Reproductive dysfunction in men. Healthy man and woman. The human reproductive system. reproductive health

spermatogenesis

The defining possibility of conceiving a child for a man is the ability to form full-fledged germ cells - spermatozoa (gum). The development of male germ cells is under constant hormonal regulation and is a long and complex process. This process is called spermatogenesis.

At the age of 5 years, the male gonads (testicles) are in a state of relative rest, at 6-10 years of age, the very first cells of spermatogenesis, spermatogonia, appear in them. Full formation of spermatogenesis occurs at 15-16 years.

The whole process sperm formation until full ripening takes about 72 days. It is conventionally divided into four stages:

reproduction -> growth -> maturation -> formation.

At each stage of spermatogenesis, the evolution of the spermatozoon can be conditionally described as follows:

spermatogonia -> spermatocytes -> spermatids -> spermatozoa.

The entire process of sperm formation takes place at a temperature that is 1-2°C lower than the temperature of the internal regions of the body. The lower temperature of the scrotum is partly determined by its position and partly by the choroid plexus formed by the artery and vein of the testis and acting as a countercurrent heat exchanger. Special muscle contractions move the testes closer or further away from the body, depending on the air temperature, to maintain the temperature in the scrotum at a level optimal for sperm formation. If a man has reached puberty and the testicles have not descended into the scrotum (a condition called cryptorchidism), then it remains sterile forever, and in men who wear too tight shorts or take very hot baths, sperm production can drop so much that it will lead to infertility. Very low temperatures also stop the production of sperm, but do not destroy the stored one.

The process of spermatogenesis proceeds continuously throughout the sexual activity of the body.(in most men almost until the end of life), but sperm is released into the external environment only at certain points. During sexual arousal, the spermatozoa accumulated in the epididymis, together with the secretion of the epididymis, move along the vas deferens to the seminal vesicles. The secret of the appendages liquefies the environment, providing greater sperm motility and nourishes the sperm during the eruption of the seed. With sexual arousal, the secret of the prostate gland is also produced at the same time, it is thrown into the posterior urethra. The secret of the gland activates sperm motility. All this mixture (prostate gland secretions, spermatozoa, seminal vesicle secretions) forms sperm, and at the moment of greatest sexual arousal, this mixture is released outward - ejaculation.

After ejaculation, spermatozoa retain their viability for a short time - 48-72 hours.

Sperm and its structure

Spermatozoa, or spermatozoa, are very small elongated mobile male cells.. The structure of a typical spermatozoon can be divided into four sections: the head, neck, intermediate section (body) and flagellum (tail).

When viewed from above, the human sperm head appears rounded, but when viewed from the side, it appears flattened. The head of the spermatozoon contains a haploid nucleus, covered by an acrosome. The acrosome is a special structure that contains the enzymes necessary for the penetration of the sperm into the egg.

In the short neck of the sperm there is a pair of centrioles lying at right angles to each other. The microtubules of one of them elongate, forming an axial filament of the flagellum, which runs along the rest of the spermatozoon.

The intermediate section (sperm body) is expanded due to the numerous mitochondria contained in it, assembled in a spiral around the flagellum. These mitochondria provide energy for the contractile mechanisms, and ensure the movement of the flagellum, and, consequently, the entire spermatozoon.

Motility is the most characteristic property of the sperm and is carried out with the help of uniform blows of the tail by rotating around its own axis in a clockwise direction. Normally, the spermatozoon always moves against the flow of fluid, which allows it to move up the female genital tract until it meets the egg at a speed of 2-3 mm / min.

However, flagellar movement alone is not enough. The main task of spermatozoa is to accumulate around the egg and orient themselves in a certain way before penetrating the membranes of the egg.

It is known that 2 sex chromosomes, X and Y, play a leading role in determining sex. Spermatozoa containing the Y chromosome are called androspermia, X-chromosome - gynospermia. As a rule, only one sperm can fertilize an egg, and, with equal probability, it can be andro- or gynosperm, and therefore preliminary predictions of the sex of the child are practically impossible. It is believed that boys are more often born from men whose sperm is dominated by androspermia.

Sperm and its indicators

The sperm of an adult male is a sticky-viscous mucus-like heterogeneous and opaque liquid with a characteristic smell of raw chestnut. Within 20 - 30 minutes, the semen liquefies, becomes homogeneous, viscous and has an opaque whitish-gray color. Its quantity is individual and can vary from 1 - 2 to 10 ml or more, on average 3 - 3.5 ml. The amount of ejaculate also depends on the frequency of ejaculation. The more often sexual or masturbatory acts are performed, the smaller the volume of each subsequent portion of ejaculate. As practice shows, a large volume of sperm does not mean its higher fertility.

In general, the fertilizing ability of sperm is characterized not so much by its volume as by the number of spermatozoa in 1 ml of semen, the percentage of actively motile spermatozoa, the percentage of morphologically normal (mature) forms, and a number of other parameters.

A fairly common misconception is the opinion that only one sperm is needed for conception, but, unfortunately, this is far from the case. Indeed, only one spermatozoon can penetrate the egg and give rise to a new life. But for this, he must go a very long way in the general flow of sperm - from the vagina through the cervix, through the uterine cavity, then along one of the fallopian tubes to meet the egg. One will simply die. And in the fallopian tube with an egg, he also cannot cope alone. The egg is large and round, and in order for one sperm cell to enter it, a large number of other sperm cells must help destroy its shell.

Therefore, there are certain standards for determining the fertility of sperm. For this, a detailed qualitative and quantitative analysis of sperm is carried out, which is called

To donate sperm for analysis, a man must fulfill simple requirements. It is necessary to refrain from sexual activity and masturbation for at least 48 hours, but not more than 7 days (the optimal period is 3-5 days), it is also important that during this period there are no wet dreams. On days of abstinence, you can not drink alcohol, drugs, bathe, take a bath (preferably wash in the shower). Sperm is best obtained in the laboratory by masturbation. It is very important that all the sperm ejected during ejaculation in full fall into the laboratory glassware. The loss of at least one serving (especially the first) can significantly distort the result of the study.

Usually, spermogram includes the following indicators(for each, their normal values \u200b\u200bare given):

ejaculate volume - 2-5 ml
color - grayish white
smell of raw chestnut
pH - 7.2-7.6
liquefaction time - 20-30 minutes
viscosity - 0.1-0.5 cm
the number of spermatozoa in 1 ml is 60-120 million / ml
the number of spermatozoa in the entire ejaculate -> 150 million
mobility, actively mobile —> 50%
slow moving - 10-15%
motionless - 20-25%
the number of live spermatozoa -> 50%
pathological forms, the total percentage -< 20%
spermatogenesis cells, total percentage - 1-2%
leukocytes - single in the field of view
erythrocytes - no
epithelium - 2-3
Bechter crystals - single
lecithin grains - a lot
slime - no
spermagglutination - no
microflora - no
special tests resistance - 120 min and more
the speed of movement of spermatozoa is 2-3 mm / min
metabolic activity - 60 minutes or more
fatigue - the percentage of mobile forms after 1 hour is reduced by 10%, after 5 hours - by 40%

Not always a deviation from these characteristics in one direction or another is a sign of a disease. Changes in spermogram parameters may be temporary and be due to the negative impact of external factors.

It should also be remembered that on the basis of one analysis it is impossible to draw conclusions about the violation of the reproductive function of a man. Therefore, in the presence of pathological changes in the ejaculate, it is necessary to retake the analysis and only then draw conclusions.

Based on the results of the spermogram, the following conclusions can be drawn:

« normozoospermia» - all indicators are within the established norms, the reproductive function (fertility) is not impaired.
« Asthenozoospermia"- reduced sperm motility.
« Teratozoospermia"- the percentage of morphologically immature forms is increased (violation of the structure of the head, tail of spermatozoa.)
« Oligozoospermia"- the number of spermatozoa in 1 ml is reduced.
complete absence of spermatozoa in the ejaculate. The onset of pregnancy in a natural way with such indicators is impossible. This condition can be caused either by impaired patency of the vas deferens (obstructive azoospermia) or by congenital or acquired inhibition of the testicles (non-obstructive, or, according to another classification, secretory form).
« Oligotheratoasthenozoospermia» - a combination of oligozoospermia, teratozoospermia, asthenozoospermia.
« Aspermia"- lack of seminal fluid

Possible causes of reproductive dysfunction in men

There are a lot of reasons that cause violations of spermatogenesis in men. The most common in practice are sexually transmitted infections(chlamydial, ureamycoplasma and other infections) and chronic prostatitis. It is characteristic that these diseases can be completely asymptomatic for a long time.

The next most common reason is varicocele. This is a violation of the outflow of blood through the vein coming from the testicles, occurring in a population of 10 - 15% of men, and can be the cause of inhibition of spermatogenesis.

Significant factors are some concomitant (or suffered in childhood) diseases, taking a number of medications, occupational hazards, exposure to high temperatures, abuse of nicotine, alcohol, and drugs.

Rarely congenital or acquired and genetic disorders. It should be noted that thanks to the achievements of genetics, it has become possible to diagnose a number of previously unknown causes of male reproductive dysfunction. In particular, this is the definition of AZF - a factor - a locus in the long arm of the Y chromosome responsible for spermatogenesis. With its loss in the spermogram, gross violations are revealed up to azoospermia. Work is also underway to study the effect of mitochondrial DNA mutations on the fertilizing ability of spermatozoa. Mitochondrial disorders can be inherited or occur de novo in germ cells. As a result, the patient has a pronounced astheno- or teratozoospermia, which cannot be treated.

In some cases, even with the most detailed examination, it is not possible to establish the cause. In this case, one can speak of idiopathic reduced fertility.

The human body is a complex of physiological systems (nervous, cardiovascular, respiratory, digestive, excretory, etc.) that ensure the existence of a person as an individual. Violation of any of them leads to disorders, often incompatible with life. The functions of the reproductive or reproductive system are primarily aimed at the continuation of the existence of man as a biological species. All life-supporting systems function from the moment of birth to death, the reproductive "works" only in a certain age period, corresponding to the optimal rise in physiological capabilities. This temporal conditionality is associated with biological expediency - the bearing and rearing of offspring requires significant resources of the body. Genetically, this period is programmed for the age of 18–45 years.

Reproductive function is a complex of processes that covers the differentiation and maturation of germ cells, the process of fertilization, pregnancy, childbirth, lactation and subsequent care of offspring. Interaction and regulation of these processes are provided by the system, the center of which is the neuroendocrine complex: hypothalamus - pituitary gland - gonads. The central role in the implementation of the reproductive function is played by the reproductive, or genital, organs. The reproductive organs are divided into internal and external.

The structure and age features of the male reproductive system

In men, the internal genital organs include the gonads (testicles with appendages), the vas deferens, the vas deferens, the seminal vesicles, the prostate, and the bulbourethral (Cooper) glands; to the external genital organs - the scrotum and penis (Fig. 9.2).

Fig. 9.2.

Testicle - a paired male sex gland that performs exo- and endocrine functions in the body. The testicles produce spermatozoa (external secretion) and sex hormones that influence the development of primary and secondary sexual characteristics (internal secretion). In shape, the testicle (testis) is an oval, slightly compressed laterally body, lying in the scrotum. The right testicle is larger, heavier and located higher than the left.

The testicles are formed in the abdominal cavity of the fetus and before birth (at the end of pregnancy) descend into the scrotum. The movement of the testicles occurs along the so-called inguinal canal - an anatomical formation that serves to conduct the testicles to the scrotum, and after the completion of the lowering process - to locate the vas deferens. The testicles, having passed the inguinal canal, descend to the bottom of the scrotum and are fixed there by the time the child is born. Undescended testicle (cryptorchidism) leads to a violation of its thermal regime, blood supply, trauma, which contributes to the development of dystrophic processes in it and requires medical intervention.

In a newborn, the length of the testicle is 10 mm, the weight is 0.4 g. Before puberty, the testicle grows slowly, and then its development accelerates. By the age of 14, it has a length of 20-25 mm and a weight of 2 g. At 18-20 years old, its length is 38-40 mm, weight - 20 g. Later, the size and weight of the testicle increase slightly, and after 60 years, slightly decrease.

The testicle is covered with a dense connective tissue membrane, which forms a thickening at the posterior edge, called mediastinum. From the mediastinum inside the testicle, radially located connective tissue septa extend, which divide the testis into many lobules (100–300). Each lobule includes 3–4 closed convoluted seminiferous tubules, connective tissue, and interstitial Leydig cells. Leydig cells produce male sex hormones, and the spermatogenic epithelium of the seminiferous tubules produce spermatozoa, consisting of a head, neck and tail. The convoluted seminiferous tubules pass into the direct seminiferous tubules, which open into the ducts of the testicular network located in the mediastinum. In a newborn, the convoluted and straight seminiferous tubules do not have a lumen - it appears by puberty. In adolescence, the diameter of the seminiferous tubules doubles, and in adult men it triples.

The efferent tubules (15–20) emerge from the network of the testis, which, strongly wriggling, form cone-shaped structures. The combination of these structures is an appendage of the testicle, adjacent to the upper pole and the posterolateral edge of the testicle, in which the head, body, and tail are distinguished. The epididymis of a newborn is large, its length is 20 mm, its weight is 0.12 g. During the first 10 years, the epididymis grows slowly, and then its growth accelerates.

In the region of the body of the appendage, the efferent tubules merge into the duct of the appendage, which passes into the region of the tail into vas deferens , which contains mature but immobile spermatozoa, has a diameter of about 3 mm and reaches a length of 50 cm. Its wall consists of mucous, muscular and connective tissue membranes. At the level of the lower pole of the testicle, the vas deferens turns upward and, as part of the spermatic cord, which also includes vessels, nerves, membranes and the muscle that lifts the testicle, follows the inguinal canal into the abdominal cavity. There it separates from the spermatic cord and, without passing through the peritoneum, descends into the small pelvis. Near the bottom of the bladder, the duct expands, forming an ampulla, and, having accepted the excretory ducts of the seminal vesicles, continues as ejaculatory duct. The latter passes through the prostate gland and opens into the prostatic part of the urethra.

In a child, the vas deferens is thin, its longitudinal muscle layer appears only by the age of 5. The muscle that lifts the testicle is poorly developed. The diameter of the spermatic cord in a newborn is 4.5 mm, at 15 years old - 6 mm. The spermatic cord and vas deferens grow slowly until the age of 14–15, and then their growth accelerates. Spermatozoa, mixing with the secretion of the seminal vesicles and the prostate gland, acquire the ability to move and form seminal fluid (sperm).

seminal vesicles are a paired oblong organ about 4-5 cm long, located between the bottom of the bladder and the rectum. They produce a secret that is part of the seminal fluid. The seminal vesicles of a newborn are poorly developed, with a small cavity, only 1 mm long. Up to 12–14 years old, they grow slowly, at 13–16 years old, growth accelerates, the size and cavity increase. At the same time, their position also changes. In a newborn, the seminal vesicles are located high (due to the high position of the bladder) and are covered on all sides by the peritoneum. By the age of two, they descend and lie retroperitoneally.

prostate (prostate) ) is located in the pelvic area under the bottom of the bladder. Its length in an adult man is 3 cm, weight - 18-22 g. The prostate consists of glandular and smooth muscle tissues. The glandular tissue forms lobules of the gland, the ducts of which open into the prostate part of the urethra. Prostate mass in a newborn

0.82 g, at 3 years old - 1.5 g, after 10 years there is an accelerated growth of the gland and by the age of 16 its mass reaches 8–10 g. The shape of the gland in a newborn is spherical, since the lobules are not yet expressed, it is located high, has a soft texture, glandular tissue is absent in it. By the end of the pubertal period, the internal opening of the urethra shifts to its anterior superior edge, the glandular parenchyma and prostate ducts are formed, the gland acquires a dense texture.

bulbourethral (Cooper's) gland - a paired organ the size of a pea - located in the urogenital diaphragm. Its function is to secrete a mucous secretion that promotes the movement of sperm through the urethra. Its excretory duct is very thin, 3-4 cm long, opens into the lumen of the urethra.

Scrotum is a receptacle for testicles and appendages. In a healthy man, it is reduced due to the presence in its walls of muscle cells - myocytes. The scrotum is like a "physiological thermostat" that maintains the temperature of the testicles at a lower level than the body temperature. This is a necessary condition for the normal development of spermatozoa. In a newborn, the scrotum is small in size, its intensive growth is observed during puberty.

Penis has a head, neck, body and root. The head is the thickened end of the penis, on which the external opening of the urethra opens. Between the head and the body of the penis there is a narrowed part - the neck. The root of the penis is attached to the pubic bones. The penis consists of three cavernous bodies, two of which are called the cavernous bodies of the penis, the third - the spongy body of the urethra (the urethra passes through it). The anterior part of the spongy body is thickened and forms the head of the penis. Each cavernous body is covered on the outside with a dense connective tissue membrane, and inside it has a spongy structure: thanks to numerous partitions, small cavities (“caves”) are formed, which fill with blood during intercourse, the penis swells and comes into a state of erection. The length of the penis in a newborn is 2-2.5 cm, the foreskin is long and completely covers its head (phimosis). In children of the first years of life, the state of phimosis is physiological, however, with a pronounced narrowing, swelling of the foreskin can be noted, leading to difficulty urinating. A whitish sebaceous substance (smegma) accumulates under the foreskin, produced by glands located on the glans penis. If personal hygiene is not followed and infection is added, smegma decomposes, causing inflammation of the head and foreskin.

Before puberty, the penis grows slowly, and then its growth accelerates.

Spermatogenesis - the process of development of male germ cells, ending with the formation of spermatozoa. Spermatogenesis begins under the influence of sex hormones during the puberty of a teenager and then proceeds continuously, and in most men - almost until the end of life.

The process of sperm maturation occurs inside the convoluted seminiferous tubules and lasts an average of 74 days. On the inner wall of the tubules are spermatogonia (the earliest, first cells of spermatogenesis), containing a double set of chromosomes. After a series of successive divisions, in which the number of chromosomes in each cell is halved, and after a long phase of differentiation, spermatogonia turn into spermatozoa. This happens by gradual stretching of the cell, changing and elongating its shape, as a result of which the cell nucleus forms the head of the spermatozoon, and the membrane and cytoplasm form the neck and tail. Each spermatozoon carries a half set of chromosomes, which, when combined with a female germ cell, will give a complete set necessary for the development of the embryo. After that, mature spermatozoa enter the lumen of the testicular tubule and further into the epididymis, where they are accumulated and excreted from the body during ejaculation. 1 ml of semen contains up to 100 million spermatozoa.

A mature, normal human spermatozoon consists of a head, neck, body, and tail, or flagellum, which ends in a thin terminal filament (Fig. 9.3). The total length of the spermatozoon is about 50–60 µm (head 5–6 µm, neck and body 6–7 µm, and tail 40–50 µm). In the head is the nucleus, which carries the paternal hereditary material. At its anterior end is the acrosome, which ensures the penetration of the sperm through the membranes of the female egg. Mitochondria and spiral filaments are located in the neck and body, which are the source of the motor activity of the spermatozoon. An axial filament (axoneme) departs from the neck through the body and tail, surrounded by a sheath, under which 8–10 smaller filaments are located around the axial filament - fibrils that perform motor or skeletal functions in the cell. Motility is the most characteristic property of the spermatozoon and is carried out with the help of uniform blows of the tail by rotating around its own axis in a clockwise direction. The duration of the existence of the sperm in the vagina reaches 2.5 hours, in the cervix - 48 hours or more. Normally, the spermatozoon always moves against the flow of fluid, which allows it to move up at a speed of 3 mm / min along the female genital tract until it meets the egg.

An important factor in planning future offspring is not only the health of a woman, but also the proper functioning of the systems of the male body. The male reproductive system is a collection of organs responsible for procreation (reproduction).

Such a system is responsible for the following functions:

Production and transportation of male germ cells (spermatozoa).
Delivery of spermatozoa into the female reproductive system (during sexual intercourse).
The production of hormones responsible for the proper functioning of the male reproductive system.

The physiology of the male reproductive system is closely related to the body's urinary system.

Consider the structure and functions of the male reproductive organs (with photo).

Modern anatomy gives a complete picture of the physiology of the structure of the human reproductive system. There are many video and photographic materials, many articles and medical manuals have been written that consider the functions and structure of the reproductive system.

Male puberty occurs not much later than female puberty, and does not have such a well-defined indicator as female menstruation. Men reach full puberty, as a rule, by the age of 18, although full-fledged spermatozoa are produced by 13-14 years. Unlike the female body, male reproductive cells (gametes) continue to be produced throughout the entire period of life after the onset of puberty. Of course, it should be noted that spermatogenesis in older men is less intense, and the number and activity of produced cells may decrease. However, their ability to fertilize remains.

The reproductive system of a man consists of two types of organs of the reproductive system: external and internal.

Outdoor:

Scrotum.
Penis (penis).

Internal:

The prostate gland (prostate).
seminal vesicles.
Testicles and their appendages.
Seminal ducts.

Consider the structure of the male reproductive organs in more detail.

The musculoskeletal sac, inside which the testicles with appendages and the duct responsible for ejaculation, are located, is called the scrotum. The anatomy of the structure of the scrotum is quite simple: it is divided by a septum into two chambers, each of which contains one of the two gonads. The main functions are to protect the testicles and maintain the optimal temperature for the formation and development of spermatozoa (spermatogenesis). According to its structure, the scrotum consists of several layers, including skin, as well as muscle tissue that raises or lowers the testicles under certain influences (changes in ambient temperature, physiological processes - arousal, ejaculation).

The penis is the main organ responsible for urination and the delivery of seminal fluid to a woman's body. The anatomy and physiology of the penis distinguishes three main sections of the structure: the head, the base, the body itself. In the upper part there are two so-called cavernous bodies. They are parallel to each other and run from the base to the head of the penis. Under the cavernous bodies is a spongy body, it contains the urethra. All of them are covered with a dense membrane containing chambers (lacunae) that fill with blood during sexual arousal. It is the gaps that contribute to the appearance of an erection. The function of external protection of the bodies is performed by the skin, which is sufficiently elastic and capable of stretching. The endings of the spongy and cave bodies are located in the head of the penis, covered with thin skin with many nerve endings.

The external genital organs, representing the male reproductive system, continue to grow only during maturation.

The testicles (testicles) are the most important paired organs that affect the process of sperm formation. The growth of the testicles proceeds rather slowly and accelerates only during puberty. Each of the paired organs in its structure is divided into seminal lobules, in which the seminiferous tubules are located, which take part in spermatogenesis. These tubules make up about 70 percent of their volume. Passing through the membrane, the tubules enter the epididymis, in which the ability of spermatozoa to fertilize is finally formed.

The epididymis is a narrow duct adjacent to the testicle and is responsible for the final maturation of spermatozoa, their accumulation and promotion through the genital tract. The process of spermatogenesis is carried out in this part of the male reproductive system. The length of the duct itself is about 8 m, and the movement of spermatozoa to the place of their accumulation takes about 14 days. The anatomy of the appendage consists of three main sections: tail, body and head. The head is divided into lobules, which flow into the epididymal duct and pass into the vas deferens.

The prostate gland is located in close proximity to the bladder and is palpable only through the rectum. The dimensions of the gland of a healthy man are set within certain limits: width from 3 to 5 cm, length from 2 to 4 cm, thickness from 1.5 to 2.5 cm. and prescribing the right treatment. The gland is divided into two lobes, connected by an isthmus. Through it pass the urethra, as well as the ejaculatory ducts.

The main function of the prostate gland is the production of testosterone, a hormone that directly affects the process of fertilization of the egg. In addition to the secretory function of the prostate, motor function can be distinguished: muscle tissue is involved in the release of prostate secretion during ejaculation, and is also responsible for urinary retention. Thanks to the secretion produced, the penetration of urethral infections into the upper tract of the male urinary system is blocked. With age, there is an increased risk of developing various prostate diseases that affect its physiology. As a result, the reproductive function of a man decreases.

The seminal vesicles are another paired organ of the male reproductive system, located above the prostate gland, between the walls of the rectum and bladder. The main function of the bubbles is the production of an important active substance (secret), which is part of the seminal fluid. The secret nourishes the spermatozoa, increasing their resistance to the negative effects of the external environment. This is the source of energy for gametes. The ducts of the seminal vesicles join the ducts responsible for ejaculation, and at the end form the ejaculatory duct. Violations of the physiology or diseases of the seminal vesicles can cause problems in conception, as well as complete infertility in men.

Violation of the reproductive system

According to statistics, women are much more likely to undergo preventive examinations and tests to identify problems of the reproductive system. Men, for the most part, prefer to go to doctors only in case of exacerbations of diseases or obvious violations of the physiology of the functioning of the genital organs. At the same time, the reproductive health of men and women is one of the most important indicators of reproduction. During the planning period for pregnancy, couples often experience conception problems caused by the failure of the male genitourinary system.

The main causes of violations:

Infectious diseases.
Failure of the prostate gland.
Colds and inflammation.

Violation of sexual function as a consequence of the disease is quite obvious. However, there are other reasons as well. First of all, it is necessary to say about the wrong way of life: taking psychoactive substances that cause a psychedelic effect (for example, hallucinogenic mushrooms), other drugs and alcohol. In addition, congenital anomalies in the structure of organs, manifested anatomically, can become the cause.

Let us dwell on the most common diseases that affect the reproductive system.

First of all, it is worth mentioning such a disease as prostatitis. This is the most common cause of reproductive dysfunction in men. Currently, every fourth man in varying degrees suffers from inflammation of the prostate. As a rule, men aged 40 and older are at risk. However, younger men are also susceptible to the disease. The influence of the work of the gland on the physiology of the reproductive system is very high. In order to improve its functioning, it is necessary to undergo a full examination, according to the results of which treatment will be prescribed. Self-administration of drugs without consulting a doctor can increase the risk of complications.

Another disease that affects the physiology of the reproductive system is vesiculitis. This pathology is characterized by inflammation of the seminal vesicles. A high risk of this disease exists in men suffering from chronic prostatitis. The main symptom of the disease: pain during ejaculation, in the perineum and groin, as well as general weakness. With advanced forms, treatment is carried out surgically, with early diagnosis, treatment with antibacterial drugs is possible.

As a prevention of diseases of the reproductive system, it is necessary to adhere to the basic rules:

Quality and varied food.
Complex physical activity.
Preventive examinations of narrow specialists.
Regular sex life.
Exclusion of casual sexual relations.

Also, do not forget about the rules of personal hygiene and adherence to sleep and wakefulness. If any symptoms of diseases of the reproductive system (itching, redness, pain, cracks in the skin or swelling) appear, you should immediately consult a doctor for diagnosis and accurate diagnosis. It is important to remember that letting any disease take its course or self-treatment can threaten even greater violations of physiological processes. The advanced stages of some diseases can be cured only by surgical intervention, and some diseases of the reproductive system become chronic and increase the risk of complications such as infertility or impaired potency.

The reproductive system of a man is a set of internal and external structures of the small pelvis that are responsible for the sexual and reproductive function of the male. A distinctive feature of these structures is the external location and a simpler anatomical structure. The reproductive system is responsible for the duration of the biological species, the production of hormones and the fertilization of a woman's egg. In order to avoid violations of the functionality of this system, it is necessary to regularly visit a urologist and diagnose organs using ultrasound, MRI or radiography.

The male reproductive organs are divided into internal and external. The anatomical structure of the entire system is much simpler than in women, since most of the organs are located outside the body.

External include:

The penis or penis is a key organ in the entire system that is responsible for the excretion of urine, genital contact and the transport of sperm directly into the female uterine cavity. There are a large number of nerve endings on the penis to make it easier for a man to cause an erection. The opening of the urethra is located in the head of the penis, covering the foreskin. The penis consists of a root, the part that connects to the frontal area. The body or trunk is a part that consists of three components (two cavernous bodies and the urethra). The head is covered by the foreskin and consists of a spongy body. At birth, the foreskin may be removed to reduce the chance of infection.
The scrotum is a skin formation in the form of a small pouch located under the penis. The testicles are located in the scrotum, responsible for the production of secretions and reproductive cells. In addition, it contains a large number of nerve clusters and blood vessels that provide a regular supply of nutrients to the genitals. Muscle tissue wraps around the scrotum to prevent cooling or overheating. This process is important in the production of sperm, as it is created under certain temperature conditions. At low ambient temperatures, these muscles move the testicles closer to the body, and in hot weather, the opposite is true.
The testicles are a paired organ resembling a small oval. They are located right in the scrotum, communicating with other structures through the seminal canal. A healthy man has two testicles, and in cases of congenital pathology, this number may vary. The main function of the testicles is the production of testosterone (male sex hormone), secretion and spermatozoa. In the middle of the structure contains a large number of seminiferous tubules that are involved in the production of spermatozoa.

If we consider the external organs from an anatomical point of view, then the penis has the shape of a cylinder and consists of a large number of spongy bodies that fill with blood during an erection. When all the cavities are filled with liquid, the penis increases in size several times and hardens. If a man has problems with erection or has certain infections of the genitourinary system, the hardness of the penis is not observed.

Since the top layer of the skin is easily stretched and takes on a different shape, the increase in the size of the penis is painless. With the onset of an erection, the penis is ready to penetrate the woman's genitals and perform intercourse. In this process, the exit of urine from the urethra becomes impossible, since the prostate gland blocks its excretion.

During intercourse, a secret is secreted from the urethra, the function of which is to prepare the penis for intercourse. The secret containing spermatozoa enters the vagina with the onset of orgasm in a man.

The organs that are located inside the abdominal wall include:

The epididymis are curved tubes that extend from the back of each testicle. They play an important role in the preparation of spermatozoa and their maturation. From the testicles, spermatozoa enter the appendages, where they mature and stay until the climax happens. During strong excitement and approach to the climax, the secret, together with the reproductive cells, is excreted into the vas deferens.
The vas deferens are tubes that start from the curved tubes of the appendages and pass into the pelvic cavity, where they are located near the bladder. During sexual arousal, these ducts transport mature spermatozoa to the urethra.
Ejaculatory ducts - these ducts are a continuation of the vas deferens and seminal vesicles. Therefore, after maturation, the sperm enters the ejaculatory or ejaculatory ducts, which direct it to the urethra.
The urethra or urethra is a long tube that runs through the entire cavernous body of the penis and ends at the urethral opening. Through this channel, the man is emptied and the seminal fluid is erupted. Despite the same transport, these two fluids do not mix due to blockage of the prostate gland.
Seminal vesicles are small capsules that are located in close proximity to the bladder. They are connected to the vas deferens and provide reproductive cells with long life. This process is associated with the production of a special liquid fructose, which is saturated with carbohydrates. They are the main source of energy reserves of spermatozoa and components in seminal fluid. Fructose allows germ cells to actively move and keep alive for a long time after entering the vagina.
The prostate gland or prostate is a small oval-shaped structure that is responsible for the energy saturation of spermatozoa and ensuring their vital activity. In addition to these properties, the prostate gland serves as a barrier between urine and semen. The fluid that comes from the prostate is rich in carbohydrates, phospholipids and other nutrients.
Cooper's glands are small capsules located on both sides of the urethra near the prostate. The glands secrete a special secret that has antibacterial properties. The secret is used during the processing of the urethra after the excretion of urine, and also as a lubricant before intercourse.

All organs are connected through hormones produced by the endocrine glands.

Diseases of the reproductive system

Diseases of the genitourinary system can occur as a result of external factors (decreased immunity, diabetes, infection during unprotected sex, and others) and structural changes in the genitals.

In adulthood, men are more susceptible to structural changes in soft tissues. This is especially true of the prostate gland, which begins to change with age.

Inflammation of the organs of the genitourinary system occurs due to hypothermia, trauma or urogenital infections. Among all diseases, prostatitis is distinguished, which affects a large number of men every year. This pathology affects individuals of a young age and men after 45 years.

The main symptoms of prostatitis are frequent urination, pain during urination and decreased erection. In order to get rid of the disease and prevent the occurrence of relapses, a man should seek medical help from a doctor. The specialist will diagnose and determine the etiological factor, after which he will prescribe the correct treatment.

infectious diseases

This type of pathology is the most common, as the number of patients with sexually transmitted diseases increases every year. Unprotected sex causes infection for both males and females.

The main diseases transmitted in this way include:

candidiasis - a disease caused by fungi of the genus Candida and occurs in people with weakened immune systems;
chlamydia is a disease caused by chlamydia;
gonorrhea is a pathology that affects the mucous membranes of the penis, rectum and the membranes of the eyes;
ureaplasmosis is a rare disease caused by gram-inactive microorganisms without a cell wall;
syphilis is a sexually transmitted disease that affects the skin, nervous and skeletal systems of a person.

If these pathologies are ignored, the patient has a serious damage to all functional systems, up to death.

With infertility caused by infectious diseases or structural changes in the pelvic organs, many patients begin to worry about how to improve the reproductive functions of a man and achieve the desired conception.

Male infertility can be caused by several reasons:

low activity of spermatozoa;
hormonal disruptions;
inflammatory processes in the organs of the genitourinary system;
structural changes in the vas deferens responsible for the transport of seminal fluid.

In order to start treatment of male infertility, it is necessary to find out the etiological factor. To do this, the doctor takes a swab from the urethra and conducts a large number of tests for bacterial cultures and hormonal levels.

Oncological formations

Allocate benign and malignant formations in the organs of the genitourinary system. Prostate adenoma or benign hyperplasia is the most common form of pathology that occurs in males with the onset of 50 years. This is the growth of glandular tissue, which is accompanied by the formation of tumors. This affects many parts of the prostate and adjacent structures, including the urethra.

This leads to the following symptoms:

pain during urination;
discomfort in the groin area;
violation of sexual function;
frequent urge to go to the toilet.

In order to identify pathology in time, a man must regularly check the health of the reproductive system and pay attention to the first signs of the disease in time.

In the case of the formation of a malignant tumor, a long course of chemotherapy is observed, during which the doctor monitors the improvement in the patient's condition. With full recovery, there is a small chance of repeated relapses, so a man should be regularly examined by a doctor.

The defining possibility of conceiving a child for a man is the ability to form full-fledged germ cells - spermatozoa. The development of male germ cells is under constant hormonal regulation and is a long and complex process. This process is called spermatogenesis. At the age of 5 years, the male gonads (testicles) are in a state of relative rest, at 6-10 years of age, the very first cells of spermatogenesis, spermatogonia, appear in them. Full formation of spermatogenesis occurs at 15-16 years.

The entire process of sperm formation until full maturation takes approximately 72 days. The entire process of sperm formation takes place at a temperature that is 1-2°C lower than the temperature of the internal regions of the body. The lower temperature of the scrotum is partly determined by its position and partly by the choroid plexus formed by the artery and vein of the testis and acting as a countercurrent heat exchanger. Special muscle contractions move the testes closer or further away from the body, depending on the air temperature, to maintain the temperature in the scrotum at a level optimal for sperm formation.

If a man has reached puberty and the testicles have not descended into the scrotum (a condition called cryptorchidism), then he remains sterile forever, and in men who wear too tight underpants or take very hot baths, sperm production can drop so much that it leads to infertility. Very low temperatures also stop the production of sperm, but do not destroy the stored one.

The process of spermatogenesis proceeds continuously throughout the sexual activity of the organism (in most men, almost until the end of life), but sperm is released into the external environment only at certain moments. During sexual arousal, the spermatozoa accumulated in the epididymis, together with the secretion of the epididymis, move along the vas deferens to the seminal vesicles. The secret of the appendages liquefies the environment, providing greater sperm motility and nourishes the sperm during the eruption of the seed. With sexual arousal, the secret of the prostate gland is also produced at the same time, it is thrown into the posterior urethra.

The secret of the gland activates sperm motility. All this mixture (prostate gland secretions, spermatozoa, seminal vesicle secretions) forms sperm, and at the moment of greatest sexual arousal, this mixture is ejected to the outside - ejaculation. After ejaculation, spermatozoa retain their viability for a short time - 48-72 hours.

Sperm and its indicators

In general, the fertilizing ability of sperm is characterized not so much by its volume as by the number of spermatozoa in 1 ml of semen, the percentage of actively motile spermatozoa, the percentage of morphologically normal (mature) forms, and a number of other parameters. A fairly common misconception is the opinion that only one sperm is needed for conception, but, unfortunately, this is far from the case. Indeed, only one spermatozoon can penetrate the egg and give rise to a new life. But for this, he must go a very long way in the general flow of sperm - from the vagina through the cervix, through the uterine cavity, then along one of the fallopian tubes to meet the egg. One will simply die. And in the fallopian tube with an egg, he also cannot cope alone.

The egg is large and round, and in order for one sperm cell to enter it, a large number of other sperm cells must help destroy its shell. Therefore, there are certain standards for determining the fertility of sperm. For this, a detailed qualitative and quantitative analysis of sperm is carried out, which is called a spermogram.

To donate sperm for analysis, a man must fulfill simple requirements. It is necessary to refrain from sexual activity and masturbation for at least 48 hours, but not more than 7 days (the optimal period is 3-5 days), it is also important that during this period there are no wet dreams. On days of abstinence, you can not drink alcohol, drugs, bathe, take a bath (preferably wash in the shower).

Sperm is best obtained in the laboratory by masturbation. It is very important that all the sperm ejected during ejaculation in full fall into the laboratory glassware. The loss of at least one serving (especially the first) can significantly distort the result of the study. As a rule, a spermogram includes more than 25 indicators. Not always a deviation from these characteristics in one direction or another is a sign of a disease. Changes in spermogram parameters may be temporary and be due to the negative impact of external factors.

Possible causes of reproductive dysfunction in men

Causes causing spermatogenesis disorders men, a lot. The most common in practice are sexually transmitted infections (chlamydial, ureamycoplasma and other infections) and chronic prostatitis. It is characteristic that these diseases can be completely asymptomatic for a long time. The next most common cause is varicocele. This is a violation of the outflow of blood through the vein coming from the testicles, occurring in a population of 10 - 15% of men, and can be the cause of inhibition of spermatogenesis. Significant factors are some concomitant (or suffered in childhood) diseases, taking a number of medications, occupational hazards, exposure to high temperatures, abuse of nicotine, alcohol, and drugs. Less common are congenital or acquired hormonal and genetic disorders. It should be noted that thanks to the achievements of genetics, it has become possible to diagnose a number of previously unknown causes of male reproductive dysfunction. In some cases, even with the most detailed examination, it is not possible to establish the cause. In this case, we can talk about idiopathic reduced fertility.