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Undescended testes are a tragic cause of male infertility, since often it is preventable. Some babies are born with one or both testicles
Dr. Malpani will be happy to provide you answers to your queries onlineConsult Now
Undescended testes are a tragic cause of male infertility, since often it is preventable. Some babies are born with one or both testicles up in their bellies instead of hanging down in the scrotum. Sometimes the condition might correct itself by the time the toddler is around 2 years old. (Don't worry unduly if you find the testes "disappearing occasionally " from the scrotum of a young boy. These are called "retractile " testes, and are very common.) However, if left unattended, the undescended testes tend to get damaged by the heat in the abdominal cavity ; and they can even because cancerous in adult life. The child should be operated before two years of age or else fertility can be lost forever. Treatment with hormonal injections (HCG injections) to cause testicular descent is another alternative.
If one of the testicles has undergone torsion, (the doctor's word for twisting), it could be damaged since it is starved of blood.
Signs of torsion are an excruciating pain and swelling of the testicle. Sadly, it is often misdiagnosed as a testes infection, and left untreated. This causes the testis on that side to shrivel up and die (atrophy). The best way to make the diagnosis of torsion is with a Doppler ultrasound ; and emergency surgery is needed right away, to untwist and fix the testis. The other testis must also always be fixed surgically to prevent it from undergoing torsion. Unfortunately, often, sperm antibodies are produced which decrease sperm production in the other testis.
The commonest reason for azoospermia in India used to be smallpox - the virus attacks and damages the epididymis, causing ductal obstruction. Tuberculosis also damages the epididymis, causing azoospermia. However, making a specific diagnosis of tuberculous epididymitis can be very difficult, because it is often a silent and indolent disease. Gonorrhea, chlamydia, syphilis and other STDs can also play havoc with the male genital tract; causing irreparable damage to its epithelium (internal lining).
Mumps can also cause orchitis (inflammation of the testis) - especially when it affects young men. This can cause severe damage to the testes, resulting in testicular failure.
What about other genital tract infections? Many doctors will do a semen culture, to look for a treatable cause of infertility, if the semen sample shows many pus cells. If the test is positive treatment with antibiotics is instituted. Male reproductive tract infections (such as prostatitis) are often chronic, and may require many weeks of antibiotic treatment. It is therefore important to recheck the semen culture after therapy, to ensure that treatment has been adequate. However, the relation between the presence of bacteria in the semen and male infertility is still unclear. Do the bacteria really cause the infertility? Does treating the infection help to improve fertility? More questions than answers, once again!
Some medications can play havoc with the sperm count or with the sex drive. These include :
A rare problem is that of anti cancer drugs and radiation therapy - used to treat young men with Hodgkin's disease, lymphoma, leukemia and testicular tumours. In these men, the chemotherapy and radiation therapy used to treat the disease also wipes out sperm production, rendering them sterile. An option available today is to store the sperms (sperm banking) which can later be used for inseminating the wife to achieve a pregnancy.
The testicles are in the scrotum because they can't make sperm at body temperature - they need a cooler environment, so they hang outside the body where the temperature is 0.8 degrees centigrade cooler. Tightly encased groins because of jock straps, tight jeans, lungottis, and nylon briefs cause the testicles to be pressed back into the warmth of the body, especially when combined with hot tub baths and saunas. Working in 