
Doctor Malpani has also written a book called
"How to Get the Best Medical Care - For Less".
click here.
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Chapter 1 Do you have an infertility problem ? When to Start Worrying! Chapter 2 How Babies are Made - The Basics Chapter 3 Finding Out What’s Wrong -- The Basic Medical Tests Chapter 4 Testing the Man - Semen Analysis. Chapter 5 Beyond the Semen Analysis Chapter 6 Diagnosis and Treatment for Male Infertility -- More Confusion ! Chapter 7 The Case of the Man with a Low Sperm Count. Chapter 8 Microinjection: The Latest Advance in Treating the Infertile Man. Chapter 9 Ultrasound - Seeing with Sound. Chapter 10 Laparoscopy -- The Kinder Cut Chapter 11 Hysteroscopy Chapter 12 The Tubal Connection Chapter 13 Ovulation -- Normal and Abnormal Chapter 14 The Older Woman Chapter 15 Polycystic Ovarian Disease (PCOD) Chapter 16 The Cervical Factor Chapter 17 Hirsutism -- Excess Facial and Body Hair Chapter 18 Endometriosis -- The Silent Invader Chapter 19 Ectopic Pregnancy – The Time Bomb in the Tube Chapter 20 Unexplained Infertility Chapter 21 Secondary Infertility -- Caught Between Fertile And Infertile Worlds Chapter 22 Empty Arms -- The Lonely Trauma of Miscarriage Chapter 23 Understanding Your Medicines Chapter 24 Intrauterine Insemination Chapter 25 Test Tube Babies - IVF & GIFT Chapter 26 PREIMPLANTATION GENETIC DIAGNOSIS - the newest ART Chapter 27 Using Donor Sperm Chapter 28 Surrogate Mothering Chapter 29 When Enough is Enough - The Decision to End Treatment Chapter 30 Adoption - Yours by Choice Chapter 31 Childfree living - Life without children Chapter 32 Stress And Infertility Chapter 33 The Emotional Crisis of Infertility Chapter 34 How to Cope with Infertility Chapter 35 Infertility and Sexuality Chapter 36 Support Groups-Self-Help is the Best Help Chapter 37 Myths and Misconceptions Chapter 38 Helping Hands - How Friends and Relatives can Help Chapter 39 RIGHTS OF THE INFERTILE COUPLE - AND WHAT SOCIETY NEEDS TO DO ABOUT THEM Chapter 40 Alternative Medicine: Exploring Your Treatment Options Chapter 41 Making Decisions about Treatment Chapter 42 How to Find the Best Doctor Chapter 43 How to Make the Most of Your Doctor Chapter 44 Let the reader beware - making sense of medical stories in the news Chapter 45 THE INFERTILE PATIENT'S GUIDE TO THE INTERNET Chapter 46 The Ethical Issues - Right or Wrong ? Chapter 47 How Much Does Treatment Cost? Chapter 48 Pregnant - At Last ! Chapter 49 Preventing Infertility Chapter 50 The Infertile Patient's Prayer and Infertility "Defined" Chapter 51 Making IVF affordable Chapter 52 Why are women scared of IVF ? Chapter 53 INFERTILITY RECORD SHEET Chapter 54 Self-Insemination |
How Babies are Made - The Basics During ejaculation, the epididymis and vas deferens muscles contract to propel the sperm into the ejaculatory duct. Here the sperm is joined with the secretions of the seminal vesicles and prostate gland (which contribute the bulk of the seminal fluid) to form the semen. The powerful muscles surrounding the base of the urethra then cause the semen to squirt out of the penis at the time of orgasm. Semen and urine never mix in a healthy male ( even though the final passage for both is common) because the bladder sphincter muscle contracts during sexual stimulation, thus closing down the exit from the bladder to the urethra during ejaculation - preventing urine from leaking forward out of the bladder during sex and also preventing semen from accidentally going backward into the bladder. What about the penis and fertility ? Most men equate their fertility potential with their virility - and therefore the size of their penis. However , the size of the penis has little to do either with fertility potential or with sexual ability. (In any case, if you worry that your penis is too small, you're not alone - most men think their penises are too small !) During ejaculation, about one teaspoon of semen spurts out of the penis. Semen is a milky white color, the consistency of egg white. Sperm account for only about 2 to 3% of semen. Most of it consists of seminal fluid - the secretion of the seminal vesicles and the prostate gland, which provide a vehicle for the sperm into the vagina. A normal ejaculation contains 200 to 500 million sperm. How can so many sperm fit into only a teaspoon of semen ? Simple - sperm are very tiny. If one average ejaculation filled an Olympic size swimming pool, each sperm cell would still be smaller than a goldfish. Sperms are the smallest living cells in the human body - and the egg the largest. Basically, sperms are designed so that they can deliver their contents - the male genetic material - to the egg. This is why they are designed like projectiles - the male DNA is in the chromosomes in the sperm head nucleus, and the tail propels the sperm up towards the egg. Sperm are also very fragile. Men make so many because very few survive the swim through the female reproductive system to fertilize an egg. Perhaps the reason for this is an evolutionary hangover . Female fish deposit eggs on the sea-bed . This is why male fish need to produce millions of sperm which are sprayed into the sea water where millions will be wasted in order to ensure that some reach the eggs . What happens to the sperms if you don't have sex for many days ? Unfortunately, you cannot "store up" sperms. If ejaculation does not occur for many days, the sperms in the reproductive ducts simply die. This is why a sperm count done after many days of abstinence shows a high number of dead or immotile sperms. But just like you cannot store your sperm, you cannot run out of sperm either - masturbation and sex cannot use sperm up. The body keeps making sperm as long as a man has even one normal testicle.
Figure 3. The male reproductive system
Figure 4. The male reproductive system
Figure 5. A section through the testis and epididymis
Fig 6. The detailed microscopic structure of the seminiferous tubule showing the stages of spermatogenesis.
The Role of Testosterone
As already mentioned, the main male sex hormone is testosterone and
this is made by the testicles, starting at puberty. Testosterone is produced
by specialized cells in the testis called the Leydig cells. These are
stimulated to release testosterone in response to the LH signal from the
pituitary . LH is luteinizing hormone - the same hormone found in women. In addition
to testosterone, the production and maturation of sperm in the seminiferous
tubules of the testis is stimulated by FSH produced by the pituitary gland -
and this FSH is identical to that found in women. FSH acts on the
Sertoli cells to cause them to secrete androgen-binding protein, which
binds testosterone and facilitates its action on sperm production. The Sertoli
cells also produce growth factors such as SGF ( seminiferous growth factor)
which help to regulate spermatogenesis.
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