infiltirity

• Infertility


  The inability to conceive and carry a pregnancy to viability after at least 1 year of regular sexual intercourse without contraception, or the inability to carry a pregnancy to term
• Primary infertility


  An inability to conceive and carry a pregnancy to viability with no previous history of pregnancy carried to alive birth
• Secondary infertility


  An inability to conceive and carry a pregnancy to alive birth following one or more successful pregnancies
• Sterility


  A total and irreversible inability to conceive
• Premature ejaculation


  The inability of a man to delay ejaculation long enough for his partner to reach orgasm on 50% of intercourse attempts
• Sperm vitality


  A reflection of the proportion of live, membrane-intact spermatozoa determined by either dye exclusion or osmoregulatory capacity under hypo-osmotic conditions

  
• Sperm morphology


  The size and shape of sperm. Abnormal sperm morphology is suggestive of a spermatogenesis problem

  
• Oligospermia


  Low sperm count
• Asthenospermia


  Poor sperm motility

  
• Teratospermia


  Abnormal sperm shape

  
• The total fertility rate in Egypt dipped from 3.5 in 2014 to 3.1 in 2018, according to a study prepared by The United Nations Population Fund (UNFPA), with data collected from the birth and mortality registration system implemented in collaboration between with the Ministry of Planning, Monitoring and Administrative Reform and the Ministry of Health and Population
• Approximately 60% of health young women conceive after 6 months unprotected intercourse and 85% conceive after 12 months
• Male infertility


  A man's inability to achieve a pregnancy in a fertile female partner after a year or more of regular unprotected intercourse
• Potential causes of male infertility

  • Sperm disorders
  • Varicocele
  • Hormonal imbalances
  • Ejaculation issues
  • Genetic factors
  • Infections
  • Testicular factors
  • Environmental factors
  • Lifestyle factors
• Diagnosis of male infertility

  1. Comprehensive evaluation of medical history and reproductive history

  2. Physical examination

  3. Diagnostic tests (semen analysis, hormonal tests, and imaging studies)

  
• Semen analysis


  The most important indicator of male fertility
• If semen parameters are normal, no further male evaluation is necessary
• For a semen examination

  1. The man is asked to produce a specimen by ejaculating into a specimen container and delivering it to the laboratory for analysis within 1 to 2 hours

  2. The man should abstain from sexual activity for 3 – 4 days before giving the sample
• Normal postcoital test results

  • Normal amount of sperm are seen in the sample
  • Sperm are moving forward through the cervical mucus
  • The mucus stretches at least 2 in (5 cm)
  • The mucus dries in a fernlike pattern
• Abnormal postcoital test results

  • No sperm or a large percentage of dead sperm are seen in the sample
  • Sperm are clumped
  • Mucus cannot stretch 2 in (5 cm)
  • Mucus does not dry in a fernlike pattern
• • Cycle of spermiogenesis takes about 74 hrs.
  • Semen parameters is may vary
  • Abnormal semen analysis should repeat at least once
  • The semen sample is collected by the man by self-masturbation near the laboratory or at home
  • Incomplete semen collection or loss of part of the sample during collection could lead to low semen volume
  • The semen should be delivered to the laboratory within 1 hour of its collection so that dehydration and temperature changes do not affect the sperm quality

  
• Values for semen analysis (WHO)

  • Volume
  • pH
  • Sperm concentration
  • Total sperm number
  • Sperm motility
  • Sperm vitality
  • Sperm morphology

  
• Low sperm count (oligospermia)


  A lower than normal number of sperm in the ejaculate
• Poor sperm motility (asthenospermia)

  A lower than normal percentage of sperm with progressive motility
• Abnormal sperm morphology (teratospermia)

  A lower than normal percentage of sperm with a normal shape
• Retrograde ejaculation


  Sperm is redirected to the bladder instead of being expelled through the penis during ejaculation
• Varicocele


  Enlarged veins in the scrotum that can impact testicular temperature and sperm production
• Hormonal imbalances


  Imbalances in hormones such as testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH)
• Abnormalities in semen analysis

  • Low sperm count (oligospermia)
  • Poor sperm motility (asthenospermia)
  • Abnormal sperm morphology (teratospermia)
  • Ejaculatory issues
  • Varicocele
  • Infections or inflammation
  • Hormonal imbalances
  • Genetic factors

  
• Common management strategies for male infertility

  • Lifestyle modifications
  • Treatment of underlying conditions
  • Medications
  • Assisted reproductive techniques (ART)
  • Sperm retrieval techniques
  • Counseling and support
  • Follow-up and monitoring
• Lifestyle modifications


  Healthy diet, regular exercise, avoiding harmful substances
• Treatment of underlying conditions

  Hormonal therapy, varicocele repair, infection treatment
• Medications


  Fertility drugs, antioxidants
• Assisted reproductive techniques (ART)


  Intrauterine insemination (IUI), in vitro fertilization (IVF)

  
• Sperm retrieval techniques


  Testicular sperm extraction (TESE) or Micro-TESE
• Counseling and support


  Psychological support
• Follow-up and monitoring


  Regular follow-up with a healthcare provider to assess the effectiveness of the chosen management plan and make adjustments as needed
• Misconceptions regarding male infertility

  • Infertility is always a woman's issue
  • If a man can achieve an erection and ejaculate, he is fertile
  • Male infertility is always due to a genetic problem
  • Only older women face fertility challenges
  • Infertility is not a common issue
  • If a man has fathered children before, he cannot be infertile
  • Tight underwear or hot baths always cause male infertility
  • Male infertility is untreatable
• Nursing management


  • Patient education
  • Support and counseling
  • Coordination of care
  • Medication administration and monitoring
• Patient education


  Explanation of procedures, guidance on lifestyle modifications