 350 to 890 ng/dL (men aged 40 to 59), and 350 to 720 ng/dL (men aged 60 and above).  Normal free testosterone levels in men range from 44 to 244 pg/mL.  Abnormally high levels may be caused by cancer of the testicles or adrenal glands.  Abnormally low levels can be caused by Klinefelter syndrome, Down syndrome, liver disease, treatment for cancer of the prostate gland, and chronic alcohol use.

  • Luteinizing Hormone (LH) - When the testosterone level is low, the pituitary gland releases LH which tells the testicles to make more testosterone.  The normal range is 1 to 9 IU/L.  Abnormally high levels indicate the testicles are absent or have been removed, testicles are not functioning, or Klinefelter syndrome is present.  Abnormally low levels may indicate Anorexia Nervosa, pituitary gland failure, damage to the hypothalamus, stress, or low body weight.

  • Follicle-Stimulating Hormone (FSH) - The pituitary gland produces FSH which helps control the production of sperm.  The normal range in men is 5 to 15 IU/L.  High FSH levels may indicate Klinefelter syndrome or the testicles are absent or not functioning properly.  Low FSH levels may indicate that the hypothalamus or pituitary gland is not functioning properly, brain tumor, stress, or starvation.

  • Prolactin - The pituitary gland produces the hormone prolactin.  The normal level in men is less than 20 ng/mL.  High levels of prolactin (usually higher than 200 ng/mL) may mean a pituitary gland tumor, liver disease, kidney disease, or hypothyroidism.  Excessive prolactin can lead to a decrease in testosterone as well as abnormal sperm.

Other Factors
Besides problems related to sperm and hormones, other factors may cause male infertility:

  • Sexually transmitted diseases or infections like Chlamydia and Gonorrhea.  Once the infection is treated, infertility usually goes away.

  • Blockages / damage in parts of the testicle that prevent sperm from getting into semen.

  • Retrograde ejaculation where semen doesn't come out of the penis during ejaculation but instead enters the bladder.  This is caused by diabetes, certain medications, and surgery to the bladder, prostate, or urethra.

  • Genetic diseases like cystic fibrosis and chromosomal disorders.

  • Autoimmune problems where the immune system mistakenly targets sperm cells as a foreign virus and damages them.

  • Erectile dysfunction and premature ejaculation.

  • Enlarged varicose veins in the scrotum (Varicoceles) that prevent blood from flowing properly.  Varicoceles are found in 15% of all men and 40% of men being evaluated for infertility.

  • Excessive exercise may lead to the release of too many steroid hormones.

  • Stress.

  • Obesity.

  • Use of drugs (like marijuana, cocaine, steroids), alcohol, or tobacco.

  • Exposure to toxins and environmental hazards like pesticides, lead, radiation, mercury, and heavy metals.

  • High temperatures in the testicles resulting from wearing clothing that's too tight, frequent bike riding, or taking too many hot baths or saunas.  This effect is usually temporary.

Western Medicine
Western medicine relies on aggressive and costly prescription drugs and surgery to deal with problems related to reproductive disorders.  Antibiotics are effective in treating infections which hinder fertility.  Surgical treatment is effective for repairing Varicoceles and obstructions in the sperm transport system.  In vitro fertilization (IVF) works well also.  During IVF, eggs are removed from the ovaries and combined with sperm in the laboratory.  The fertilized eggs are placed into the woman's uterus.

Medications are effective in only about 5% of men with hormonal imbalance.

When hormonal imbalance is the result of disrupted signals between the hypothalamus, pituitary gland, and the testes (thereby affecting sperm production), men often receive Gonadotropins injections (2 or 3 times a week) which are helpful but might take up to a year to achieve normal fertility.  There are 3 types of Gonadotropins: human chronic (hCG), human menopausal (hMG), and recombinant human follicle-stimulating hormone (rFSH).  Side effects in men include acne, breast enlargement, changes in emotions or mood, headache, and inflammation at the injection site.

Testosterone deficiency attributed to a lack of Gonadotropins is treated with Antiestrogen medications like tamoxifen (Nolvadex) and clomiphene citrate (Clomid) which stimulate the release of Gonadotropins.  However the use of Antiestrogen durgs may boost testosterone production in men to above normal levels which can negatively impact sperm production.  Side effects of these drugs include hot flashes, nausea, dizziness, blurred vision, vomiting, weight gain or loss, elevated cholesterol and other fats in the blood, abnormally high levels of calcium in the blood, muscle pain and weakness, loss of appetite, and kidney failure.

Excessive prolactin is treated by Bromocriptine medication.  Side effects of Bromocriptine in men include high blood pressure, worsening of mental and liver disorders, confusion, hallucinations, and uncontrolled bodily movements.

Hypogonadism (lack of testosterone production) is treated by synthetic testosterone administered through oral pills, injections, or transdermal gel / patch.  Testosterone pills have been associated with elevated liver function and abnormalities in liver scans and biopsy.  Injections require frequent trips to the fertility specialist and do not always provide a consistent level of hormones causing a man's libido, energy levels, and mood to fluctuate.  Transdermal applications, while more expensive, are proving to be a popular choice because they are considered the safest and most efficient for providing a consistent level of testosterone in the body.  The most troublesome side effect is the natural ability of the body to produce testosterone is reduced with the administration of synthetic testosterone. 

Once medication is stopped, the body will produce even less testosterone than it did prior to medication!

Other side effects include vomiting, nausea, swelling of the arms and legs, yellowing of the skin and eyes, prolonged and painful erections, difficulty in breathing, swelling of the tongue, lips, or face, shrinking of testicles, gynecomastia (breast growth in men), changes in libido, decreased sperm production, male pattern baldness, water retention, liver damage, and cancer.

Ayurvedic Medicine

yogi

Ayurveda, the science of life, prevention, and longevity, is the oldest and most holistic and comprehensive medical system available.  Its fundamentals can be found in Hindu scriptures called the Vedas - the ancient Indian books of wisdom written over 5,000 years ago.  Ayurveda uses the inherent principles of nature to help maintain health in a person by keeping the individual's body, mind, and spirit in perfect equilibrium with nature.

India Herbs has a seasoned group of Ayurvedic doctors specialized in Vajikarana, one of the eight major specialties of Ayurveda.  Vajikarana is "a process or a drug, which make a man as healthy as a ox and able to undergo many hours of physical rigors."  Vajikarana prescribes the therapeutic use of various herbal and tonic preparations for enhancing the capabilities and vigor of the your reproductive and urogenital system while strengthening the body and overall well-being.

India Herbs' Vajikarana scientists combine a proprietary herbal formula based on centuries' old wisdom with advice on diet, exercise, mental training, and relaxation to help men address their potency concerns for the long-term through safe, natural means.

Recommendations
You can optimize your semen volume, sperm production, and fertility by:

1) Reversing Damage - Years of stressful living caused damage to your body.  To help reverse this, Sukraja releases hundreds of phytonutrients that act at the molecular level to elevate hormone levels, stimulate liver functions, remove toxins, nourish nerves, rejuvenate your prostate gland and testicles, reduce sperm abnormalities, and improve your sexual response.

2) Taking a Multi-Vitamin - A daily multivitamin can help provide selenium, zinc and folic acid - trace nutrients that are important for optimal sperm production and function.  A multi-vitamin also usually contains antioxidant vitamins such as C and E, which may help protect sperm from damage.

3) Reducing Stress - Researchers are investigating whether stress might interfere with certain hormones needed to produce sperm.  Stress can also impair sexual function.

4) Exercising Regularly - Physical activity is good for reproductive health as well as your overall health.  But don't overdo it.  Men who exercise to exhaustion show a temporary change in hormone levels and a drop in sperm quality.

5) Maintaining Optimal Weight - Too much or too little body fat may disrupt production of reproductive hormones, which can reduce your sperm count and increase your percentage of abnormal sperm.  You are most likely to produce lots of high-quality sperm if you maintain a healthy weight.

6) Minimizing Exposure to Toxins - Experts think certain workplace and household substances might have an effect on sperm quantity and quality.  These include heavy metals, and pesticides and chemicals in solvents.  Use protective clothing, proper ventilation, and face masks to reduce the risk of absorbing such toxins.

7) Quitting Smoking - The sperm of men who smoke may be misshapen and may move more slowly than those of nonsmokers.  Smoking can also damage your sperm's DNA.  Experts suspect such damage could even affect fetal growth and development and increase a child's chance of having certain health problems, including cancer.  And chewing tobacco isn't safe either - it also may cause low sperm counts and damage.  As if that weren't enough, tobacco use can increase erectile dysfunction.  Research shows men who both smoke and drink alcohol have lower sperm counts and motility than do men with either habit alone.

8) Limiting Alcohol -  Heavy drinking may reduce the quality and quantity of sperm.  Limit alcohol to no more than one or two drinks a day  The combination of tobacco and alcohol is particularly harmful.

9) Avoiding Recreational Drugs -  Marijuana can decrease sperm density and motility and increase the number of abnormal sperm.  Cocaine and opiates can contribute to erectile dysfunction, and amphetamines can decrease sex drive.

10) Avoiding Steroids -  Anabolic steroids, usually taken illegally, can shrink the testicles and drastically reduce fertility.  Anti-androgens used to treat prostate enlargement and cancer interfere with sperm production.  Testosterone supplements also decrease fertility.

11) Skipping the Tub - To maximize the quality and quantity of your sperm, avoid hot tubs and baths.  Spending more than 30 minutes in water 102 F (40 C) or above may lower your sperm count.  Saunas and steam rooms may have a similar effect.

12) Staying Cool - Increased scrotal temperature can impair sperm production.  Experts know that hot work environments, tight-fitting underpants, prolonged sitting, and use of laptop computers can all increase scrotal temperature.  They are still studying how these activities affect fertility.

13) Not Using Lubricants during Sex - Personal lubricants, lotions, and even saliva can interfere with sperm motility.

Results: The precise combination of ingredients in Sukraja along with a mind-body focus precisely addresses your sexual and urogenital concerns!

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