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If a man testify despite regular and unprotected sexual intercourse for two years no child could we speak of a sterility in men.

Most couples can, within eight to ten months after discontinuation of contraceptive methods to bring about a pregnancy. Also, this period can be for some couples a test of patience. Ten to 15 percent of couples in Germany can fulfill their desire for children not in the longer term, the causes are not only the man but the woman or can affect both simultaneously.

Causes of the sterility of the man
There are many causes that can cause sterility of the man:
Anatomical factors:
One example is not treated in time undescended testicles (cryptorchidism). The testes move in most cases already in the fetus, but not later than the end of the first year from the abdomen into the scrotum . In the abdomen or the groin remaining testes are exposed to a higher temperature than in the scrotum. This can affect the formation and movement of sperm and sustainable disturb. Also similar to varicose veins jammed in the testes (varicocele) can cause sperm problems and lead to an infertility favor.

Hormonal causes:
Sperm develop under the influence of hormones such as the male sex hormone testosterone . Testosterone deficiency leads to reduced sperm count in the semen. Even the so-called prolactinoma, a hormone-producing tumor of the pituitary gland can cause sterility in men.

Hereditary diseases:
Hereditary diseases such as the Klinefelter syndrome go infertility of the affected men is associated with.

Infections:
They include, among other things after puberty made by mumps infections that attack and damage the testicles can also. Bacterial infections, for example, chlamydia can also cause a male infertility.

Side effects of treatment:
Radiation or certain drugs can affect the development of sperm usually temporary. As part of operations, for example in the treatment of a hernia , can accidentally be cut through the vas deferens.

Adverse influences from the outside:
Stress, excessive smoking, alcohol, drugs , environmental toxins such as pesticides, or a constant overheating of the testicles, for example, by seat heaters can reduce fertility in men as the.

In the seminal fluid present antibodies against their own sperm.

Retrograde ejaculation:
In retrograde ejaculation, the ejaculation is not released to the outside, but backwards through the urethra into the bladder. Diabetes mellitus, for example, is the cause in question.

Preceding sterilization (vasectomy)
About five percent of men develop after sterilization has taken place, again a desire for children.

Idiopathic infertility:
In about 15 percent, no cause of infertility of the couple are found.

Symptoms of sterility of the man
In the sterility of a man, the main problem is that he can not father children. the desire for children is strong, the men concerned with time often suffer self-doubt and feelings of inferiority.

Other symptoms may occur depending on the underlying cause. If, for example, even before puberty, a lack of male sex hormones, body proportions can be changed (eunuchoid high growth) to draw attention to the defect. The men in question are very large. Arms and legs are long, the trunk is relatively short. Testicles and penis to remain small, the beard is growing scarce. In addition, there will be no voice change. Creates the lack of male sex hormones after puberty, the body proportions are normal. The men in question may, however, feel limited in their performance. The hair growth is waning, so they do not so often have to shave as usual. Also go back libido and potency. The body fat is distributed, similar to the female body fat distribution, rather the hips and lower abdomen.

Diagnosis of sterility of the man
First, the doctor asked the couple concerned for detailed medical history and current complaints (medical history). The conversation touches include intimate topics such as possible sexual diseases or the frequency of sexual intercourse. Even the lives such as stress and lifestyle habits such as smoking and alcohol consumption are included in order to narrow the cause of sterility.

The man goes in the other mostly in the hands of a specialist urologist or internist. On physical examination, the doctor pays special attention to signs of hormonal disorders. In addition, the genitals are sampled. The size (volume) of the testis, using an ultrasound examination determined. Too small testes can suggest impaired sperm development. In addition, the ultrasound for example, provide evidence of inflammatory changes, testicular tumors, or a varicocele.

In addition, a so-called sperm is made. There is a semen analysis of the man. The sperm production takes place after several days of abstinence by masturbation. It will include verification of number, appearance and mobility of sperm. In addition, the semen be tested for an infection of the genitals or antibodies directed against their own sperm. A biopsy from the testis may depend on the outcome of the spermiogram be required.

Suspected of having a hormonal cause of infertility, in addition certain hormones such as testosterone, FSH and prolactin in the blood of the affected man can be determined. It may also further studies such as the MRT or chromosomal analysis is necessary.
Treatment of infertility in men

In some cases, the sterility of the man be causally treated. In a subject such as testosterone deficiency, the most affected men with testosterone therapy. Depending on the cause of testosterone deficiency, perhaps, other hormones are used. Bacterial infections in the genital region for example, chlamydia usually require antibiotics. Lie in the semen anti-sperm antibodies before, some men benefit from corticosteroids, which suppress the body’s immune system. The retrograde ejaculation in the present diabetes mellitus can be treated with so-called sympathomimetics. They provide a more solid closure of the bladder outlet, so that the semen can no longer flow into the bladder, but the outside again. Formed after a sterilization astonishing return a child’s wish, it is possible to connect the originally severed vas deferens to microsurgery.

Does the man not the cause of sterility treated, various methods of artificial insemination available to increase the likelihood of pregnancy. In the so-called artificial insemination (semen) are obtained by masturbation specially prepared sperm in uterus and fallopian tubes or transferred directly. For example, limited motile sperm saves the path to the egg as far as possible. When I n-vitro fertilization (IVF) of women are taken from the body with sperm and ova together outside of the partner. If the egg is fertilized, it uses the doctor into the uterus. The Spermatozoeninjektion intracytoplasmic ( ICSI ) requires only a single sperm, which a tiny needle directly taken from an egg cell is injected in with. The fertilized egg is finally introduced as in the IVF to the uterus. Contains the semen of the man, for example, with closed vas deferens no sperm (azoospermia), it is possible to remove them directly from the testis or epididymis by a small operation under local anesthesia.

Course of a sterility of the man
For the longer-lasting sterility of the man take the opportunities on more and more to be able to treat successfully. After twelve months, the couple should seek the advice of a doctor already.

After infertility treatment occurs in up to 20 percent become pregnant. Since there are more to incorrect treatment of infertility and premature births can occur one after, there may be only about ten percent of couples lucky, ultimately to be parents. Multiple pregnancies are more common for infertility treatments.

After sterilization, the vas deferens are reconnected in about 85 percent successful. In just over 45 percent of cases it is possible the man following a child to witness.

Men with conception problems develop in about 0.5 percent of the testicular tumors. The ultrasound examination is therefore of particular importance.

Can a man’s infertility be prevented?
Congenital causes of sterility of the man can not be prevented. Otherwise, the couple can reduce a healthy lifestyle without excessive smoking, alcohol, drugs or stress, and by a partnership of trust, the risk of sterility. Sterilization should think through the man in the run always good. Against sexually transmitted diseases like chlamydia infections that can lead to infertility, the man can be protected by condoms.