Health and Wellness
Dr Oluwadare Adepetu
More men are now coming forward for examination and for medical assessment, so we are discovering more and more problems with men that relate to the inability of the couple to achieve pregnancy.
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When you talk about male factor infertility, the chief cause is abnormality with the semen production. The fact is that it’s no longer seen as the problem of the woman in our society. More of the men are coming to the hospital with their wife; this might be the reason why it appears as if there is increase in male factor infertility, not that there is actual increase but we are detecting more and more cases because more and more people are coming forward; that’s why it appears as if there is increase.
When you look at the causes of infertility generally, about 30 per cent is due to the male factor. When you look at abnormality with the semen, that’s the sperm production, boldly we can classify this into three categories; the abnormalities that we call pre testicular problems. Talking about the pre testicular problems, these are the abnormalities that occur before the production of sperm cell. Before the production gets to the level of testicles, what are the problems that can occur before that time? These are mainly hormonal problems, men not producing enough hormones, that’s those who are producing sub-normal quantity or men not producing at all or those who produce male hormone but their male hormones don’t get converted to the active form. The male hormone is testosterone and the active form is five hydro testosterone. Some of them don’t produce at all, some of them produce low quantity of male hormone. Some of them produce normal hormones but they don’t get their hormones converted to the active form. Men in this category for those who produce, who don’t get it to the active form may manifest with no sperm production because it is the active form that acts on the testicle. Some of them produce this active form in lower amount, those people produce low sperm count, those are the people that manifest with low sperm count, then some of them produce, some of them don’t even produce this male hormone at all. So, those people will manifest with no sperm production. For men in this category, when they come to the hospital, there is treatment for them once we identify that they are in that category and we make this hormone available or the active form available to them.
For those with testicular problems, those whose problems is at the level of the testicles, they have normal hormones, you see them they have features of a normal man, they have beards, they have hair frontal erection and all that, but the receptors for this hormone on the testicle is absent. It’s just like trying to pluck your device to a socket; the hormone is your pluck, the receptor is that socket. If the socket on the testicle is absent, or not functional so these people produce normal hormones but there is no receptor for these hormones on the testicle, the hormones will not work on the testicle to produce sperm. That’s one problem. Some people engage in long distance driving, men who wear tight fitting underwear, men who smoke, those who take a lot of alcohol, those who work in hot environments, these people they make the testicle to work in an environment that is not favourable. That is not good for sperm production because if you look at the testicle, it functions well within a narrow temperature range. That’s why the testicle is not within our body like the ovary in women. It’s outside the body and when you look at the sack that contains the testicle on a very cold morning you discover that the sac will shrink and bring the testicle close to the body so that the testicle is not too cold, it gets heat from the body, then on a very hot afternoon or hot weather, if you check this skin, it looks like rag, such that the testicle is away from the heat of the body so that it’s not too hot. If you now see men who now put this testicle in between their laps and drive long distance, it’s like those people who are cooking their testicles in coat or those who wear tight fitting underwear. The testicle is trying to get away from the body you now use your pant to bring it close to the body, or those who work in hot environments, those who work in environment with radiation, those who work with instruments that vibrate, those who work in petrochemical industries, these are people that are at risk of testicular problems.
Now the third category is post testicular problems. For those with post testicular problems, it can be congenital problems such that they don’t have the conduit. That’s the vast difference that brings the sperm out after production. They need to bring it out after sexual intercourse with the woman, now, they don’t have this pathway.
There are those whose passage has been blocked due to previous infections. Most of these sexually transmitted infections or those whose passages have been narrowed by these infections, they produce the sperm but they cannot bring them out. So when a man is having issues with sperm production he should come to the hospital. We need to make diagnosis to know the category he falls into, before treatment can be made available to them.
Heat is not friendly with the testicle. So those who put laptops on their laps and the thing is there for a very long time and you know these computers generate heat, that’s one thing, then we talk about radiation for your phone in your pocket to receive call and send calls, to receive internet message and all that is through internet connectivity. These are things that affect the function of the testicles.
The man who has issues producing sperms and therefore cannot impregnate a woman needs to stay away from smoking, stay away from indulging in alcohol, tight fitting underwear, try as much as possible to stay away from hot environments. For those who work with instruments that vibrate, as much as possible, you should take a break, stay away and go back. For those working in petrochemical industry, what do I say? Then when this problem is noticed, come to the hospital, come for assessment, we need to know what the problems are before we know the solution.
For food that they can eat, food that are rich, that are antioxidant generally, fruits that are rich in antioxidant, those ones can help them, including nuts, like walnut, coconut etc. But groundnut does not belong in that category actually, but people have talked about food with nuts that is okay for them but then generally, food that is rich with antioxidant are okay. Fruits generally.