Genetic disorders leading to infertility in humans.

Most of the famous mutations lead to the absence or delay of puberty and, as a result, to infertility. However, people who belong to the doctor about infertility sexual development fine. The survey on the majority of mutations leading to infertility, the practical meaning now does not have. However, some cases deserve special mention because they are often found in everyday practice.

Bilateral seed applaus

Bilateral Aplasia of seed-winning ducts is available in 1-2% fruitless men. According to most data, in 75% of cases, the mutations are detected by the CF gene, leading to the fibrosis. The main risk in such cases is the possibility of the birth of a child with cystic fibrosis. It is necessary to examine the presence of mutations of both partners, after which it is necessary to conduct appropriate counseling. If both partners are carriers of the fibrosis, its risk in a child reaches 25% (depending on the nature of the mutation). Even if the man found only one mutation, leading to the fibrosis, and a woman is not a carrier, it is better to be restrained and send a couple for consultation to genetics. Approximately 20% of cases, a bilateral aplasia of the seed-handed ducts is accompanied by the deposit of the kidney development, and in one study, such patients did not identify mutations leading to the fibrosis (although the number of analyzed mutations was small).

It should be emphasized that the purpose of the mass examination is to identify the fibrosis, and not aplasia. The combination of mutations leading to aplasia of the seed-handing ducts is diverse and complex, which makes it difficult to counseling with the disease. In the first studies dedicated to the genetics of the bilateral aplasia of seed-handed ducts, there was not a single participant, homozygous by AF508 mutation, the most frequent from mutations in the CF gene, which, in the classical form of fibrosis, occurs in 60-70% of cases. Approximately 20% of patients are at once two mutations in the CF gene are characteristic of cystic fibrosis - in many cases it is a mismotation (a combination of two alleles causing light shape Mukobovidoza, or one allele, causing a light shape of the disease, and one is heavy). Also, polymorphism was found in the intron 8, in which the number of thimins in different alleles is 5, 7 or 9. If there is an allele 5t, the exon 9t is passed during transcription, and the mRNA, and in the future, the protein is shortened. The most common genotype with a bilateral aplasia of seed-handing ducts (about 30% of cases) is a combination of an allele that carrying a mutation that causes fibrosis, and allele 5t.

The R117H mutation is included in the mass examination, since its combination with other, heavier mutations in the CF gene may cause fibrosis. When the R117H mutation is detected, a derivative test for the presence of polymorphism 5t / 7t / 9t is carried out. When the allele 5t is detected, it is necessary to install whether it is on the same chromosome with R117H (i.e. in the cis-position) or another (in the trans position). Allel 5t in the "C-position relative to R117N causes fibrousosis, and if a woman is also a carrier of one of the alleles, causing diseaseThe risk of fibrosis in the child is 25%. The complexity of the genetics of the fibrosis becomes obvious, if you look at the diversity of phenotypes in homozygoths by allele 5t. The presence of allele 5t reduces the stability of mRNA, and it is known that in patients who have the level of unchanged MRNA is 1-3% of the norm, fibrosis develops in classical form. At the level of unchanged mRNA, which makes up more than 8-12% of the norm, the disease does not appear, and at intermediate levels are possible different variants, from the complete lack of manifestations of the disease to a bilateral aplasia of seven-way ducts and light shape Fibergation. It should also be noted that the aplasia of seed-handing ducts in light cases is also one-sided. Among the population as a whole, Allel 5T occurs with a frequency of about 5%, with a one-sided aplasia of seed-handing ducts - with a frequency of 25%, and with a bilateral aplasia - with a frequency of 40%.

The American College of Medical Genetics and the American College of Obstetricians and Gynecologists recommend to identify only 25 mutations, the prevalence of which among the US population is at least 0.1%, and the analysis of Polymorphism 5T / 7T / 9T is carried out only as a derivative test. However, in practice, many laboratories can reduce costs, including this analysis to the basic program, which, as shown above, can lead to colossal difficulties in interpretation of the results. It should be remembered that the purpose of the mass examination is to identify the fibrosis.

Genes regulating spermatogenesis

The genes that are presumably responsible for spermatogenesis are mapped on the Y-XPoosmos in the AZF area located in the Locus YQ11 (SR gene is located on the short shoulder Y-chromosome). In the direction of the centromer to the distal shoulder, sequentially sequentially, Azfa, AZFB and AZFC sections are located. The AZFA section contains USP9Y and DBY genes, on the AZFB section, the RBMY gene complex, and in the area / 4Z / C - the DAZ gene.

A part of the genes involved in the regulation of spermatogenesis is presented in the genome several copies. Apparently, in the genome there are 4-6 copies of the DAZ gene and 20-50 genes or pseudogenes of the RBMY family. DBY and USP9Y are presented in a single copy genome. because of big number Repeating sequences and differences in research design analysis of the areas of Y-chromosomes controlling spermatogenesis are conjugate with considerable difficulties. For example, detection of deletions in the field of AZF was carried out mostly by analyzing DNA labeling sites, short DNA sequences with known chromosomal localization. The more they are analyzed, the higher the probability to detect deletions. In general, a deletion in the field of AZF is found in fruitless men, but there are cases of their discovery and in healthy.

Proof of the fact that the AZF region contains genes regulating spermatogenesis, served as an intragenic deletion in the USP9Y gene, which is also called DFFRY (since the appropriate FAF genome in Drosophila is homologous). A fruitless man was discovered to deleting four pairs of grounds, which was not from his healthy brother. These observations are associated with in vitro analysis data made it possible to assume that the mutation in the USP9Y gene disrupts spermatogenesis. With a re-analyzing of previously published data, the researchers revealed another single deletion in the USP9Y gene, disturbing spermatogenesis.

An overview of the survey data of nearly 5,000 fruitless men on mutations in the Y-chromosome showed that in about 8.2% of cases (compared with 0.4% in healthy) there are deletions in one or several sections of the AZF region. In some studies, the indicators ranged from 1 to 35%. According to the reference, most often there are deletions in the AZFC site (60%), then in AZFB (16%) and AZFA (5%). The remaining cases are a combination of deletions in several sites (most often including deletions in AZFC). Most mutations were found in men with azoospermia (84%) or severe oligozoospermia (14%), defined as spermatozoa content of less than 5 million / ml. Interpretation of data on delegation in the field of AZF is extremely complex, since:

1. they are found in both fruitless and healthy men;
2. the presence of DAZ and RBMY clusters containing several copies of genes makes it difficult;
3. in different studies, various sperm parameters were studied;
4. the set of continigory cards Y-chromosomes due to the presence of repeated sequences was not complete;
5. it was not enough data on healthy men.

In a double-blind study, 138 men from couples who applied to a doctor for ECO, 100 healthy men and 107 young Danish servicemen were identified levels of sex hormones, sperm parameters and an analysis of the AZF region was carried out. 21 DNA labeling site was used to study the AZF region; With normal sperm parameters and in all cases where the number of spermatozoids exceeded 1 million / ml, the deletions were found. In 17% of cases of idiopathic azoospermia or cryptozoospermia and in 7% of cases, with other types of azoospermia and cryptozoospermia, deletions were identified in the AZFC site. It is interesting to note that neither one of the research participants has not been deleted in the AZFA and AZFB sites. It makes it assume that the genes located in the AZFC site are most important for spermatogenesis. Later a larger study was conducted, which gave similar results.

When detecting deletions in the Y-chromosome, it should be discussed with both future parents. The main risk for the offspring is that sons may inherit this deletion from the Father and will be fruitless - such cases are described. On the effectiveness of the ECO and the frequency of pregnancy, these deletions seem to do not affect.

Lickening X-chromosome syndrome in women with premature ovarian failure

In sporadic cases of premature deficiency of ovaries, about 2-3% of women detect the presence of premutation in the FMR1 gene, which is responsible for the occurrence of the cross-chromosome syndrome; In women with hereditary premature ovarian failure, the frequency of this promotion reaches 12-15%. The fragile area in the XQ28 locus can be revealed during karyotyping of cells grown in deficiency conditions folic acidHowever, DNA analysis is usually carried out. Syndrome is broken X-chromosome refers to diseases that are caused by an increase in the number of trinucleotide repetitions: Normally, the FMR1 gene contains less than 50 repetitions of the CHG sequence, their number is 50-200, and in men with a short-chromosome syndrome (more than 200 Full mutation). The syndrome of the brittle X-chromosome is characterized by a X-clutch dominant type of inheritance with incomplete penetrance.

It is important to identify carriers of promotion, since they can be other family members: they have the birth of sons with the syndrome of the brittle X-chromosome, which manifests itself mental retardation, characteristic features Persons and macroorphism.

Secondary hypogonadism and squid syndrome in men

For men with squid syndrome, anosmia and secondary hypogonadism are characterized; The defects of the middle line are also possible, one-sided kidney anesthesia and neurological violations - Sinknesia, eye-minded and cerebellar disorders. Salchean syndrome is characterized by a X-lucked recessive type of inheritance and caused by mutations in the Kali gene; It is assumed that the squid syndrome caused 10-15% of cases of the isolated shortage of gonadotropic hormones in men with an alimony. The outosomalic shape of the squid syndrome, which causes mutations in the FGFR1 gene is found. With an isolated shortage of gonadotropic hormones without anosmia, the mutations in the GNRHR gene (Gonadoliberin receptor gene) are most often found. However, they account for only 5-10% of all cases.

Before the population of many developed countries, the problem of male and female infertion. In 15% of married couples of our country there is a violation of the reproductive function. Some statistical calculations say that the percentage of such families is even more. In 60% of cases, the reason for this is a female infertility, and in 40% of cases - male.

Causes of disorders of men's reproductive function

Secretor (parenchymal) violation, in which the sematozoa products are broken in the seed tubules, which is manifested in Aspermia (there are no sperm cells, as well as directly spermatozoa), azoospermia (there is no spermatozoa, but there are sperm cells), oligozoosperm (changed the structure and mobility of spermatozoa).

1. Egg function disorders.
2. Hormonal violation. Hypogonadotropic hypogonadism is a shortage of pituitary hormones, namely luteinizing and follicle-sufficient, participating in the formation of sperm and testosterone.
3. An autoimmune violation. Own immune cells produce antibodies to spermatozoa, thereby destroying them.

Excretory violation.Violation of the patency (obstruction, obturation) of the seven-way path, as a result of which the output of the composite elements of sperm in the urethra canal through the genital paths. It may be permanent or temporary, single and bilateral. The sperm includes spermatozoa, secret prostatic gland And the secret of seed bubbles.

Mixed violation.Excretory-inflammatory or excretory toxic. Due to indirect damage to the toxins of spermatogenic epithelium, disorders of metabolism and the synthesis of sex hormones, as well as the immediate affecting effect of bacterial toxins and sperm, leading to the deterioration of its biochemical characteristics.

Other reasons:

• Sexy. Erectile dysfunction, violations of ejaculation.
• Psychological. Anxyaculation (no sperm emission).
• Neurological (consequence of damage spinal cord).

Causes of violations of the female reproductive function

• Hormonal
• Tumors of eggs (cystoms)
• The consequences of inflammatory processes in a small pelvis. These include adhesions form, pipe-peritoneal factor or, in other words, obstruction uterine pipes.
• Endometriosis
• Tumors of uterus (moma)

Treatment of female infertility

According to the results of the tests, the doctor appoints certain methods of treating infertility. Usually the basic forces are directed to proper diagnosis reasons for infertility.

In the case of endocrine pathology, treatment is normalization. hormonal background, as well as in the use of stimulating the ovaries of drugs.

In case of obstruction of the pipes include larposcopy into treatment.

Endometriosis is also treated by Lavoroscopy.

Defects for the development of uterus are eliminated using the possibilities of reconstructive surgery.

Immunological cause of infertility eliminate artificial fertilization sperm husband.

Most difficult to carry out infertility treatment, if the reasons cannot be accurately determined. As a rule, in this embodiment, eco-artificial fertilization technologies are used.

Treatment male infertion

If a man has infertility, which is a secretory character, that is, having a bond with a spermatogenesis impaired, the beginning of treatment is to eliminate the reasons. Treble infectious diseases, eliminate inflammatory processesApplied hormonal agents To bring spermatogenesis to normal.

If a man has diseases such as grocery hernia, cryptorchism, varicocele and others are assigned surgery. Operational intervention is also shown in cases where the man's infertility is due to the obstruction of the seven-way paths. The greatest difficulty causes the treatment of male infertility in the case of the effects of autoimmune factors, when the mobility of spermatozoa is impaired, antispermal bodies affect. In this option assign hormonal drugsUsed laser therapy, as well as plasmferres and other.

Violations and their reasons for the alphabet:

violation of reproductive function -

Violation of reproductive function (infertility) - the inability of the married couple to conceive with regular sexual intercourse without protection within 1 year (WHO).

In 75-80% of cases, pregnancy occurs during the first 3 months of regular sexual life of young, healthy spouses, that is, when the age of a husband is up to 30, and wives are up to 20 years. In older age group (30-35 years) This term increases to 1 year, and after 35 years - more than 1 year.

Approximately 35-40% of fruitless pairs caused him a man, in 50% - a woman and 15-20% there is a mixed factor of violation of the reproductive function.

Under what diseases there is a violation of the reproductive function:

Causes of violation of reproductive functions in men

I. Parenchimato (secretory) violation of the reproductive function - a violation of spermatogenesis (spermatozoa products in the convolve seminal tubes of testicles), which manifests itself in the form of aspermia (absence in ejaculate sperm cells and spermatozoa), azoospermia (absence in spermatozoa ejaculate when detecting spermatogenesis cells), oligosoospermia , reduction of mobility, disruption of the structure of spermatozoa:

1. Disorders of the Egg function:
- Cryptorchism, Mongorhism and Egg Hypoplasia
- Orchitis (viral etiology)
- twisted eggs
- Primary and secondary congenital hypogonadism
- increased temperature - Violation of thermoregulation in the scrotum (varicocele, hydrocele, tight clothing)
- syndrome "only-cell-sulfoli"
- diabetes
- excessive physical tension, psychological stress, heavy chronic diseases, vibration, body overheating (work in hot shops, sauna abuse, fever), hypoxia, hypodynamia
- endogenous and exogenous toxic substances (nicotine, alcohol, drugs, chemotherapy, virtuality)
- radiation therapy
- Mutations: Mutation of the Music Geno (congenital absence of seeding ducts - obstructive azoospermia, is determined by polymerase chain reaction; micride y chromosome (violations of spermatogenesis of various degrees of gravity of the karyotype disorders - structural chromosomal abberats - Kleinfelter syndrome, Hyy syndrome, chromosomal translocations, autosomal aneuplodia) - Fluorescent hybridization method (Fish) using probes labeled with fluoroches to various chromosomes

2. Hormonal (endocrine) impairment of the reproductive function - hypogonadotropic hypogonadism - a lack of luteinizing (LH) and follicle-suite (FSH) pituitary hormones that play a role in the formation of testosterone and spermatozoa:
- Pathology of the region of the hypothalamus
o isolated gonadotropin deficiency (squid syndrome)
o Isolated Luteinizing Hormone Deficiency (Fermal Enun)
o Isolated FSG deficiency
o congenital hypogonadotropic syndrome
- Pathology of pituitary gland
o pituitary insufficiency (tumors, infiltrative processes, operations, irradiation)
o hyperprolactinemia
o hemochromatosis
o The influence of exogenous hormones (excess estrogen and androgens, excess glucocorticoids, hyper- and hypothyroidism)

3. Autoimmune processes - the destruction of sperm with their own immune cells, the production of antibodies to spermatozoa
O. parotitis - "Pig"
o Eagic injury
o Cryptorchism (testicular mind)
o operations on the bodies of the scrotum
o Passive homosexuals

II. Obstructive (excretory) violation of the reproductive function is due, as a rule, with a bilateral, temporary or constant disorder (OBTUMATION, obstruction) of a seven-way tract and a violation of the output of composite sperm elements (spermatozoa, the secret of the prostate gland, secrets of seminal bubbles) through the genital in the urethra :
- congenital underdevelopment or absence of a seed-handed duct, violation of its passability, lack of communication by the tube of an appendage of seed-eyed duct and seed-milling duct
- Muller's cysts of the prostate gland
- Inflammatory process in the genital organs, complicated by obliteration of seven-way paths - chronic epididimitis, Deferventit, spermotocele
Retrograd ejaculation - aspermatism (lack of ejaculate with sexual interchange) with innate or edged changes in the urethra at the level of seed tuberculk, stricture of his webbed part ureyeing Canal, damage to nerve centers regulating ejaculation.
- injuries of the genital organs, including during operational interventions (for example, with hangeal),
- The consequences of the vase project

III. Mixed violation of the reproductive function (excretory-toxic, or excretory-inflammatory) result of mediated toxic damage to the spermatogenic epithelium, violation of the synthesis and metabolism of sex hormones and a direct damaging effect of pus and bacterial toxins on spermatozoa biochemical sperm characteristics:
- spermatozoa vulnerability for immune system Due to the violation of ripening, enveloping protein protection in the appendages of ovaries (epididimitis)
- change in the composition of the proportion of the prostate gland, seed bubbles (prostatitis, vesiculitis), STI
- Others inflammatory diseases Male sexual system (urethritis)

IV. Other reasons for violation of reproductive function
- sexual problems - erectile dysfunction, ejaculation disorders
- aneeaculation, aspermy - psychological, neurological (spinal cord damage)

V. idiopathic impaired reproductive function
The reason cannot be established.

Causes of violation of reproductive function in women
- inflammatory processes and their consequences ( safety process In the small pelvis and obstruction of the uterine pipes - "Pipe-peritoneal factor)
- endometriosis
- hormonal disorders
- Tumors of the uterus (Moma)
- Ovarian tumors (cystoms)

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A comprehensive study that allows you to determine the leading genetic causes of male infertility and choose the appropriate patient's tactics.

The study includes the most frequent genetic causes of male infertility: detecting deletions in the field of locus AZF.affecting spermatogenesis, determining the amount of Cag repetitions in the gene ARassociated with changes in androgen and search for mutations in the gene CFTr.responsible for the development of the disease, the clinical manifestation of which is obstructive azoospermia.

What kind of biomaterial can be used for research?

Boncal (peek) epithelium, venous blood.

How to prepare for research?

Preparation is not required.

General research information

Male infertility (MB) is a serious pathological conditionrequiring comprehensive comprehensive diagnosis, emergency correction, and in some cases and prevention.

Infertility suffers 15-20% of the pairs of reproductive age. In half cases, it is associated with the "male factor", manifesting deviations in the ejaculate parameters.

The complexity of the diagnosis of MB is large quantities The reasons for its causing. These include anomalies gOOD SYSTEM, tumors, urinary tract infections, endocrine disorders, immunological factors, genetic mutations, etc. Unlike the above reasons, genetic does not always have clinical manifestationsHowever, it is extremely important for the diagnosis of MB from the surveyed.

It is important to understand that the diagnosis of "MB" and its forms can put only specialist doctor based on animal data, inspection data, instrumental results and laboratory studies. The reason for appeal to the doctor may be the following reasons:

• the impossibility of conceiving a child during the year, subject to the absence of signs of female infertility in a partner;
• disorders of erectile and ejaculatory functions;
• related diseases of the urogenital sphere (inflammatory, tumor, autoimmune, congenital, etc.);
• reception of hormonal and cytostatic drugs;
• discomfort in the urogenital region.

Frequent causes of male infertility are violations of the structure and quantity of spermatozoa, affecting their mobility and the ability to fertilize.

The main genetic causes of the development of the MB are:

1) deletion (removal of genetic fragments) locus AZF;

2) polymorphism (increasing repetition of the genetic fragment - Cag) gene AR;

3) M.yatthey (sequence violation) gene CFTr. .

Currently, these markers are an integral part of the standard criteria for comprehensive diagnostics Genetic manifestations of MB, meeting in a group of patients in 10-15% of cases.

Locus deletions AZF and Sry gene

An important role in the development of such pathologies such as oligozoospermia and azoospermia is played by deviations in the specific area of \u200b\u200bY-chromosome - AZF-locus (azoospermia factor). Incoming B. it Determine the normal course of spermatogenesis, and in violation of the genetic structure AZF.-Locus The formation of male genital cells can seriously break.

AZF-locus is in the long shoulder Y-chromosome (Q11). Genes located in this locus play an important role in the spermatogenesis process.

The Y-chromosome microdeption is the fallback of certain areas, it is found on average in 10-15% of cases of azoospermia and in 5-10% of cases of oligozoospermium of severe and determine spermatogenesis and infertility in men.

Locus AZF. divided into 3 sections: Azfa, Azfb. and AZF.c. In each of them, genes involved in the control of spermatogenesis are identified. Deletions in the AZF locus can be full. entirely removing one of AZF.-roregions or more and particularWhen they do not completely capture any of its three regions.

With complete AZF.- Operations are traced quite clear dependence of the degree of spermatogenesis of the size and localization of deletions, which may have prognostic value in obtaining spermatozoa suitable for embarofer fertilization programs.

• Lack of just Lokusa AZF.as well as deletions, entirely exciting regions Azfa. and / or Azfb., indicate the impossibility of obtaining spermatozoa.
• Almost all patients with deletions Azfb. or AZFB + C. Azoospermia is noted due to severe spermatogenesis (SERTOL cell syndrome ").
• With complete delegations of the region AZFC. Manifestations vary from azoospermia to oligozoospermia. On average, 50-70% of patients with deletion, entirely exciting AZF.c-region, it is possible to obtain spermatozoa suitable for artificial fertilization.
• With partial AZF.c-deletions of manifestations vary from azoospermia to noduleospermia.

Study of the state AZF-locus y-chromosome in patients with azoospermia and oligozoospermium of severe allows genetic cause spermatogenesis violations differential diagnosis infertility in men and adjust treatment, check the possibility of obtaining sperm at a testicular biopsy and the possibility of obtaining sperm for Ixi (intracitoplasmic spermatozooid injection).

It should be borne in mind that in case of successful use of auxiliary reproductive technologies, the deletion of the Y-chromosome is transmitted by the male line. This shows the need dispensary observation For boys born after the use of Ixi in fathers with micride in Y-chromosome, to assess their fertile status.

Indications for screening AZF.- Operations are based on the amount of sperm and include azoospermia and severe oligozoospermia (

In genetic monitoring of development on male type, the gene is especially important Sry. (SEX-DETERMINING REGION Y). It is in it that the largest number of mutations associated with the dysgenesis of gonad and / or inversion inversion were found. In the absence of a section of chromosome containing gene Sry.The phenotype will be female with a male karyotype 46h.

This genetic study includes analysis AZF.-Locus chromosome - 13 clinically significant deletions: SY86, SY84, SY615, SYA1197, SY134, SY142, SY1197, SY254, SY255, SY1291, SY1125, SY1206, SY225, as well as a definition of gene deletion Sry..

AR androgen receptor gene

Another determinant factor of male infertility is a violation of the hormonal regulation of spermatogenesis, a key role in which the men's sex hormones play androgens play. They interact with specific androgen receptors, determining the development of male genital signs and activating spermatogenesis. Receptors are contained in the cells of the seeds, prostate, skin, cells nervous system and other fabrics. The androgen receptor gene is characterized by the presence of a sequence of CAG repeats (cytosine-adenin-guanine), the number of which can vary significantly (from 8 to 25). The Cag triplet encodes the glutamine amino acid, and when the amount of Cag repetitions changes, the nucleotide is changed, respectively, the amount of glutamine amino acid in protein. From the number of repetitions in the gene AR The sensitivity of the receptor K is dependent, and the connection is inversely proportional: the more repetitions, the receptor is less sensitive. An increase in the amount of Cag repetitions in receptors reduces their activity, they become less sensitive to testosterone, which can lead to a spermatogenesis impaired, increases the risk of oligozoospermia and azoospermia. There are also data that with a reduced amount of Cag repetitions (AR has increased sensitivity to androgens and increases the risk of men. The increase in the number of Cag repetitions up to 38-62 leads to spinobulbar muscle atrophy, the type of Kennedy.

The result of the test makes it possible to assess the activity of spermatogenesis and take appropriate measures to compensate for pathology if necessary.

Men's infertility when cystic

Luteinizing hormone (LH)

Follicle-stimulating hormone (FSH)

Prosthatspecific Antigen General (PSA General)

Study karyotype

Important comments

Throughout life, these genetic markers do not change, the study is carried out once.

Literature

1. Naina Kumar And Amit Kant Singh Trends Of Male Factor Infertility, An Important Cause of Infertility: A Review Of Literature J Hum Reprod Sci. 2015 Oct-Dec; 8 (4): 191-196.

What can be more a pleasant eventthan happy marriage? Logically, the majority comes to answer. It is only best to become happy parents. Most often, every married couple is sooner or later think about such an important steplike the birth of a child. However, to great unfortunately, not everyone turns out to be made conceived from the first attempt, and in 15% of the pairs, such efforts are doomed to failure. What could cause such a situation?

Faced with a similar problem, do not panic. If the desire to start a child has not been implemented within 2-7 months - it is not scary. Need to calm down and do not bike on it. The reasons for not the occurrence of pregnancy many: from simple psychological factor Before developing serious problems.

These issues include:

infertility of men;

infertility of women;

immunological incompatibility (Allergy in a woman on the components of men's sperm) - At the same time, none of the spouses suffers from pathologies capable of provoking infertility, but the general children cannot appear at such a pair;

psychological aspects.

However, if a completely healthy woman has a regular sexual contact without the use of contraceptive means during the year, pregnancy does not occur, then it's time to think about what the case can be in a man. About such a situation is worth talking more - what is it? How to diagnose? How to treat?

Men's infertility - despite regular sex contacts - the inability of the sperm of men fertilize women's eggs. Ideally, in a spermogram of a healthy man in 1 ml of sperm should be contained about 20 million spermatozoa, which are rapidly moving forward and are capable of fertilization. Also about 50% of spermatozoa must have the right structure.

Causes

Reasons that can provoke infertility in men may be:

complication after steaming;

inflammation of the organs of the urinary sector;

diabetes mellitus (violations of ejaculation);

small quantity and sluggish activity of sperm in sperm (also not excluded and the complete absence of "headastrics");

psychological infertility (when a man at the subconscious level is subject to fear before the future responsibility, which will arise with the birth of a baby or with other obsessive concerns and arguments);

immunological infertility (the formation of antibodies that interfere with spermatozoa normally perform functions on them).

Well, the simplest and most common reason that comes to mind last, is the presence harmful habits. Smoking, alcohol abuse also addicted to the man's body as a whole and on the reproductive function in particular.

Diagnostics

Male infertility is divided into:

primary - in which a man could not fertilize any representative of the opposite sex;

secondary - when, at least one woman got pregnant from a particular man.

Reveal this pathology A manologist-andrologist and endocrinologist-andrologist will help to determine the cause of such a condition. The start of research is to pass the analysis of sperm. A similar analysis is called spermogram. It determines the activity and viability of spermatozoa, in addition, an assessment of other pathological changes is made.

Also doctors can advise other studies to determine accurate reason or pathology:

Prostate ultrasound;

hormone analysis;

diagnosis of immune infertility - mar-test;

bacteriological sowing on the identification of infectious pathologies of the urogenital sphere.

Depending on the results of the analyzes, the specialist will prescribe treatment. Therapy is divided into three methods that will be disassembled below.

Treatment methods

Conservative therapy

Is to use medicinal preparations In the presence of genital infections various origin. Also, a similar type of treatment is also prescribed in the presence of infertility against the background of hormonal failure.

Surgery

Prescribed in the presence of an anomalies of the urethra, if there is inguinal gryzh and other anatomical deviations that cannot be corrected without surgery.

Alternative therapy

This method is resorted to the presence of serious disorders of the reproductive function in a strong floor. It lies in the artificial introduction of spermatozoa in the genital path of the woman to achieve fertilization.

The treatment of infertility should be complex and adequate. In addition, presented strong sexes (not only in diagnosis, but also when planning pregnancy) should revise their own rhythm of life and resolve it if necessary. It is worth abandoning bad habits, start well eat and not forget about a full-fledged vacation. The solution of intimacy problems in men can be achieved by using phytopreparations for the treatment and prevention of pathologies of the men's sexual system. Quite often after the normalization of your own power and recreation and rest simple rules Reproductive function is normalized without additional interventions.