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Male Factor Infertility
Infertility From His Perspective
By Tamar Weiss
Dr. Jay Sandlow, assistant professor in the Department of Urology, University of Iowa Hospitals and Clinics says that infertility caused by drug, alcohol or tobacco use can be reversed. Dr. Peter Kolettis, assistant professor of urology at the University of Alabama at Birmingham, recommends that his patients who smoke and drink excessive amounts of alcohol cease such behavior and begin taking multivitamins with antioxidants in addition to 400 milligrams of vitamin E each day, in an effort to aid fertility.
One of the purposes of the physical exam is to identify whether a varicocele is present. This is an enlarged varicose vein in the scrotum. According to Dr. Sandlow, varicoceles are the most common cause of infertility among men. "These dilated veins around the testicles raise the temperature in both testes, causing a decrease in sperm count, motility (rate and direction of movement) and morphology (shape and size of sperm)," he says. Another common cause of infertility in men is obstruction, or blockage, of the pathways from the testes to the urethra.
Testing for both of these conditions may be uncomfortable for the patient. The physical examination, which aids in diagnosing varicoceles, is a careful palpation of the scrotum while the patient stands, lies down and bears down on his pelvic floor muscles while holding his breath. A difference in size between right and left testes may also indicate varicoceles. To see if there are blockages, a physician may perform a testis biopsy, radiologic and other tests.
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