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Comprehensive Male Infertility Profile (CheckUp S7)

Diagnostiki Athinon's Comprehensive Male Infertility Profile (CheckUp S7), includes the testing of all hormones which are responsible for sperm production and maturation along with their disorders that may lead to infertility as well as the most important genetic tests that can help determine the causes of male infertility.

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Infertility is the inability of a sexually active couple, who does not use any contraceptive methods, to conceive after a year of effort. Male infertility factor contributes to approximately 40% of infertile couples.

What causes male infertility?

Numerous different health and pathological problems can lead to infertility. In 30-40% of cases, the problem is found in the testes, i.e. the glands that produce sperm and testosterone (the main male sex hormone). Testicular damage can derive from either, infections (e.g. mumps), cancer treatments such as radiation or chemotherapy, injuries, or surgery.

Heat may affect sperm production. Thermal damage can be caused if one or both testes do not descend out of the scrotum (cryptorchidism) during pre-birth. Many patients have enlarged veins around the testes (varicocele), which can also increase the temperature inside the testes. If the varicocele is too large, it may affect sperm production.

Some inherited (genetic) diseases can also cause low or no sperm production or sperm that cannot move or fertilize a woman's oocytes.

In 10%-20% of cases, the problem is an obstacle that blocks the movement of the sperm from the testicles to the urethra. This can be due to scars from an infection, surgery, or cystic fibrosis (genetic disease). Sperm traveling backward into the bladder, instead of exiting the urethra, can also cause infertility (retrograde ejaculation).

Sometimes, infertility is due to hormone deficiency. Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) cause testes to produce testosterone and sperm. The pituitary, located in the brain, synthesizes these hormones. Any condition that lowers the levels of LH and FSH, such as pituitary tumors, can lead to low or no sperm production and low blood testosterone levels.

In 30-40% of men with infertility, no cause can be detected. These patients usually have an abnormal spermogram (e.g. slow-moving sperm, sperm morphology abnormalities, or even low sperm concentration).

There are also other conditions that may reduce sperm production and fertility such as chronic diseases, poor general health, obesity, certain medications, and more.

Testosterone

Testosterone affects almost every process in the human body. Its main function, however, is to control sexual and reproductive health. Testosterone is released by Leydig cells in the testes and stimulates sperm production. Very low testosterone levels can lead to a condition called hypogonadism, which can be treated with hormone replacement therapy. Excessive levels of testosterone, on the other hand, can turn into estrogens (female hormones), which can lead to mood swings, decreased testicular volume, and gynecomastia.

Luteinizing Hormone (LH)

Luteinizing hormone is a hormone released by the pituitary gland and stimulates testosterone production in the testes, allowing it to perform its essential functions. Too high or too low luteinizing hormone levels may cause infertility, so it is important to have a balance.

Follicle Stimulating Hormone (FSH)

FSH or Follicle Stimulating Hormone is another important hormone. Its primary role is to interact with Sertoli cells in the testes to stimulate sperm production. Testosterone and inhibin (a hormone that regulates FSH secretion), regulate FSH production and are crucial for controlling the hormone cycle involved in sperm production. High levels of FSH may be indicative of low testosterone levels. This impedes normal sperm production and maturation and is an indication of infertility. Similarly, the presence of low FSH levels can cause limited sperm production.

How do hormone disruptors affect male fertility?

Hormone disruptors are substances that can be absorbed into the body and disrupt the endocrine system, affecting all of its functions, from metabolism to fertility. Although it may not be possible to completely avoid all hormone disruptors, knowing where they are can help to reduce the body's exposure to these substances.

Some of the most common hormone disruptors that may affect fertility include:

Bisphenol A (BPA) is found in plastic water bottles, food containers, and canned food.

Dichloro-diphenyl-trichloroethane (DDT) is an insecticide that can be found in meat, fish, and dairy products.

Dioxins are among the most widespread chemicals known to disrupt male reproductive health. They are found in many products, such as coffee filter paper, animal protein, household cleaners, personal care products (especially those containing triclosan, disposable towels, and napkins).

Polychlorinated biphenyls (PCBs) are chemicals that can be found in infected meat products, dairy products, and certain fish.

Phthalates are a group of chemicals that can inhibit testosterone production as well as the function of Leydig cells, which affects sperm production and sperm quality. Often found in non-organic foods, personal care products such as lotions, colognes, shaving foams, hair dyes, and household cleaners.

Phytoestrogens are a type of estrogen known to reduce sperm count and are found in soybeans, flaxseeds, sesame seeds, oats, as well as in pesticides and industrial chemicals.

Atrazine is a herbicide found in corn, cane, pineapple, and sorghum.

Mercury is found in seafood, especially mackerel, swordfish, and big fish.

Bisphenol S (BPS) replaces BPA, which is equally dangerous and is found in plastic water bottles and food containers.

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