STERILITY is a condition which may be present in either sex where from various types of disorder there is incapacity to reproduce the species. In the male sex the spermatozoa may be absent in the semen or if present may be diseased and incapable of impregnating the ovum of the female. A practical type of steril ity may arise from impotence in the male, whereby the consummation of the reproductive act is impossible. This is not a real sterility cause, technically speaking, but is practically so for certain matings, for many males are impotent with certain mates and not so for others. (See IMPOTENCY). The chief causes which render the male sterile are either anatomi cal defect of the genital apparatus producing an obstruction to the discharge of semen or to some disease of the testicles themselves. Ab sence of the testicles, accidental or induced (eunuchs), is a rare cause. Various inflam mations of the testicles such as gonorrhoeal orchitis, mumps orchitis or other type of testicular inflammation may destroy the spermdtozoa or reduce their viability. Syphilis is also a frequent cause for reducing the ca pacity of the spermatozoa to fecundate the ovum. A large group of rare conditions re lated to the glands of internal secretion may cause sterility. (See SYNDROMES, ENDOCRINOUS).
A peculiar accidental type of sterility occurs among individuals exposed frequently to X-ray emanations. Some of these emanations or rays of light of very high. wave velocity have an action upon the testicles causing loss of power to manufacture spermatozoa or to cause a loss of their fecundating power. The development of spermatozoa is largely regulated by the nervous system, and there are certain individ uals who permanently or periodically are unable from nervous (mental) disturbance to manu facture viable spermatozoa. Little is known of this important group but recent researches in psychopathology are revealing the relation ships between faulty affective reactions (psychoses and psychoneuroses) and the proper metabolic activities of the body which make healthy spermatozoa. This is an extremely large group and is classed, in general, by psychopathologists under the broad head of compensating neuroses. Here the individual's over-compensatory affective striving for social potency may so disturb the endocrinous func tions as to bring about the results just de scribed. This psychogenic basis for sterility affects both male and female and is to be seen in many individuals who show such symptoms as unusually eccentric individuals either voca tional, such as professional, religious, artistic, mechanical, commercial, philosophic striving: Exaggerated sexual strivings as seen' in pimps, seducers, white slavers. Eccentric penitentials,
reformers, reconstructionists, hyperconscious individuals, obsessional, occultists,' mystics, divine inspirationists. These over-compensatory strivings are frequently obvious in eccentric food habits, exhibitionistic clothing, eccentric modesty, grandiloquefits, etc. The affective cravings cause hypertensions in fhe muscles, increased heart action, raised blood pressure, hyperactive adrenal glands, thyroid and liver activities and cause retrograde changes in the sex glands, thus impairing fecundity. This type of individual may be helped by the use of the organic endocrine extracts or by proper psychotherapy-psychoanalysis (q.v.).
In the female the causes for sterility are equally plentiful. These may be grouped as (1) failure of development of the ovary, uterus or other important parts of the reproductive apparatus. (2) Disease of the qvary, similar to diseases of the testicles, from syphilis, al coholism, gonorrhoea, mumps and other inflam mations. (3) Obstructions to the passage of the spermatozoa to the ovum or of the ovum to the uterus, the chief one of these is gonor rhoeal disease of the fallopian tubes and is the one greatest single factor in causing sterility in the female. (4) Disease of the uterus lin ing membranes or of the vaginal membranes, causing changes in the chemisms of the secre tions which destroy or weaken either the ovum or the spermatozoa or both. (5) The psycho genic factors already enumerated which may affect the vitality of the ovum through the nervous system mediated through the balance of endocrine function, or such affective dis turbances can modify permanently or periodi cally the chemism of the vaginal or uterine secretions and destroy the viability of sperma tozoa. Very minute variations in the chemistry of these secretions can prove disastrous to the viability of both ovum and spermatozoa.
In the determination of what factors may be operative in causing sterility of any given mating all of the factors enumerated may have to be investigated. The mechanical causes de scribed are readily determined but the study of and amelioration of the psychogenic factors is extremely complicated and difficult. In the present state of knowledge many of these fac tors cannot be thoroughly comprehended. Con sult