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WHY the UROLOGIST is the MOST SUITABLE SPECIALIST for a CONSULTATION after a SEMEN ANALYSIS?

As many of you know in about half of the cases, fertility issues are due to male factor. For this reason, even if the treating obstetrician-gynecologist identifies a possible cause of infertility in the woman, her male partner has to be checked as well. Semen analysis is the first test to be performed in men. It gives information about the three basic fertility parameters – sperm concentration, motility and morphology.

At New Life Fertility Center patients can come for semen analysis any time between 10 am and 3 pm on week days without an appointment. The results of the test are ready in about 2 hours after the biological material is made available and can also be sent via e-mail.

Despite having reference values ​​in the semen analysis, which allows the patient to compare his results with the norm, those results need to be explained to the patient by a doctor. In general, this is the partner’s obstetrician-gynecologist or a urologist.

At New Life Fertility Center, we recommend patients to consult a urologist, preferably experienced in the treatment of male infertility. The partner’s treating physician may also look at the results, but in any case if there are deviations from the reference values, the patient is referred to a urologist. As well as interpreting the results of the semen analysis, the urologist may, if necessary, examine the patient, refer him for further tests, and treat him. That is why, consultating a urologist straight after your semen analysis results come out saves you time and money.

At New Life Clinic we offer a discounted package price for “semen analysis + urologist consultation”, because we want to take good care of our patients.

CHLAMYDIA, MYCOPLASMA AND UREAPLASMA AND THEIR IMPACT ON MALE FERTILITY

Nowadays, sexually transmitted infections are still a problem, despite the improved level of sexual education and the widely available means of protection. Chlamydia infection remains one of the most common in sexually active people.

We can be infected with chlamydia during vaginal, oral and anal intercourse. Chlamydia infection can affect many parts of the body outside the reproductive system. For instance, it can infect the throat during an oral contact or the rectum during anal intercourse. If the infection goes untreated, the bacteria can even reach the eyes and the heart through the bloodstream.

The main problem with Chlamydia is that for both men and women in over 50% of cases there are no symptoms, so no medical care is sought. In the rest of the cases, men complain of a white to yellowish discharge from the penis or pain during urination.

WHAT ARE THE RISKS FOR YOUR FERTILITY?

From the urethra, chlamydia moves towards the prostate, epididymis and ultimately the testicles. This poses the risk of inflammation in these structures. Especially dangerous is the inflammation of the epididymis. This part of the testis is comprised of a complex network of tubules in which sperm matures. During ejaculation sperm moves from the epididymis through the urethra and outside of the body.

If left untreated, a chlamydia infection can cause obstruction of the tubules of the epididymis, preventing sperm’s movement. Such a condition is known as obstructive azoospermia (a complete lack of sperm in the ejaculate due to a blockage).

The best option is for the infection to be diagnosed as early as possible and treated successfully. If a blockage is already present, the treating urologist has to decide together with the patient what the best course of action is. Epididymis or testicular biopsy remains as a last resort option for the procurement of spermatozoa.

MYCOPLASMA AND UREAPLASMA

Bacteria of the genera Mycoplasma and Ureaplasma are found in the reproductive tracts of many men and women. These bacteria do not cause problems in a normally functioning immune system. If an infection develops, men complain of a burning sensation and frequent urination.

The diagnosis of sexually transmitted infections in men is determined after a microbiological examination of semen (ejaculate), urine or urethral secretions. If diagnosed early, they are successfully treated with antibiotics. We believe that prevention of sexually transmitted infections should always be a priority. So if you do not plan to become a parent in the near future, always use condoms!

WHAT PERCENTAGE OF MEN WHO ARE TRYING TO GET THEIR PARTNER PREGNANT HAVE ABNORMAL SEMEN ANALYSIS RESULTS?

Dear friends,

In the past when a woman could not conceive, people always assumed she was the reason. Nowadays, we know that half the time they were wrong. Regardless of whether we are talking about female or male factor infertility, if a woman, 35 years old or younger, has been trying to conceive for 1 year with no results, she should consult a fertility specialist. According to the World Health Organisation (WHO) for women over the age of 35, that time is shortened to 6 months. This is due to the rapid decline in female fertility after that age.

A 2012 survey from WHO with data from 190 countries, states 1 in 4 couples of reproductive age is affected by infertility. In half of those cases, infertility is caused by male factor. We have to exclude cases of unexplained infertility (_~ 10%), because in those cases conventional diagnostic methods did not identifying the cause of infertility.  In other words if 1 in 4 couples has fertility issues, then 1 in 8 (_~13%) of those couples is affected by male factor infertility. Once we subtract unexplained infertility cases, we get that roughly 10% of men trying for a baby have serious deviations from normal semen parameters. That percentage does not include men with slight deviations from the norm, which do not necessitate treatment or in vitro fertilization to achieve a pregnancy.

WHAT INFORMATION DOES CONVENTIONAL SEMEN ANALYSIS GIVE?

Semen analysis evaluates male fertility based on different parameters of the ejaculate (semen). The three most important parameters which it analyses are:

1. Sperm concentration per ml of ejaculate
2. Sperm motility and
3. Sperm morphology (shape).

According to the World Health Organisation at least two semen analyses have to be done for reliable results. There has to be at least a month between the two analyses. In this way the treating physician will know that the results are not just momentary but accurately represent the fertility status of the patient.

Unfortunately, some men do not wish to get semen analysis testing, because they fear the results. It is important to know, however, that the result of a semen analysis is not a diagnosis. Diagnosis is given by a physician after physical examination and a number of tests. The earlier you take care of yourself and your fertility, the better!

Тestosterone and its synthetic derivatives have been used to increase muscle mass for a long time. Although forbidden for professional athletes, they are sometimes used by men practicing amateur sports. Along with their effects on  physical appearance and libido, steroids also affects male fertility.

WHAT HAPPENS IN THE BODY WHEN YOU TAKE ANABOLIC STEROIDS ?

Testosterone stimulates spermatogenesis. When a man is taking extra testosterone, its internal production in the testes is inhibited and spermatogenesis is disturbed. The result is reduced amount to a complete absence of sperm in the semen, which can be detected by a regular semen analysis. This effect is very often observed when anabolic steroid administration is not prescribed or overseen by a physician.

Some couples have problems conceiving because of anabolic steroids intake by the male partner. Although their use may lead to complete suppression of spermatogenesis, this condition is in most cases reversible. The longer the drugs were taken, the longer the recovery of spermatogenesis takes. Improvement of semen analysis results can be observed after at least 3 months following discontinuation of the anabolic steroids. After that many couples get pregnant naturally. In rare cases, long-term use of steroids leads to permanent suppression  and male infertility.

ANABOLIC STEROIDS AND ASSISTED REPRODUCTION

Even if the man hasn’t used anabolic steroids for a long time, sometimes there are indications for in vitro fertilization (IVF) or intrauterine insemination (IUI). This could be caused by a female infertility factor. If this is your case, you must inform the treating fertility specialist that you have taken steroids in the past.

Anabolic steroids are strictly prohibited prior to an assisted reproductive procedure (IUI or IVF). ANABOLIC STEROID INTAKE NOT PRESCRIBED BY A PHYSICIAN ESPECIALLY PRIOR TO AN ASSISTED REPRODUCTIVE PROCEDURE HAS STRONG NEGATIVE IMPACT ON THE OUTCOME OF THE PROCEDURE.

If you use or have used steroids and you have been trying to get your partner pregnant for more than a year, consult with a reproductive medicine specialist. They will refer you for the necessary hormonal tests (e.g. for testosterone, follicle stimulating and luteinizing hormone) and semen analysis. This will give you information about your hormonal profile and sperm count. If necessary you will be prescribed medication that will improve hormonal imbalance and stimulate spermatogenesis.

Polycystic ovary syndrome or PCOS is a hormonal condition. It is characterized by irregular ovulation or the lack thereof, irregular menstruation, ovarian cysts and insulin resistance.

Close to 20% of women worldwide have PCOS. Often, but not necessarily, they are overweight. These women have increased levels of androgens which get converted into estrogens in the fatty tissue. The more fatty tissue a woman has, the more estrogen she has. When estrogen levels get too high, ovulation is impaired.

Polycystic Ovary Syndrome and Pregnancy

Most women with PCOS conceive naturally shortly after they lose weight and restore their hormonal balance. If weight loss alone does not lead to pregnancy, they can start taking drugs that stimulate ovulation and inhibit androgen conversion. With such medication, these women usually conceive naturally or through intrauterine insemination (IUI).

The belief that the only way for a woman with PCOS to conceive is through IVF is completely wrong. IVF is considered only when the more conservative methods have proven unsuccessful.

OUR CHILDREN’S NAMES IN 21ST CENTURY

Our name is among the things that create the first impression about us.  Choosing the right name has always been a difficult task for the parents especially when friends and relatives start giving ideas.

Although the world has changed so much in the past 10 years, the popular names among the newborns in Bulgaria remain almost the same. The most preferred names in 2007 were Victoria, Maria and Gabriela for the girls, and Georgi, Alexander and Ivan for the boys. Today the ranking looks quite similar, with the only difference that we have Martin instead of Ivan and Nicole instead of Gabriela. In addition, there are more girl names that were not so common 10 years ago. Such names are Raya, Sofia and Daria.

Mixed marriages and emigration these days are not unusual. This also reflects on the choice of a name for the newborn. Parents prefer names that sound good in combination with a foreign surname or are easy to pronounce by foreigners, such as Daniel, Martin or Nicole.

The media also influences the choice of baby names. It is now common practice for children to be named after celebrities, movie or book characters. For example, during the past year, 222 girls were named Krisia.

According to an old Bulgarian tradition, the boys should have the grandfather’s name, and the girls – the grandmother’s from the father’s side, thus ensuring continuity in the family. The “modern” version of this custom is for the name of the child to start with the same letter as the grandfather’s or grandmother’s name. Therefore, it is quite possible to meet a Yoana, who is named after her grandmother Yordanka, for example.

The name is the first gift we give to our children. It must be  a  good wish that follows the child everywhere they go. For this reason, it is always necessary to be aware of the meaning of the name we have chosen. What names did you choose for your children?