男性不妊症の概要
男性不妊症とは、男性が女性を妊娠させる能力が低下している状態を指します。アメリカでの不妊症に関する統計によると、男性不妊症は約13％のカップルに影響を与えています[10]。男性不妊症の診断には、一般的な身体検査や遺伝的条件、慢性病、外傷や手術が原因であるかどうかを調べる問診が含まれます[4]。
不妊症と一般健康との関係
不妊症と一般健康の関係は、男性不妊症が将来の健康に影響を与える可能性があるため重要です。例えば、精子産生異常と関連する健康リスクについて、臨床医は不妊症の男性や精液異常の男性にカウンセリングを行うことが推奨されています[1 ]。
射精禁欲期間と妊娠成功率
射精禁欲期間と妊娠成功率との関係についての研究では、短い禁欲期間が妊娠率や出生率を向上させることが示されています[2]。また、短い禁欲期間と長い禁欲期間のカップル間で流産率に有意差は見られなかったことから、短い禁欲期間が生殖補助技術（ART）治療を受ける患者において、より高い着床率や妊娠率をもたらす可能性があることが示唆されています[3]。
短い禁欲期間の利点
短い禁欲期間は、精子のDNA断片化の可能性を減らすことができます[2]。これは、精子の質が向上し、妊娠の成功率が高まることを意味します。
長い禁欲期間の影響
一方で、長い禁欲期間は、精子の質や妊娠成功率に悪影響を及ぼす可能性があります。研究によれば、禁欲期間が長いほど、精子の品質が低下し、妊娠成功率が低くなることが示されています[8]。
禁欲期間と精子の品質
禁欲期間は、精子の品質に影響を与える重要な要素です。禁欲期間が短いと、精子のDNA断片化の可能性が減少し、精子の品質が向上することが報告されています[2]。
精子のDNA断片化
精子のDNA断片化は、不妊症や流産のリスクを高める要因となります。したがって、精子のDNA断片化を低減することは、妊娠成功率を向上させるために重要です。短い禁欲期間が精子のDNA断片化を減らすことができるため、妊娠の成功率が高まる可能性があります[2]。
不妊治療での禁欲期間の適切な長さ
不妊治療を受けるカップルにとって、禁欲期間の適切な長さは個々の状況によって異なります。医師の指導の下、最適な禁欲期間を見つけることが重要です。適切な禁欲期間を実践することで、精子の品質が向上し、妊娠成功率が高まることが期待できます。
まとめ
短い禁欲期間は、精子の品質を向上させ、妊娠成功率を高めることが研究で示されています。一方、長い禁欲期間は、精子の品質が低下し、妊娠成功率が低くなる可能性があります。不妊治療を受けるカップルは、医師の指導のもと、最適な禁欲期間を見つけることが重要です。
よくある質問
- 禁欲期間が短いと、どのような利点がありますか？
短い禁欲期間は、精子のDNA断片化の可能性を減らし、精子の品質が向上します。これにより、妊娠成功率が高まる可能性があります。 - 長い禁欲期間は、どのような影響がありますか？
長い禁欲期間は、精子の品質が低下し、妊娠成功率が低くなる可能性があります。 - 禁欲期間と精子の品質の関係は？
禁欲期間が短いと、精子のDNA断片化の可能性が減少し、精子の品質が向上します。 - 不妊治療での禁欲期間の適切な長さはどのくらいですか？
適切な禁欲期間は、個々の状況に応じて異なります。医師と相談し、最適な禁欲期間を見つけることが重要です。 - 禁欲期間を調整することで、妊娠成功率が向上する理由は何ですか？
短い禁欲期間により、精子のDNA断片化が減少し、精子の品質が向上するため、妊娠成功率が向上する可能性があります。
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1 “Lifestyle Factors and Relationships Between Infertility and General Health. 5. Clinicians should counsel infertile men or men with abnormal semen parameters of the health risks associated with abnormal sperm production. (Moderate Recommendation; Evidence Level: Grade B) 6.”
URL: https://www.auanet.org/guidelines-and-quality/guidelines/male-infertility
2 “Overall, the review findings suggest that shorter ejaculation abstinence periods improved the rates of pregnancy and live births, while also reducing the likelihood of DNA fragmentation in …”
URL: https://www.news-medical.net/news/20230320/Shorter-ejaculation-abstinence-times-linked-to-better-reproductive-outcomes-during-fertility-treatments.aspx
3 “No significant difference in miscarriage rates between the short and long SAP couples was found (p = .88). The meta-analysis indicates that a shorter abstinence period could result in higher implantation and pregnancy rates for patients undertaking ART treatments.”
URL: https://journals.sagepub.com/doi/full/10.1177/1557988320933758
4 “Diagnosing male infertility problems usually involves: General physical examination and medical history. This includes examining your genitals and asking questions about any inherited conditions, chronic health problems, illnesses, injuries or surgeries that could affect fertility.”
URL: https://www.mayoclinic.org/diseases-conditions/male-infertility/diagnosis-treatment/drc-20374780
5 “In Karimpur’s study in 2011, varicocele was responsible for 42.7% of cases of infertility in males (19). The higher prevalence of varicocele in the infertile men population is the most important evidence supporting the theory of the relationship between varicocele and male infertility (29).”
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8458922/
6 “Male reproduction is a complex process, and numerous medical conditions have the potential to alter spermatogenesis. In addition, male factor infertility may be a biomarker for future health. In the present review, we discuss the current literature regarding the association between systemic diseases …”
URL: https://pubmed.ncbi.nlm.nih.gov/32089256/
7 “The semen parameters of the men in couples trying to achieve a pregnancy might have changed due to the increased age at marriage. In this study, as expected, men with secondary infertility were older than men with primary infertility, consistent with other reports (Walsh et al., 2009). However, there were no differences in patient age between …”
URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7517893/
8 “Tom Merton / Getty Images. If you want to have a baby, you need to have sex around the time of ovulation.But having frequent sex throughout the month also can boost fertility. That said, research also has shown that short periods of abstinence could have the potential to benefit sperm health—whether you are trying to conceive naturally or will be providing a sperm sample for insemination.”
URL: https://www.verywellfamily.com/tips-to-increase-fertility-for-men-1959906
9 “Infertility is defined as not being able to become pregnant after having regular intercourse (sex) without birth control after one year (or after six months if a woman is 35 or older). Infertility is common. Out of 100 couples in the United States, about 12 to 13 of them have trouble becoming pregnant. About one-third of infertility cases are …”
URL: https://opa.hhs.gov/reproductive-health/understanding-fertility-basics
10 “Male infertility is any health issue in a man that lowers the chances of his female partner getting pregnant. About 13 out of 100 couples can’t get pregnant with unprotected sex. There are many causes for infertility in men and women. In over a third of infertility cases, the problem is with the man. This is most often due to problems with his …”
URL: https://www.urologyhealth.org/urology-a-z/m/male-infertility
11 “Obesity-Induced OS in Male Infertility. Obesity ensues when there is an energy imbalance between the energy consumed and energy expended, therein leading to excessive accumulation of fat ().Obesity is a multifactorial disorder influenced by genetic or environmental factors, and the incidence has tripled since 1975 as reported by the WHO ().In 2016, more than 1.9 billion adults of ≥18 years …”
URL: https://www.frontiersin.org/articles/10.3389/frph.2022.822257/full
12 “Abstinence and outercourse have lots of benefits. Both abstinence and outercourse are simple, free, and work really well to prevent pregnancy. In fact, abstinence is the only 100% effective way to avoid pregnancy. And outercourse really lowers your risk a lot. There are other benefits of abstinence. People choose abstinence to: wait until they …”
URL: https://www.plannedparenthood.org/learn/birth-control/abstinence-and-outercourse/what-are-benefits-and-disadvantages-abstinence-and-outercourse
13 “Infertility is typically defined as the inability to conceive after at least one year of regular, unprotected sex. This affects 15-20% of couples. 1 A male factor is estimated to be present in about 50% of cases, with sole responsibility in 30% of cases and a co-contributing female factor in 20% of factors. 2 Male infertility is associated with significant psychosocial and marital stress. 3”
URL: https://www.racgp.org.au/afp/2017/september/male-infertility/
14 “Prevention. Male infertility describes a reproductive issue that results in a male being unable to impregnate their fertile partner. Studies indicate that approximately 15% of American heterosexual couples will encounter fertility issues when trying to conceive. Male infertility is a contributing factor to as many as half of all these cases and …”
URL: https://www.verywellfamily.com/what-is-male-infertility-5212728
15 “Numerous studies show that the large majority of couples who practice NFP feel it improves their marital relationships, and that even with the periodic abstinence required by such methods, they are satisfied with the frequency of intercourse. However, in one study, 19% of men reported that periodic abstinence is often difficult (Fehring, 2016).”
URL: https://naturalwomanhood.org/struggling-with-nfp-when-men-resent-abstinence/
16 “Infertility is medically defined as occurring when a woman is unable to get pregnant despite having unprotected sex for a year or longer. Because barriers fertility can exist in both men and women …”
URL: https://www.psychologytoday.com/us/basics/infertility
17 “Discover some signs of infertility in both men and women, as well as the risk factors, medical conditions, and drugs that may contribute to it. Also learn about diet tips, natural treatments …”
URL: https://www.healthline.com/health/infertility
18 “Medication. Medical therapies can be very effective for men with certain causes of infertility, such as hormonal abnormalities. For men with low testosterone, a number of medications, such as clomiphene citrate, human chorionic gonadotropin (HCG) and anastrozole, can help to boost the body’s natural production of testosterone.”
URL: https://www.nm.org/conditions-and-care-areas/urology/male-infertility