Modern treatments for male infertility and the safe application of contraceptive technologies

For men, infertility treatment often begins with tests of sperm count and motility. A low sperm count is relative, as many men with borderline sperm counts and quality can still father children. On average, there are 20 million sperm per milliliter of semen (a normal ejaculation contains 3-5 milliliters). Another commonly recommended test is the postcoital test to determine if the woman's vaginal mucosa is compatible with sperm. Sometimes this incompatibility is easily corrected. Experts may also recommend tests to determine the sperm's ability to penetrate hamster egg cells, as well as some hormonal examinations. In women, it's often necessary to determine if ovulation is normal, if there are any malformations or blockages in the uterus or fallopian tubes, and if the endometrium is suitable for implantation of a fertilized egg. Once the cause of infertility is identified, many cases are treatable. Male infertility caused by varicocele can be treated by surgically removing the varicose veins and correcting the resulting high testicular temperature, thus improving sperm quality in about half of these patients. Recently, the FDA (Food and Drug Administration) approved the production of a cooling device similar to an athlete's groin protector to treat overheated testicles. This device must be used continuously for four months during the day to lower the testicular temperature by 3 degrees Celsius. While the device is not known to cause significant discomfort, many experts believe its effectiveness is still uncertain. A promising new therapy utilizes luteinizing hormone-releasing hormone (LHRH). This hormone is produced in the brain and acts on the pituitary gland, regulating the activity of the reproductive organs. Low doses of this hormone can treat some cases of female infertility. It is also effective for some cases of male infertility caused by low hormone levels. Inducing ovulation in women with relatively inexpensive hormones has become an acceptable treatment for women with ovulation disorders. However, because these drugs can potentially cause multiple embryos to develop simultaneously, this therapy carries the risk of increased maternal and infant mortality. For infertility caused by the inability to transport a fertilized egg to the uterine cavity, in-vitro fertilization (IVF) can be used, followed by surgical implantation of the early-stage embryo into the uterus. Artificial insemination is also an alternative for some infertile couples. Doctors consider the procedure similar to blood transfusions or donations; however, some orthodox religious authorities consider artificial insemination, using sperm from an anonymous donor, to be tantamount to adultery. Some couples' desire for a child is so strong that they persist with treatment despite the fact that it can sometimes worsen. They understand that this treatment exposes their privacy, and they are constantly worried about the high cost and potential failure of the treatment, as well as being forced to turn intercourse into a prescribed, structured therapeutic act. Researchers have found that more than half of the men undergoing infertility testing experience temporary erectile dysfunction or ejaculatory disorders. Most men know little about the principles, effectiveness, and correct usage of some common contraceptive methods. Women have about a dozen options, while men have only three: coitus interruptus, condoms, and vasectomy. When used correctly, latex condoms are the most effective way to prevent HIV, gonorrhea, chlamydia, hepatitis B, and non-gonococcal urethritis (NGU). In the United States, improper use is the leading cause of condom failure. The most common misuse is inserting the penis into the vagina before putting on the condom. How to use a condom: Before intercourse, unfold the condom to the length of the erect penis. Leave a small gap at the tip of a flat-tipped condom to collect semen. If it has a small reservoir tip, remove the air before use. If it is a dry condom, apply a water-based lubricant to the outer layer, applying more to the tip to prevent tearing. After ejaculation, remove the penis and condom while the penis is still erect. Do not reuse condoms. Store condoms in a cool, dry place; discard any that are sticky or brittle. Vasectomy. Approximately 10 million American men have undergone vasectomy. This surgery only renders a man infertile and does not affect sexual function. The testes continue to secrete testosterone and other sex hormones normally after the surgery. A recent study of 5,000 men who underwent vasectomy 15 years ago showed that it did not lead to coronary heart disease, even many years after the surgery. A newer, more in-depth study indicates that men who have undergone vasectomy are at least as healthy as they were before the surgery, if not healthier than other men. Sexual safety. The following points can help prevent STIs: Be aware of some of the characteristics of STIs, such as vulvar discharge, painful urination, skin changes or pain, vulvar itching, and abdominal pain. Avoid sexual intercourse with men who have redness, swelling, pain, or discharge in the vulva and who have multiple sexual partners. If you suspect you have an STI, see a doctor immediately. Remember: Even if you wear a latex condom throughout intercourse, it only protects the vulva, not the rest of the body. Women are particularly susceptible to contracting STIs without symptoms and unknowingly transmitting them to others.