Assoc. Prof. Tayfun Kutlu, MD from the Reproductive Health Center at Anadolu Medical Center shares insights on male infertility
What factors affect the production of spermatozoa in the testicles?
The best environment for the production of spermatozoa in the testicles is when the temperature is a few degrees below the body temperature. An increase by even 1 or 2 degrees may significantly influence the production of spermatozoa and testosterone. Wearing tight jeans, slim fit sweat pants and leather trousers, hot showers, long stays in saunas or hot tubs, may result in increased testicular temperature and cause such an effect. Smoking affects adversely the number of spermatozoa and their motility. Alcohol reduces testosterone levels, thus cutting down the number of spermatozoa.
According to some studies, toxic chemicals may induce a reduction in the levels of spermatozoa. If one handles materials such as paint thinners or insecticides, one should always wear a mask and premises should be regularly ventilated. In addition to environmental wastes and hydrocarbons, although not definitively proven, radiation emitting devices, such as computers and mobile phones, may also lead to infertility.
How is male infertility diagnosed?
First of all, a semen analysis is carried out. A semen sample should be provided after 2 or 3 days of sexual abstinence, as this is the most appropriate evaluation period. Samples taken after shorter abstinence are characterized by lesser density and fewer number of spermatozoa. On the other hand, a longer period would reduce their motility. Analysis includes evaluation of the volume of semen, number and morphology of spermatozoa, pH and the presence of any round cells.
Male fertility is evaluated based on certain ratios. The norm is for spermatozoa with irregular or anomalous shape to be below 40%. The number of spermatozoa moving forwards should be at least 60%. The number of spermatozoa in 1 ml of semen should be at least 20 million. The normal reference range in terms of volume is set between 2 to 5 ml. The analysis based on these criteria provides prior information if the male may father children or medical intervention will be necessary. If the number of spermatozoa in semen is reduced, chances are thinner and it might take a little longer. Spermatozoon abnormalities are very successfully overcome with certain procedures such as intrauterine insemination or in vitro insemination. If necessary, microbiology tests and tests for antisperm antibodies may also be assigned. If the results point to any abnormalities, the tests may be carried out again two or three times within a month.