history of male partner in a case there is subnormal seminal parameters, say azoospermia or male sexual disorders

How relevant is history of male partner in a case there is subnormal seminal parameters, say azoospermia or male sexual disorders ’ ??

 A thorough examination of male with systemic evaluation is important in order to determine what therapeutic measure may be useful.

So many time personal history only is nonproductive. Physicians have to collect data on past marital status, family history, reproductive, developmental, past medical and surgical events, childhood disease, chronic disease, and most important occupation, environmental factors.

Marital History

Duration of infertility

Fertility of patients or his partner in previous marriage

Frequency of intercourse

Use of coital lubricants

Sexual potency

"Sexual technique.

Childhood Disease

Cryptorchidism

Timing of puberty

Mumps in childhoods and not

Adult Illness

Mumps orchitis

Tuberculosis

Acute viral or febrile illness in

Renal disease

Radiation therapy.

Surgery

Herniorrhaphy

Vasectomy

Retroperitoneal surgery.

Drugs

Alkalylating agents

Amebicide

Nitrofurantoin

Hormones

Alcohol and other drug abuse.

Occupational and Habits

Exposure to radiation and chemicals

Exposure to excessive heat, sauna baths

Wearing tight underwears, synthetic underwear.

1)      SCROTAL TEMPERATURE :patients who wear tight underclothes

Several studies are conducted on effect of temperate on scrotum and physicians have found the litterateur that from scrotum if is insulated for long time there is detrimental effect on the sperm count and when motility and insulation is removed after some time, he gains his original motility and count.This may be true for the patients who wear tight underclothes and physicians have seen that after changing the habit they improve a lot.

STRESS

In today's life stress is everywhere and if see surgical, occupational and psychological are of prime importance and studies have proved that this stress will decrease spermatogenesis and is most likely mediated by an adrenal- pituitary hypothalamic feedback mechanism.

In man, surgical stress and combat stress have shown to depress circulating testosterone levels.

ALCOHOL USE

Excessive use of alcohol can result in impotence or reduced fertility or increased progeny mortality.

Chronic alcoholism characterized by hepatitis, fatty liver, and cirrhosis reduce fertility indirectly by decreasing gonadotropins levels and directly by affecting the Leydig cells and reducing testosterone levels.

The androgen levels although low, may still be in normal range, but because of an increase in androgen binding globulin the levels of the free active forms of testosterone may be reduced!  Under such condition, if physician perform test of FSH and LH he will see elevation in hormonal levels. This syndrome is characterized by testicular atrophy (biopsy reveal marked reduction in the germinal epithelium and peritubular fibrosis).

With progressive changes in alcoloism there is decreased growth of for as little as 5 days, a blunting of the episodic release and fall in the circulating level of testosterone occur and with increasing length of alcohol consumption this reduction continues.