Male

Surgical Causes

• Hydrocele
• Herrneoa
• Varicocele Produces Thermo genic effect over testis
• Surgical fault in young age around testis - "CRYPTORCHDISM"
• Tortion of Testis
• Pelvic Surgery
• Prostatic Surgery

Quality of Semen Count

• 60 to 120 million normal
• 20 to 50 million - Sub-normal
• < 20 milllion - abnormal

Motility: 20 microns / second

Morphology: double head tailess are normal

Low Sperm count and less motility

• Highly thick semen
• Infection of semen
• Cervical fluid in female infected
• Alcohol damages liver
• Tight underwears
• Hot bath, Sauna Bath
• High temperature - boilers, Welding engine rooms
• Radiation exposure
• Pesticides
• Tobacco Cigarettes leads to spasm of tetsicular arteries

Low levels of Testosterone

KALLMAN's Syndrome A congenial disease of Hypothalamus-short- left palate loss of smell - low levels pf FSH - LH - Prolactin - Testosterone

• FSH
• LH
• Prolactin
• Testosterone

Hyper PROLACTENIMIA

Serum Prolactin Milky Breast in male
Tt: Tab PROCTINAL 1.25 mg (Bronocryptine) 1st to 4 days - 1od evening daily 5th t0 8^th days - 1Bd 9th to 13^th days - 1.25ml morning and 2.5mg in the evening

From 14^th day - 2.5mg-1Bd for 6 months

KJLIEN FILTERS Syndrome

• FSH
• LH
• FSH-LH hormones increased levels and low levels of testoesterone
• Testoesterone

SYSTEMIC INFECTIONS

• GENITAL TUBERCLOSIS
• FILARISIS
• LEPROSY
• MUMPS
• SCHISTOSOMIASIS
• Sexually Transmitted Diseases like Syphihis, Gonorrohea, Chlamydia
• METABOLIC Disease
• Diabetes - Symphathetic Nerve Damage
• Chronic Renal failure

Sexual Disorders

• Impotency
• Premeture Ejaculation
• Retrograde Ejaculation

Abnormal Chromosomes

Drugs leads to Infertility

• Sedative Drugs
• Anti-Depressive Drugs
• H ypertensive Drugs
• Gastric Ulcer Drugs
• Cardiac Drugs

Untreatable causes of infertility

Absence of Vas-Seminal vesicle-Epididmis Testicular atrophy Germinal cell Aplasia-or meturation arrest Immunologically conditioned infertility

Coital Abnormalities

• Fractured Pelvis
• Spinal Cord Damage
• Post Periapism

• Ejaculatory failure
• Retrograde ejaculation.
  • Bladder neck damage
  • Sympathetic nerve damage

Varicocole

Obstruction

Congential absence of vas Seminal Vesicle Epididimis

Infection

• Gonorhoea Urethrites
• Chlamydial Urethrites
• Urogenital Tuberclosis
• Lepromatons form of leprosy
• Mumps in post pubertal males
• Filariasis
• Schisotosomiasis
• Nitrofurnatoindrugs - depress spermatogenesis

Gonadotrophin Defeciency Hypo Gonodo Trophic - Hypogonadism

• Syndrome
• Delayed puberty
• Short stature
• Azoospermia
• FSH
• LH

• Pituotary a supra cellar turuour
• FSH
• LH

HYPER PROLACTINAEMIA

• Impotence
• Galactorrea
• Infertility
• Testicular size small
• Oligopermia
• Prolactin

KLINE FELTERS'S Syndrome

• Genetic disorder
• Infertility
• Azospermia
• Impotence
• Additional 'X' chromosome [47XXY] in Buccal smear
• FSH
• LH
• Testosterone

GERMINAC CELL APLASIA or GERMINAL CELL ARREST (Testicular abnormality)

• Azoospermia
• normal sex function
• FSH
• LH
• Testosterone

CRYPTORCHIDISM

Other Causes

• Chronic Renal Failure
• Drugs - Anticancer
• Radiation
• Exposure to pesticides
• Excessive alcohol
• Cigarette smoking

IMMUNOLOGICALLY conditioned infertility

Hyper Gonado Trophic - High Functions of Hypothalamus and Petuotary and low functions Testes

• Klinfilters Syndrome [47XXY male]
• Anorchism
• Male Turners's Syndrome [45-X0 female]
• Orchitis (Mumps, Gonorrhoea)
• Sequelae of irradiation
• Myotonic dystrophy
• Drugs
• Femilial Cerbellar Ataxia
• Spinal cord injuries