Infertility can be a challenging and emotional time for people trying to grow their family. While primary 不孕不育—when a couple has never conceived—is often discussed, 继发性不孕症 can be just as difficult to navigate. 二次 男性不育 means that issues with the father’s reproductive health can prevent conception after already naturally conceiving and having a child.
查明原因
二次 不孕不育 affects about 11% of couples in the United States, with about 三分之一 of all cases being male factor 不孕不育.
Even after successfully conceiving before, 各种因素 can change over time and impact a man’s fertility, including:
- Being 40 years or older
- 精子数量低 or reduced semen quality
- 减少 睾酮 水平
- 睾丸 精索静脉曲张, a condition where the veins in the scrotum become enlarged
- 射精障碍
- Prostate enlargement or removal
- Medical conditions such as hypertension and diabetes
- Taking medications that affect sperm production
- 遗传疾病
- Lifestyle factors such as weight gain, alcohol consumption, or smoking
“Poor diets with high saturated fat, 糖, and sodium can contribute to obesity, which can affect reproductive hormone 水平 such as estrogen and 睾酮,” Laura Claflin, DPN, APRN, a nurse practitioner in 男性健康服务 at University of Utah Health. “Moderate physical activity and a well-balanced diet can help regulate sperm production and improve hormone 水平.”
Diagnosis and Treatment
Both partners can undergo diagnostic tests after trying to conceive for a year if the female partner is under 35 or for six months if she is older than 35.
To diagnose male factor 不孕不育, men will likely have:
- A thorough physical exam. Reviewing a patient’s medical history and discussing lifestyle factors can help determine if there is an underlying medical reason for 不孕不育 or changes they could make to their lifestyle to increase conception chances.
- 精液分析. A sperm count and analysis can determine the quality and quantity of the sperm.
- 荷尔蒙测试. Checking 睾酮 水平 might point to sperm production problems.
- 基因检测. A blood test can rule out certain genetic factors, such as chromosomal conditions, that can contribute to 男性不育.
- 结构检查. Additional tests like a scrotal ultrasound or transrectal ultrasound can help identify any structural issues.
Treatment options for 男性不育 will vary based on the underlying causes, but include:
- 生活方式的改变. Before or in tandem with other medical interventions, you can make positive health changes that can enhance fertility, such as improving your diet, 锻炼, reducing alcohol consumption, 戒烟, and avoiding exposure to harmful toxins.
- 激素治疗. If 睾酮 or other hormones are not in an ideal range, certain medications or hormone replacement might be recommended.
- 外科干预措施. Certain procedures can address any physical abnormalities, such as 精索静脉曲张 repair or correcting an obstructed vas deferens.
- Assisted Reproductive Technologies (ART). 一些不同的 治疗类型 are common for couples experiencing 不孕不育, including:
- In vitro fertilization (IVF). An egg is fertilized with sperm in a lab, and an embryo is then implanted into the uterus.
- Intrauterine insemination (IUI). Sperm is placed directly into the uterus.
- Intracytoplasmic sperm injection (ISCI). This type of IVF is used when sperm quality is poor. Live sperm is injected directly into an egg to fertilize it.
“Whatever the cause of your male factor 不孕不育, your team will help you understand all your options for treatment, while also considering you and your partner’s specific goals,克拉夫林说.
Navigating Your Journey
Experiencing 继发性不孕症 when trying to grow your family can be confusing and frustrating. Don’t be afraid to seek out emotional support from health care professionals or support groups.
“One important way couples can support one another through struggles with 不孕不育 is to work together as a team,克拉夫林说. “Communicating with each other and taking time off when needed is important. Counseling and support groups are great resources to learn how to communicate and support one another while making the experience less isolating.”
Understanding the causes of secondary 男性不育 and your treatment options can provide hope. With the right support and intervention, many couples struggling with 不孕不育 go on to successfully grow their families.