Male Infertility Treatment
In 25% of couples who cannot have children, only male-related disorders are seen, and in 40-50% of couples, both female and male disorders are seen together. Semen analysis (spermiogram) is one of the examinations that should be performed depending on the man. Along with sperm count and motility, the morphological structure (external appearance) of sperm cells is also important. In the research on sperm analysis, it was revealed that different results were seen in sperm analysis of the same man in various time periods. Therefore, 2-3 spermiogram tests may be required to obtain healthy results.
Spermiogram (Sperm Analysis)
Spermiogram (sperm analysis) is a test that evaluates the number, movement and shape of sperm. In this test, the ratio of normal sperms to abnormally shaped sperms, the amount of sperm with good movement, the volume of the semen sample, liquefaction, the presence of leukocytes, color, fructose amount, pH are also evaluated. Classification is made according to movement types and light is shed on the treatment. This test is recommended to be performed with a sexual abstinence of at least 3 days. In order for the test to give accurate results, the sperm sample must be delivered to the laboratory within 1 hour. Preferably, the sperm sample should be given in close proximity to the laboratory. For this purpose, there is an area where sperm samples can be given in the centers where the analysis is performed. Several different sperm evaluation criteria are used. One of them is the Kruger criteria. It is a method that evaluates especially for sperm deformities. After a special staining, the shape (morphology) characteristics of the sperm are examined and the effect on fertility capacity, for example, is determined. According to the results of sperm analysis, at least 2 different sperm samples made at 1 month intervals should be examined in order to make the ideal decision. If a problem is detected in the sperm analysis, the man is examined physically and hormonally.
What are the factors that lead to male infertility?
Infertility in men can occur for very different reasons. Inflammatory diseases, genetic problems, previous surgical procedures, abnormalities during delivery, hormone-related diseases and chemical factors are the most common factors. In addition, varicocele, which is the most common and can be obtained with good results with surgical procedures, ie varicocele in the veins, can also cause infertility. It is a symptom. In addition, alcohol and smoking can also cause reproductive disorders in men. Doping and steroid-style drugs taken to build muscle can lead to infertility in men and prevent them from having children. Doping-style drugs can cause hormonal diseases, in particular. Taking such drugs can cause a production disorder in the body, inactivating the organs of production. Infertility in men can also be caused especially by the work and their daily routine behaviors. Working in a very hot environment, working in constant sitting, working in jobs where chemicals are used is also one of the important factors that cause infertility.
We can divide the causes of infertility in men into two main groups.
- Impaired sperm production
- Problems in the ducts that carry sperm out of the testicles
Sperm Production Disorders
Low sperm count, low motility and deformity in sperm make it difficult to achieve pregnancy naturally. It can even make it impossible sometimes. There are many factors that affect sperm production and maturation.
Abnormal developments in the veins of the testicle are called varicocele. Varicocele can cause an increase in temperature, disrupting sperm production and motility.
Mumps in adolescence or adulthood can also cause orchitis in the testicles. This can disrupt sperm production.
At birth in a male child, the testicles should have descended into place through the canal. If the testicles do not descend into the scrotum by the 1. year after birth, they must be lowered into place through a surgical procedure. Otherwise, since the testicles remaining in their abdomen and testicular canal will be exposed to heat, sperm production may be irreversibly impaired and this situation also prepares the ground for testicular cancer.
Medications and radiation therapies used to treat cancer can disrupt sperm production by causing damage to sperm host cells in the testicle. This situation should be explained to the patient before the treatment and it should be recommended that the sperms be frozen and stored.
Medication and Habits
Conditions that disrupt the production and balance of male hormones by affecting the brain stem, liver and kidney diseases, febrile diseases, drugs that affect hormone production, alcohol, smoking and drug use, being in very hot environments, exposure to chemicals and radiation can disrupt sperm production.
A man who has no sperm in his semen or fewer than 5 million sperm may have a genetic disorder. In this case, chromosome determination and microdeletion screening on the Y chromosome are appropriate. These disorders will be genetically transmitted to the male child through the Y chromosome and the male child may face the same problem in the future. In such cases, PGD applications can help.
Disorders of Sperm Channels
Obstructions that prevent sperm from coming out of the testicles, which are the place of production, can be the cause of infertility. These ducts may not have developed from birth or may be blocked later due to previous infection and surgical operations. Nervous system diseases, diabetes, prostate, urinary bladder and canal operations can cause infertility by causing semen to escape back to the bladder and not to be expelled.
Symptoms of Infertility in Men
Infertility in men can often manifest itself by showing symptoms. These may be burning and straining when urinating. Some wrong treatment methods can also cause the progression of these diseases. Drugs taken from the pharmacy without a doctor’s advice can not completely cure the disease and spread to the prostate and testicles, causing infertility. Tuberculosis that has been experienced in earlier times can also cause infertility. Therefore, seeing a specialist doctor is beneficial in the treatment of infertility, which creates the inability to have children.
Advanced Tests in Male Infertility
Counseling from a urologist is sought to investigate the cause of male infertility. It is aimed to examine and repair conditions such as varicocele and undescended testicle in men.
Desired Assays for the Investigation of Male Infertility
- Follicular stimulating hormone (FSH)
- Luteinizing hormone (LH)
- Prolactin (PRL)
- Testosterone (T)
- Treatment of Male Infertility
In infertility treatments, first of all, simple and cause-oriented treatments are applied. In IVF treatment methods, the sperms of the male prepared in the laboratory environment can be performed by the gynecologist into the uterus of the woman with the method we call insemination. Microinjection method application in men with severe condition is a valid method today. Thanks to this treatment, there are many couples who have children today.
Thanks to microsurgery, endoscopy and medications, many couples can have children without the need for IVF treatments.
With the treatment methods applied in our clinic and in our country in AZOOSPERMIA patients, couples who are unlikely to have children have been able to achieve their dreams.
In cases of male infertility, medication is gave only in patients with hormonal disorders. There is currently no medication for disorders outside this group.
Insemination can be applied in mild sperm disorders. This procedure is applied together with the provision of ovulation in the woman. This treatment procedure should be tried no more than 3 times. In order to achieve success in this method, motile sperm should be found as a result of sperm analysis. Patients below these values are given IVF / ICSI.
Can success be achieved with IVF in male infertility?
Infertility, which is a problem experienced in the majority of couples who turn to IVF treatment methods, has ceased to be an unsolvable problem. Nowadays, infertility is defined as a disease, not a problem. It does not belong to a certain gender. It can be seen in both men and women. What is important is the factors that cause infertility and the studies aimed at removing these factors. Thanks to the treatments performed with precursor sperm cells (Round sparmatid) in the recent period, our couples who have children have achieved their dreams.