There are many couples that can’t achieve pregnancy, after one year of having sexual relationships without protection. It’s in this moment when they must turn to an expert in fertility.
Approximately in 30% of the cases it’s due to a male infertility problem and in 25% of the cases it’s due to a combined cause, which means that, with more than half of the cases of couples with sterility, the man has something to do. Firstly, an interview is carried out and a fertility study is performed to both of them. In the case of the man, a sperm analysis is done, his seminal sample is observed to diagnose and point out the right treatment.
Once the male infertility has been diagnosed, the specialist must approach it as any other alteration or anomaly. Firstly, a questionnaire must be answered to find out as much as possible; then a medical examination and lastly the analysis and lab studies must be carried out.
Function of the testicles
The main testicular function is the production of spermatozoa, process that takes place inside the seminiferous tubules and is named spermatogenesis.
There are several kinds of cells inside the testicles and every one has a specific function in spermatogenesis:
- Spermatozoa: it’s the male gamete, i.e. has the half of the genetic material, and the formation of the embryo will take place from its union with the egg. The spermatozoa appear as a result of spermatogenesis.
- Sertoli cells: they are nurse cells that cover the seminiferous tubules and that are in charge of spermatogenesis.
- Leyding cells: they are in charge of the synthesis of the androgenic hormones. In men there are several hormones, such as the luteinizing hormone (LH), testosterone and FSH, which are in charge of the production of the spermatozoa, i.e. the spermatogenesis.
The types of male infertility are classified depending on where the problem is found:
- Pre-testicular origin: hormonal alterations in the axis hypothalamus-pituitary gland-testicles.
- Testicular origin: alterations in the testicles.
- Post-testicular origin: alterations in the sperm or seminiferous tubules.
Sertoli cell-only syndrome
In this alteration, no spermatozoa are found within the seminiferous tubules, there are only Sertoli cells, which means the man is sterile. This illness is also named germ cell aplasia.
Males with this alteration can’t have children, since without spermatozoa no assisted reproduction technique can be performed. They must turn to sperm donation. Sertoli cell-only syndrome produces permanent and irreversible sterility.
There aren’t any other symptoms related to this syndrome, the Leydig cells function with normality and there are average levels of LH and testosterone. Nevertheless, in some cases the FSH levels may be higher than the common ones.