Enemies of spermatogenesis
"Beer belly", emotional stress and others
The problem of family infertility is traditionally considered to be "female", but feminists need not worry: today it is precisely established that full equality is observed with regard to the inability to have children. In other words, among infertile couples, the number of which in Russia reaches 19%, in half of the case the "fault" lies with the man. To count all the factors that provoke the development of male infertility, there are not enough fingers and toes. The saddest, but at the same time optimistic, is that a significant part of them is non-hereditary and amenable to prevention and correction. Your reproductive health, future fathers, is in your hands!
We can say that in terms of fertility, a man, unlike a woman, is lucky. The expectant mother is born with an already set, limited number of eggs; male reproductive organs work without interruption throughout life, constantly producing completely "brand new" germ cells. But not everything is smooth here either…
The process of maturation of spermatozoa – spermatogenesis – is quite long and takes up to 3 months. At the same time, sperms are gentle and vulnerable creatures, like men themselves (although it is considered otherwise), and almost any adverse effect immediately leads to their "spoilage". As a result, there are either too few spermatozoa in the sperm (oligospermia), or they lose their mobility (asthenospermia); finally, real freaks (teratospermia) can appear instead of neat tailed vivacious ones: giant or dwarf, two-headed or with "crooked" heads and tails... It's just a horror movie that only an andrologist can see under a microscope.
One of the factors affecting male fertility is prolonged psychoemotional stress, otherwise – chronic stress. This factor acts most vividly during wars and natural disasters, for which a significant part of the male population pays with testicular atrophy. But even in our seemingly "peaceful" life, there are enough reasons for the development of such stress. Physiologically, the inhibition of sexual function in this case is explained by the fact that the adrenergic structures of the nervous system that respond to stress are also involved in controlling the activity of the male sex glands. With chronic stress, there is a decrease in the production of the hormone testosterone and, accordingly, the development of infertility.
Harmful habits also harm spermatogenesis. Nicotine promotes vasoconstriction, which disrupts the nutrition of the spermatogenic epithelium, from which spermatozoa are formed, as a result of which the latter are obtained with defects or are not obtained at all. As for alcohol, in order to avoid problems, doctors strongly recommend giving up its use at least three months before the intended conception, or even better – a year. And finally, overeating and a passion for fast food against the background of a sedentary lifestyle, leading to overweight and obesity, which, unfortunately, is no longer perceived as a problem and pathology in our society. At the same time, the highest risk of reproductive disorders was noted for men with abdominal obesity, or, simply put, with the so-called "beer belly", when fat accumulates mainly in the upper part of the trunk. The result is a decrease in the number and mobility of spermatozoa, their immaturity, increased DNA fragmentation, production of antisperm proteins… Is it worth continuing, or is it better to send another mouth-watering and such a high-calorie burger to the dumpster?
Among this sad picture, another distinctive feature of male fertility stands out as an island of hope – it is floating. High fertility may decrease up to infertility, but the reverse process is also possible if suitable conditions are created. Disorders of spermatogenesis, if they are not genetically determined (unfortunately, it happens so), are in principle fixable – not all, but many. A potential father can do something on his own (for example, give up bad habits), but if the much–desired conception does not occur within a year, you should definitely contact a specialist in male diseases - an andrologist to accurately diagnose and jointly solve the problem.
Spermogram (semen analysis) is one of the most accessible and common methods of diagnosing male infertility. First of all, this test gives a general assessment of the properties of the ejaculate, the quality and quantity of sperm. The analysis is carried out using a phase contrast microscope at magnification * 100 ... * 200. Counting is carried out in a special counting chamber. To study the motility of spermatozoa, 5 fields of view are viewed twice in a microscope to evaluate at least 200 spermatozoa.
Here and below is a video by E.Y. Kirs (Novosibirsk Center for Reproductive Medicine).
Normally, the antigens of spermatozoa and spermatogenesis cells are reliably protected by a biological (hematotesticular) barrier. If the barrier is broken, antisperm antibodies to their own spermatozoa begin to be produced in the male body. Antisperm antibodies to spermatozoa reduce mobility, promote adhesion, worsen the "quality" of embryos, etc. The intensity of antibody production is determined by immunological examination of sperm, MAR (total antiglobulin reaction). Antiserum to antibodies and antibody-related latex beads are added to the sperm. As a result, the balls "stick" to the spermatozoa coated with antibodies, forming a "particle-sperm" complex, clearly visible under the microscope. Sperm cells without antibodies will float freely between the latex particles. Thanks to the latex "shell", it is possible to clearly identify the fragment of the sperm (head, neck or tail) against which the antibodies are directed. The presented videos show that the antibodies are located on the head, neck and tail of each sperm; there are no freely moving sperm.
The key moment of natural fertilization is the binding of the sperm to the protective layer of the egg. The cells that form it are interconnected by bridges of hyaluronic acid, which mature spermatozoa must dissolve. The HBA test is a new functional test for determining the ability of spermatozoa to bind to hyaluronic acid using receptors located on their membrane, which stimulates the production of a dissolving enzyme. With the help of the test, you can estimate the number of full-fledged spermatozoa capable of fertilizing an egg. Sperm is added to the area of the drop with hyaluronic acid, and after a few minutes the acrosome, an organoid in the head of the sperm, should bind to the surface of the hyaluronate. To assess the quality of sperm, the associated, mature spermatozoa are counted (their external sign is movement around its axis).
For sperm with a low level of the HBA test, there was a significant increase in the rate of clinical pregnancies when using PICSI cups when selecting sperm for the ICSI procedure – intracytoplasmic injection of sperm into an egg. To do this, specially prepared spermatozoa are placed in the area of a drop with hyaluronic acid, as in the NVA test, and then only mobile, bound spermatozoa are selected with a microneedle. Thus, the best, mature spermatozoa are selected, which are then used for artificial insemination by ICSI.
Read more about the problem of male infertility in the journal "Science at first hand" in an article by a practicing Novosibirsk andrologist, Ph.D. E.A. Epanchintseva.
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