Male Infertility Factors 1.

Pretesticular Causes Endocrine problem like diabetes and thyroid disorder Hypothalamic disorder Cushing Syndrome Hyperprolactinemia Hypopituitarycele Drug and alcohol 2. Testicular Causes Genetic defects of white chromosome White chromosome micro deletion Abnormal set of chromosomes Neoplasm such as semiloma Idiopathic failure Varicocele Trauma Hydrocele Mumps leading to orchitis Testicular dysgenesis syndrome 3. Post-testicular Causes Vasdeferens obstruction Infection Prostatitis Ejaculation/retrograde Hypospadia Impotence Acrosomal defect or egg penetration defect Low sperm count in men Diagnostic Test 1. Paternal Test a. Comprehensive installing physical exam b. Semen analysis (20million/cm) Progressive sperm motility more than 50% Ejaculation volume of more than 2ml

Poor Prognosis Motility less than 50% Ejaculation less than 2ml 2. Maternal Test a. Sims Huchner Test It is a post-coital test commonly 2 hours after the last and the woman will remain in supine position for 15 mins. Normal strength is 8-10cm with 50-20 million sperm if less than, low sperm count. Check problem with secretion Unreliable b. Endometrial biopsy c. Hormonal testing d. Thyroid testing e. Laparoscopy f. Measurement of the progesterone in the 2nd half of pregnancy g. Pap smear h. Pelvic exam i. Special X-ray test Management For Fertility Medications 1. Clomid (Clomiphene Citrate) Action: a. Use external only, spermatogenesis in case of low sperm count. b. Stimulate ripening and release ova from the ovary Management of Unovulation Due to hyperprolactinemia

1. Parlodel (Bromocriptine Mesylate) Action: Anti-hyperprolactinemia, use clomid Side Effects: Multiple pregnancies 2. Restoration Tubal Patency (Tuboplasty)

Medical Management 1. 2. 3. 4. Hysterosalpingonacele Artificial insemination Invitro fertilization Alternative and complementary treatment Acupuncture Diet and supplement Healthy Lifestyle