In 20-30 percent of cases, the impossibility of having children in a couple depends solely on him. Already from puberty it is important to investigate any pre-existing pathologies
What if you can’t become fathers? The infertility of the couple in half of the cases also depends on male factors and in 20-30 percent these are held solely responsible. Preventing infertility in men from adolescence is the best way to treat it. The period of puberty is important for investigating any pre-existing conditions that could compromise reproductive and sexual health in adulthood declares Alberto Ferlin, professor of Endocrinology at the University of Padua and past president of the Italian Society of Andrology and Sexual Medicine (Siams). Hence the importance of perform a first andrological examination between the ages of 14 and 16 (obviously if no problems have been found before which need to be acted on very early, such as cryptorchidism or others).
Who to contact
To the pediatrician, general practitioner or andrologist specialist – continues Ferlin -. Through a general visit, the development of the testicles and the genital system will be verified and in-depth examinations will be recommended when symptoms affecting the reproductive system are suspected. 27% of pediatric and adolescent males report the Ministry of Health, suffering from andrological pathologies. Fabrizio Palumbo, urologist at the San Giacomo hospital in Monopoli (Bari) and scientific director of the Italian Society of Andrology (Sia), lists the main ones: Cryptorchidism, ie the absence of one or both testicles in the scrotal bag; varicocele, due to a reduced flow of blood from the testicles; phimosis, characterized by a narrowing of the foreskin; hydrocele, which is the collection of fluid around the testicle; hypogonadism, which is the lack of testosterone production; congenital curvatures of the penis; sexually transmitted diseases, such as Hpv infection, Chlamydia and gonorrhea, and testicular cancer, the most common malignant neoplasm in males between the ages of 15 and 40.
Varicocele is a major risk factor for male infertility. In 40% of infertile men present. In another 15% infertility resulting from prostate or testicular infections and in another 30-50% idiopathic, ie the exact cause is not known, Palumbo recalls.
The second visit
The andrological control under the age of 20 therefore makes it possible to diagnose various pathologies at an early stage and to assess and modify all risk factors for reproductive and sexual health, including obesity and overweight, small testicular size and hormonal alterations, and lifestyles that can harm it (smoking, alcohol consumption and drugs, sedentary lifestyle, unprotected sexual intercourse). During the examination, the doctor will be able to teach the boy self-examination of the testicles
Ferlin resumes, to identify in time the signs of a tumor affecting these organs, which usually begins with a lump, swelling, acute pain and a rapid increase in the volume of the testicles. Unfortunately, less than 5% of Italian minors, according to the ministry, undergo an andrological control.
Hpv vaccination
At this stage of life, before the onset of sexual activity, vaccination against HPV is also recommended, free in all regions for 11-year-olds (and other age groups by region). In the male it can cause warts in the genitals and anus and cancer of the oropharynx. The contraction of the virus is then associated with a reduction in sperm motility, which deteriorates fertility, Ferlin points out. A second visit to the andrologist is recommended between the ages of 18 and 20.
To perform a seminal fluid test that informs the young man about the number, vitality and motility of spermatozoa, three parameters that affect the state of his fertility – he continues -. If the values are not optimal, a cure is made and if this fails, the sperm can be cryopreserved before the clinical picture worsens and becomes irreversible. Fertility is an indicator of an individual’s general health. Behind an alteration of the seminal fluid, which will require a testicular ultrasound or hormone tests, they can hide
metabolic syndrome, ie the coexistence of diabetes, obesity and high blood pressure, and cardiovascular diseases. On the other hand, erectile dysfunction can be a symptom of cardiovascular problems and diabetes.
The third check
The appointment with the andrologist expected at 30 years. Many pathologies and lifestyles if not addressed and corrected previously could have already compromised the situation or made it more difficult to treat – warns Ferlin -. Diabetes or thyroid disorders impair sperm production. Testicular dysfunction reduces that of testosterone, exposing the patient to the risk of osteoporosis, cardiovascular and metabolic diseases. Regular andrological checks and healthy habits are therefore essential to prevent or promptly diagnose many problems.
Global warming also affects infertility. Increasing the ambient temperature by one degree raises the scrotal temperature by 0.1 degrees, which should remain approximately 2 degrees lower than body level. The increased heat can reduce sperm production and worsen their quality, Palumbo concludes.
March 24, 2022 (change March 24, 2022 | 10:46)
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