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INSUFFICIENT LIKE FACTION OF SPERM CAN BE THE CAUSE OF INFERTILITY
Turkey Medicals member and JCI hospital department Urology Specialist Prof. Dr. said, He writes a lot of results in sperm analysis reports. The first thing to look for among them is the number of spermatozoa, their and morphology. However, other values also provide very important information in understanding where the problem originated. One of them is the likefaction time.
Special collection containers are used for sperm analysis. An example is also given in this. When the ejaculate first comes out, it remains attached to the inner wall of the container in the form of a clot. But in order to be able to examine it under a microscope, it must melt and become a liquid. Here we call the process of transformation of semen from a clot to a liquid liquid likefaction, that is, melting. Microscopic examination of sperm can also not be done in cases where this does not happen.
Also during normal intercourse, when semen is thrown into the female genital tract, it is in a clot state. After a while, it melts, and the sperm cells in it are able to move towards the egg, which can easily move. In the absence of likefaction, that is, melting, pregnancy is also not observed, since spermatozoa cannot reach the egg. Likefaction disorder is one of the causes that causes infertility. Therefore, it should be checked whether the likefaction is normal in the assays.
Likefaction of semen occurs within 5 to 20 minutes. It is a protein-dissolving enzyme that comes from the prostate and is known as PSA, that is, a prostate-specific antigen. Because it is associated with a prosthesis called Kallikrein, it is also referred to as KLKs in most places. This likefaction-making enzyme secreted from the prostate is mixed into it during ejaculation, when semen is expelled from it. Immediately after that, the semen melts and becomes a liquid liquid.
Prolonged or no likefaction time of sperm in the assays is one of the reasons leading to infertility. One reason for this is that the structure of the PSA enzyme is genetically impaired. Although it is known which gene is responsible for this, there is practically no test to measure it. A genetic disorder should be suspected when no reason can be established. Among other reasons, the most common are disorders in the work of the glands on the dec tract. The main reason for this is inflammation of the glands of the epididymis, prostate and seminal vesicles. If the number of leukocytes in the sperm test has increased, this should come to mind. But not always an increase in leukocytes may be observed. In such cases, the painful exit of semen, pain in the testicles or burning during urination may also indicate inflammatory diseases of the glands. In particular, prostate inflammation should be investigated in this regard. Prostatitis is one of the most complicated urological diseases, the diagnosis and treatment of which are decontaminated.
Since the likeficiency enzyme will also disappear after prostate surgeries, likefaction may not occur. It is important that this situation is discussed with the patient before the operation and not worried about it afterwards.
Even if all this is normal, some disorders of the woman can also prevent the semen from melting and becoming fluid. Because some enzymes secreted from the female genital tract are able to prevent the likefaction process. In women, progesterone and estrogen hormone disorders and menstrual disorders, as well as inflammatory conditions can cause it.
It is worth noting that sometimes there are small, solid particles in the semen that come out of a very dark consistency. They can be caused by inflammation in the genital tract. There is also often an increase in leukocytes with it. This condition is indicated in the assays as increased viscosity. An increase in viscosity is a different problem than likefaction, and its treatment is also planned according to it.
First of all, inflammatory diseases of the genital tract should be investigated in spermatozoa with a problem of likefaction. Particular attention should be paid to the increase in leukocytes in the assays. If necessary, culture tests can be performed to investigate the microorganism that causes inflammation. Microorganisms such as chlamydia or urioplasma can only be detected by special examinations. Insufficient work of the genital glands can lead to an increase in oxidative stress and concomitant DNA damage. If there is such a finding, likefaction disorder can be associated with it.
First of all, fluid intake should be increased during treatment. Because drinking little water also reduces the fluidity of semen. Depending on the location, antibiotics, anti-inflammatory drugs that disperse inflammation can be used. Products that regulate the work of the genital glands may be useful. Antioxidant treatments for oxidative stress and DNA damage have an important place. If these do not benefit, vaccination with laboratory processing of the ejaculate, that is, intrauterine insemination or IVF in Turkey, is recommended as a last resort. Especially in cases where DNA damage is a problem, testicular sperm and IVF can also be considered.
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