MALE & FEMALE INFERTILITY

Infertility in women

Conditions affecting a woman’s fertility can include:

- Damage to the fallopian tubes
- Ovulatory problems
- Endometriosis
conditions affecting the uterus
- A combination of factors
- No identifiable or Unexplainable factor.

Other factors that may play a part include:

- Age – female fertility declines sharply after the age of 35
- Polycystic Ovary Syndrome (PCOS)
- Gynaecological problems such as previous ectopic pregnancy or having had more than one miscarriage
medical conditions such as diabetes, epilepsy, and thyroid and bowel diseases
lifestyle factors such as stress, being overweight or underweight, and smoking.

Infertility in men

Conditions that may result in infertility include:

- Low sperm count or quality
problems with the tubes carrying sperm
- Problems getting an erection
- Problems ejaculating.

Other factors that may play a part in infertility include:

- Having had inflamed testes (orchitis)
- A past bacterial infection that caused scarring and blocked tubes within the epididymis as it joins the vas
- Having received medical treatment such as drug treatment, radiotherapy or surgery – for example to correct a hernia
undescended testes or twisted testicles
- Genetic problems
- Diabetes
- Lifestyle factors such as being overweight
having a job that involves contact with chemicals or radiation.

Male fertility is also thought to decline with age, although to what extent is unclear.
I am going to take for granted that much has been known about Low sperm count, quality, weak erection & ejaculation factors regarding male factor infertility, hence we will be looking at UNDESCENDED TESTICLES MALE FACTOR INFERTILITY

CRYPTORCHIDISM, or undescended testicle refers to a testicle (testis) that has not moved into the scrotum (the bag of skin that hangs behind the penis) before a baby is born. It is estimated that 3% to 5% of newborn boys have undescended testicle(s). Premature newborn boys are much more likely to be born with an undescended testicle, compared to babies born at full term.

Cryptorchidism can also refer to both testicles undescended - and is much rarer (15% of cases). Whether it is just one or both testicles, cryptorchidism generally corrects itself within a few months.

Sometimes surgery is needed to relocate the testicle into the scrotum. What are the scrotum and testicles? The scrotum is a small pouch (sac) of skin that hangs behind (under) the penis. The scrotum holds the testicles in place. The scrotum also holds the edpididymes (a structure within the scrotum attached to the backside of the testis) and lower portions of spermatic cords.

(Testis = testicle. Testes = Testicles). A pair of testicles (testes) is located inside the scrotum. The testicles are oval-shaped sex organs that form part of the male reproductive system. The testicles produce sperm and testosterone.

Testosterone is a hormone which plays a key role in male sexual development, such as the development of the reproductive organs, body and facial hair, low voice, and wide shoulders.

The medical word cryptorchidism comes from the Greek word kryptos which means "hidden", and the Greek word orchis which means "testis, testicle".

During pregnancy a baby's testicles form in his abdomen, before gradually descending into the scrotum, usually around the 8th month. Experts are not sure why sometimes one of them, or both, do not descend.
So just like we do request our women to do a breast examination for lump(s), we request our men to do a scrotum examination to determine if both testes are in the scrotum. God bless you sirs!
What are the signs and symptoms of cryptorchidism (undescended testicle)?

Doctors generally refer to palpable undescended testicles or unpalpable undescended testicles.

Palpable undescended testicles - the testicle(s) can be felt during a physical examination. Accounts for about 80% of cases. The testicle(s) is usually located at the end of the inguinal canal, where it is lodged. The inguinal canal is a channel in the anterior abdominal wall which conveys the spermatic cord towards the penis and scrotum in males.Unpalpable undescended testicles - the testicle(s) can't be felt during a physical examination.

There are three main types:

- Abdominal or intra-abdominal - the testicle is inside the abdomen, generally near the upper opening of the inguinal canal. These account for about 40% of cases of unpalpable testicles

- Inguinal - the testicle has moved into the inguinal canal (which it should), but has not moved down enough to be detected by touch (unpalpable). These account for about 40% of unpalpable testicles.

- Atrophic or absent - an atrophic testicle is very small, while an absent one was never formed (it is missing). These account for about 20% of cases of unpalpable testicles.

What are the risk factors for cryptorchidism (undescended testicle)?

A risk factor is something which increases the likelihood of developing a condition or disease. For example,* Obesity significantly raises the risk of developing diabetes type 2. Therefore, obesity is a risk factor for diabetes type 2. The following risk factors are linked to cryptorchidism:

- Premature birth - the earlier the baby boy is born, the higher the risk.Low birth weight - boys who weigh less than 5.5lb (2.5 kilograms) at birth are two to three times more likely to be born with undescended testicles, compared to boys of normal birth weight.

- Alcohol consumption during pregnancy by the mother

- Down syndrome and other conditions of the fetus that can hamper growth

- Exposure to pesticides by either or both parents

- Family history of problems of genital development, including cryptorchidism - a baby boy whose older brother was born with an undescended testicle(s) is twice as likely to be born with the same condition, compared to babies whose older brother was not born with the condition.

- Tobacco smoking by the mother during pregnancyType 1 diabetes, type 2 diabetes, or gestational diabetes in the mother - a mother with diabetes is twice as likely to give birth to a boy with an undescended testicle(s), compared to mothers without diabetes.
CAUSES OF CRYPTORCHIDISM (undescended testicle)

Early on in the pregnancy all embryos have identical genitals, regardless of sex. The baby receives a pair of sex chromosomes from its mother and father.

Sex chromosomes are a pair of DNA molecules - XX if the human is female, XY if the human is male. At a certain stage in the unborn male baby's development the testicles start to form; once they are formed they stay inside the baby's abdomen until about the 7th month of pregnancy.

Experts believe that at this point some hormones trigger the descent of the testes - they make their way down the abdomen, through the inguinal canal, and into the scrotum. In about 97% of cases the testicles are in the scrotum before birth.

During the 9th week of pregnancy, the male baby will start producingtestosterone.

Testosterone is a hormone which triggers the development of male genitals. The production of testosterone is triggered by the male sexual chromosomes XY.

Experts believe that the problems linked to absent or atrophic testicles arise at this stage. Abnormal genital development may also be caused by androgen insensitivity syndrome (androgen resistance syndrome). This is a genetic disorder in which XY fetuses are unresponsive (insensitive) to male hormones (androgens, such as testosterone).

The baby is born looking like a normal girl externally. They have a short-blind pouch vagina, but no uterus, ovaries or fallopian tubes. Testes are present in the abdomen or the inguinal canal. Experts say that in the majority of cryptorchidism cases, a combination of genetics, maternal health and some environmental factors disrupt the hormones, physical changes and nerve activity that bring about the development of the testicles. However, nobody knows what the exact cause is.

- Testicular dysgenesis syndrome (TDS)

- this describes four conditions which have become more prevalent in Western countries over the last thirty years; they include:

* Decreased spermatogenesis (low sperm count)

* Testicular cancers
* Hyposdadias - the tube in the penis through which urine passes (urethra) is not in the right place

* Cryptorchidism (undescended testicle).

Some scientists suggest that these four conditions are linked (not separate conditions); i.e. they form part of one syndrome (testicular dysgenesis syndrome).Nobody is sure whether testicular dysgenesis syndrome exists. If it does, scientists believe chemical exposure during pregnancy may undermine normal hormonal balance, which interferes with the proper development of male genitals.

Chemicals that disrupt hormonal balance are called endocrine disruptors, and include some pesticides, PCBs (polychlorinated biphenyls), and dibutyl phthalate.