00:01
Now let's talk about
male factor infertility.
00:06
So it's interesting when we talk
about male factor infertility,
because often we're testing
the female for infertility,
and she may go through an
incredible amount of work up
only to find that the cause is
actually related to the male.
00:20
So now we know that whenever there's
infertility suspected in a couple,
the better option would
be to test the male first.
00:28
Let's find out why.
00:30
The first thing we're going
to do is do a semen analysis.
00:33
So within the semen analysis,
we're going to be able to note,
are the sperm active?
Are they wiggling?
Or are they asleep?
Do they have 1 head?
Do they have 2 or 3,
which would be abnormal?
Do they have one tail again,
or do they have 2 or 3?
So any abnormality in the sperm is going
to affect its ability to fertilize an egg.
00:54
So that's a really good place and
very important place to start.
00:58
An ultrasound will also be performed to
really take a look at the vas deferens
and to look at the
testes and the scrotum
to make sure they're not
any structural anomalies
that could cause problems
for sperm transport.
01:10
Genetic testing is important because
if there are any genetic abnormalities,
such as Klinefelter syndrome,
or anything like that,
that can be passed
on to the fetus.
01:19
If you remember from our
bleeding and pregnancy lecture,
the most common cause for miscarriage
or loss is chromosomal abnormalities.
01:27
And absolutely the sperm
can play a role in that.
01:31
A hormonal analysis is
going to be important.
01:33
Males have to have sufficient
production of testosterone
in order to have normal
sperm development.
01:40
If that's not there,
this test will pick that up.
01:43
Looking at the causes
for male infertility,
you'll notice first off that
34% are the highest rate
for male factor infertility
is actually unexplained,
very different than female.
01:56
But important to pay attention.
01:58
The number two cause
is a Vericocele.
02:01
Now a Vericocele can cause
sperm to actually be warmed up,
and sperm can be too warm,
and sperm that's too
warm actually die
and they're not really good
at producing a pregnancy.
02:12
So that's the number two reason.
02:14
So make sure you take
a look at this list.
02:17
Now there can also be other factors
that cause male factor infertility.
02:22
There can be structural issues.
02:24
Again, this may have a lot to do with how
the sperm moved through the vas deferens
and through the urethra to
be able to fertilize an egg.
02:32
There may be
endocrine disorders.
02:34
Again,
we're talking hormones here,
they are the neurotransmitters
that make things happen.
02:38
If something's off there,
fertility will be affected.
02:42
And finally,
sexually transmitted infections.
02:45
So sexually transmitted
infections untreated
can change the
morphology of a sperm
and can also scar tubes
for the male as well.
02:54
Other issues that may need to be addressed
for male factor infertility is nutrition.
02:59
Poor eating habits can also
affect sperm development.
03:02
We want to think about
genetic disorders,
I mentioned Klinefelter
syndrome before,
this can definitely
be an impact here.
03:10
Obesity and being overweight
can affect sperm development,
and also sperm transport.
03:15
So this needs to
be investigated.
03:18
Steroid use which may be
common for building muscle mass
also can change the morphology and
the number of sperm that are produced.
03:26
So knowing that a male
is utilizing steroids
could be important in
making a diagnosis.
03:32
Also sperm quality.
03:33
So not just thinking
of the number,
but is it shaped the
way it's supposed to be?
And is it mobile?
Or is it still?
This matters.
03:42
And finally, any other medications
that the client might be taking.
03:46
So we have to do a good history.
03:48
And don't forget to talk about things
that are recreational or herbal use
because that can play
a role in fertility.