Male infertility, is a man’s not being able to be a father in natural way. This situation, which does not negatively affect the male sexual life, affects to be a father.

The male infertility of N46 is essentially no different from that of male infertility. N46,  is the code set for the Turkish Ministry of Health due to male reproductive problems. Men who have undergone reproductive treatment in any official health institution are registered with this code in the system.

Infertility symptoms are actually evaluated not only male-based, but on a couple basis. It is considered as a sign of infertility if there is no pregnancy despite sexual intercourse regularly maintained for a year. The symptoms of infertility are very related to age. Therefore, this period, which is considered to be one year before 35 years of age, is limited to 6 months after the age of 35 years.

Genetic problems, abnormalities during birth, hormonal causes, chemical factors, inflammatory diseases, varicocele and surgical operations cause male infertility, in other words male-related infertility.
The causes of male infertility are determined by some tests deemed appropriate by your urologist. Semen analysis is the most important infertility test. Since it is an easily applicable test, it is important to perform semen analysis first. Semen analysis should be performed after 3-5 days of sexual abstinence. It is generally desirable to collect all of the semen into a sterile container by masturbation in a special room at the clinic. The volume of the semen is measured and a drop is examined under the microscope for number and movement.

In a normal semen analysis the volume should be at least 2 ml, at the latest 30 minutes, the liquid consistency of the gel should turn to liquid and to have at least 20 million sperm per milliliter. At least 30% of the sperms should in normal shape and at least 50% of the sperms should be active, and the vitality rate, should be at least 75% and the number of white blood cells should be less than 1 million.

If semen analysis is normal, it is assumed that the male is not infertile. However, if there is a problem in semen analysis, the test should be repeated at least 2 times in 3 weeks intervals and if the abnormality is continuous.

In the evaluation of male infertility, serum hormone measurements are also desired in some cases. FSH, LH, testosterone and prolactin levels are desired especially in azoospermia cases.

Reasons of Male Infertility:

1- Azoospermia – No Sperm in Mena
This is due to the absence of sperm production in the testicles or congenital absence or obstruction of the carrier channels. Usually sperm production is not problematic. A trauma related to the testicles, post-adolescent mumps, chemotherapy or radiotherapy may lead to azoospermia. Chromosomal problems (Klinefelter syndrome, Y chromosome problems) can also cause sperm deprivation in men. Cystic fibrosis disease should be investigated in the absence of congenital channels. Previously genital infections can also block the channels. Sometimes in men, a situation where the semen to pass backward to the bladder during the ejaculation which is called retrograde ejaculation, may occur. This is a side effect of prostate surgeries or some drugs.

2- Oligospermia – Low Sperm Count, Astenospermia – Low Sperm Mobility and Teratospermia – Sperm Structure Is Poor Than Normal
There are many reasons leading to these three conditions that cause infertility in the title. Hormone deficiency, infections, antidepressant drugs, blood pressure medications, anabolic drugs used in bodybuilding, drugs, smoking and alcohol use, taking frequent hot baths and sauna are some of them.

Minority in Spermin Fertilization Capacity
Although semen analysis yields normal results, in some cases, sperm may not fertilize the egg, or the sperm exhibits a performance that is less than the expected fertilization capacity based on the analysis result. These two problems usually occur as a result of the structural problems of the sperm. It is frequently seen in head and tail pathologies.

No Ejaculation
As a result of diabetes or some drug use, ejaculation problem may occur in men. In this case, since the father is unable to deliver sperm naturally, the sperm is collected from the testis with TESE or Micro-TESE surgeries, and the patient is provided to be a father.

Varicocele
Varicocele is the expansion of the veins in the male genital area. Although it is suggested that varicocele operations increase sperm motility, this operation should be done in case of complaints such as pain. Varicocele surgery should not be seen as a corrective surgery for sperm motility.

For detecting male-related infertility sperm tests are coming firstly. In addition, the medical history and physical examination of the father are of great importance in establishing the correct diagnosis. According to the patient’s history and especially the medical history, the tests that will be requested later are determined. The methods used to diagnose male infertility are listed as follows:

At the beginning of the tests to be applied to male hormones and genetic examinations come. In addition, ultrasound examination of the testes with imaging methods, the prostate and sperm output of the channels through the ultrasound rectal examination of the channels are also tried to  diagnose.

The incidence of testicular tumors in men presenting with infertility is 1%. This rate is about 16 times the rate seen in the normal population. In order to detect this disease in which the early diagnosis prolongs the life expectancy, it is necessary to perform a medical examination by a urologist.