Infertility is defined as failure by a couple to conceive after one year of unprotected intercourse. Vital statistics have shown 40% of infertility cases having an abnormality of Male Factors, which are important in Spermatogenesis.
Sperm piercing the Ovum
u Requires 72 to 74 days for germ-cell maturation i.e. Spermatogonia to spermatozoa
u Most efficient genesis at 34 centigrade (93.2 Fahrenheit)
u Within the somniferous tubules, cells of sertolli sustain and regulate the sperm maturation.
u Leydig’s cells produce Testosterone
u Fructose secreted by seminal vesicles shows patency of ejaculatory ducts.
Causes of Azospermia
u Obstruction i.e. Varicocele
u Congenital absence of Vas Deference
u Primary Testicular Disorder
Definition: A cystic accumulation of blood in the spermatic cord. It is a most common anatomical abnormality of the veins, especially Pampiniform plexus. Varicocele is mostly found as left sided where the spermatic vein empties in the left renal vein. In short, variocele causes insufficient drainage of the blood from the testes that causes excessive pooling of the blood resulting in higher intra-scrotal temperature.
Very rarely retrograde ejaculations occur into the urinary bladder in cases of:
u Diabetes mellitus
u Hodgkin’s disease (prior to retro peritoneal dissection)
u Neurological dysfunction
HOW TO DIAGNOSE?
u Abstinence of 3 to 4 days is very essential.
u Usually 2-3-4 ejaculates should be examined.
u Semen should be obtained by masturbation in a clean sterile glass jar from the lab.
u Patients having difficulty in getting samples by masturbation should use Silastic Condoms – which is free of lubricant and chemical toxins.
u Liquefaction should be at room temperature within 20-30 minutes.
The following parameters should be observed carefully:
Volume (ejaculate) 2-6 ml
Viscosity within one hour, liquefaction should take place
Appearance Gross and Microscopic
Gross: Opaque or cream coloured
a) 1 to 3 WBC / HPF
b) ph of 7 to 8 (alkaline)
c) Motility (at 1-3 hours) more then 50%
d ) Sperm count. More then 20 million / ml
e) Linear sperm velocity. Clinical correlation of velocity is Unclear.
Morphology Evaluation of sperm structure:
u Male Sperm Factors: 40%
u Ovulatory Dysfunction: 20%.
u Cervical Factors: 05%
u Abnormal Tube Function: 30%.
u Un-Identified Factors: 05%
Be careful in taking history.
u Cryptorchism – One or both of the testes fail to descend from the abdomen into the scrotum.
u Testicular injury
u Exposure to Industrial or Environment Toxins
u Excessive Heat Exposure.
u Acute illness
u Prolonged Fever
u Recreational drug use
u Alcohol intake
1) Anabolic Steroids
2) Exposure to Diethylstilbestrol
Inadequate length of abstinence prior to analysis
Physical evaluation is equally important
u Decreased Testicular Volume
Male -Infertility Factors:
After understanding the above stated causes, you can apply the knowledge of Homeopathy to the disease condition of the patients.
ROLE OF HOMEOPATHY
Homeopathy has entirely different in approach from conventional medicine. It is based upon the Law of Similars, which states that a substance that can produce, in a healthy person, symptoms similar to the patient’s, will cure those symptoms in the patient. In every case, the Homeopath looks at everything that is going on in the patient’s life based upon a “totality of symptoms”. Homeopathy addresses etiology as well as all aspects of the patient, including inherited tendencies and emotional disposition.
SOME REMEDIES IN MALE INFERTILITY
Homoeopathic Nux Vomica has proved excellent in Oligospermia.
a) I administer Nux Vomica to patients whose history included bad-effects of coffee, tobacco, alcoholic stimulants, highly spiced or seasoned food, over-eating, long continued mental over-exertion, sedentary habits, loss of sleep.
b) According to Boericke: Very Irritable, sensitive to all impression, ugly malicious, cannot bear noises, odours, light etc.
c) According to Nash: For very particular careful, zealous persons, inclined to get excited and angry or of a spiteful, malicious disposition.
All the great Homeopaths have clearly drawn the picture of azospermic and oligospermic patients in their observations and the medicines are as follows.
1) Agnus Castus: By relieving mental depression, it corrects the desire and improves the functional impotence.
2) Anacardium Orientalis: Dual personality – Lacking self confidence with severe depression associated with impaired memory.
3) Argentum Nitricum: Very Apprehensive – from the first night of marriage, fearful and nervous, leading to pre mature ejaculations. Erection fails when coition attempted.
4) Caladium: Excellent for smokers and tobacco chewers. Increases the sperm count rapidly, in smokers.
5) Conium Mac: Testicular injury Hydrocele, Varicocele, orchitis, effects of suppressed sexual appetite.
6) Dioscorea: Suits very well to tea drinkers.
7) Phosphoric Acid: Gives excellent results in Oligoasthenospermia. Increases the acrosomal activity of the sperm (motility).
8) Titanium: Too early ejaculation.
9) Tribulus Terrestris: A very good medicine for patients in their mid 40’s having partial impotence caused by overindulgence.
10) Lycopodium: It has proved its great value in sexual dysfunction (acquired and situational). Very effective in premature ejaculation.
11) Tinospora Cardifolla: Proved its great value in anti-sperm antibody positive cases (2X).
12) Orchitinumm: Azoospermia
13) Manigifera: Varicocele
14) Potas Xanthae: Impotence
This was the quick tour of male- infertility therapeutics. Above all, the well selected constitutional remedy is the best answer to cases of infertility.
Dr. Nikunj Trivedi © Copyright in UK