Orchitis and fertility in men

Orchitis is an inflammatory disease of the testicles that most often occurs in men as a result of infections such as mumps or influenza. In its acute form, the disease can be caused by sexually transmitted infections, particularly gonorrhea and chlamydia. Sometimes, the inflammation is caused by Escherichia coli, Enterococcus, and other pathogens.

The inflammation is most commonly diagnosed in men of reproductive age. The acute form of orchitis begins suddenly and is accompanied by a rapid deterioration of the general condition. In the chronic form, symptoms are mild: there is moderate pain in the scrotum, especially on touch.

Among the characteristic signs of acute orchitis are

• sudden enlargement and change in the shape of the scrotum,
• sharp pain in the affected testicle,
• elevation of body temperature to 39-40°C,
• reddening of the skin of the scrotum,
• hypertrophy of the inguinal lymph nodes,
• weakness, headaches, loss of appetite.

In the absence of timely treatment, orchitis can become chronic and lead to complications: obstruction of the seminiferous tubules, decreased libido, erectile dysfunction, and the development of infertility.

Diagnosis and therapeutic approaches

If orchitis is suspected, it is necessary to consult a urologist. The diagnosis includes a urine analysis, a urethral swab, a general blood test, and an ultrasound of the scrotum. Identification of the causative agent and its sensitivity to antibiotics is mandatory.

Treatment aims to control the inflammatory process and eliminate the infection. Antibiotic medications, analgesics, and non-steroidal anti-inflammatory drugs are prescribed. Angioprotectors are used to relieve swelling. During the period of acute inflammation, bed rest is recommended.

In severe forms of the disease, accompanied by abscesses or necrosis, surgical intervention may be necessary: from opening the pustule to removing the testicle in particularly severe cases.

Prevention of orchitis

To prevent inflammation of the testicles, it is important to avoid unprotected sexual intercourse and to treat urogenital infections in a timely manner. It is advisable to prioritize:

• a rational diet,
• the rejection of bad habits,
• moderate sexual activity.

The "Natuvitro" clinic specializes in the diagnosis and treatment of infectious-inflammatory diseases and male infertility using modern methods.

Orchitis and the ability to conceive

Orchitis can significantly reduce a man's fertility. Inflammation disrupts the process of spermatogenesis, deteriorating the quality, motility, and morphology of sperm. The consequences are particularly severe in cases of bilateral lesions or neglected forms of the disease.

Natural conception after orchitis

Even after complete recovery, men may present with asthenozoospermia or oligozoospermia. Sometimes, immunological infertility develops due to the production of anti-sperm antibodies, particularly after viral orchitis. If you are considering conceiving a child, you should undergo tests such as sperm analysis, MAR test, and hormonal profile.

In severe cases, with marked spermatogenesis pathology or testicular atrophy, assisted reproductive techniques may be used.

IVF in cases of anamnestical orchitis

If the course of orchitis is mild and the sperm analysis is normal, the patient's sperm can be used for fertilization within the framework of a classic IVF. If sperm is absent or of very poor quality, a testicular biopsy (TESE) is performed, and ICSI is carried out.

The prognosis depends on the state of the testicular tissue and the residual activity of spermatogenesis. Even in cases of serious disorders, it is possible to obtain viable cells.

IVF with donor eggs and male infertility

If a woman uses donor eggs but plans to conceive with the sperm of a partner suffering from orchitis, a thorough diagnosis is necessary. Sperm analysis, MAR test, and ultrasound of the scrotum allow determining the possibilities of using their own gametes. If the indicators are unsatisfactory, donor sperm may be used.

The presence of orchitis in the medical history is therefore not an absolute contraindication, but requires an individual tactical choice.

Double donation in cases of severe lesions

If neither the woman's eggs nor the man's sperm can be used due to the severe consequences of orchitis, double donation is resorted to. This program involves the use of donor eggs and sperm, possibly with preimplantation genetic testing.

These protocols allow for a successful pregnancy even in cases of total loss of reproductive function and require comprehensive medical and psychological support for the couple.