Male Infertility Treatment

Infertility (Male infertility Treatment or Female Infertility Treatment) is defined by the World Health Organization (WHO) as the inability of achieving a pregnancy for a couple having regular and unprotected intimacy for a period of at least 12 months. The rate of infertility is around 15 % of couples who want to have babies. The reason for infertility is usually 50% male and 50% female factor. Male can have children almost regardless of age, but women have an egg reserve and usually is much more difficult to get pregnant after the age of 40.

Male infertility may be related to different factors. Male side of a couple with the intention of having a baby should be evaluated at the same time as the women. Initial evaluation consists of our expert examining the genitals and the sperm analysis.

Semen Analysis: It is the gold standard test to analyze the overall sperm health which will tell the men’s ability to conceive if there is an infection or sometimes the presence of sperm cells after a vasectomy. Semen refers to all the ejaculate, and sperm refers only to the cells that can penetrate the egg to impregnate. Semen analysis may be affected by many factors especially the frequency of the previous ejaculation as the sperm cells are very fragile.

To get a reliable result, the test is recommended to be performed after 2-3 days of abstinence. The parameters assessed are:

Motility: the movement of the sperm

Morphology: the ratio of normal shaped sperms

Count: the number of sperms present in one sample

Vitality: the ability of sperms to survive

Q&E

  • Can I bring the sample from home?
    • Semen has different functions and to get a good result, the sample should be examined as soon as it is taken. Therefore even if your house is very close by the test should be given at the hospital lab.
  • I have a low sperm count, should I get worried?
    • Low sperm count is the main reason for infertility. But, keep in mind that the result may have been affected by many factors including the recent flu, medicine you have taken recently for what so ever cause, the frequency of your ejaculation or even to the fact that you have been in a very hot environment recently. We can not say that you have a problem unless two consecutive semen analysis reveals the same problem even taking care of the effecting factors.
  • Can the results of semen analysis vary?
    • Yes, if your results are all in the normal limits we can say that you are on the safe side; however, if you have some problems in any of the parameters we usually prefer to repeat the test in a weeks’ time to check if the problem is actually there or if it was transient.

Scrotal Doppler Ultrasound:

This is an ultrasound to evaluate the testicles, sperm channels and the epidydimis (a part of the semen carrying system where the sperm produced in the testicles mature for 3-6 months). Echogenity and size of the testicles are important predictors of function. The vasculature is evaluated by the Color Doppler features. Varicocele, a condition where the dirty and less oxygenated venous blood from the testicles returns back to the origin instead of being pumped to heart to be cleaned, is one the most common cause of correctable male infertility. By scrotal doppler examination, it is possible to diagnose the presence of varicocele and its grade.

Hormonal Analysis:

Hormones play an important role in the production of sperms in the testicles. A simple blood sample will provide important information. There are balancing hormones and an increase of some and decrease of some may affect testicular function.

Genetic Analysis:

A substantial number of causes in male infertility are genetically transmitted. It is crucial to know if there are genetic variations that may cause sperm abnormalities. This information may be relevant to the chance of having a child, as well as informing the family of possible problems the baby might also experience.

Male Infertility Treatment:

Treatment options of male infertility depend on the cause and the severity of the situation. Oral medical and supplementary medical treatments may be used alone or in conjunction with other treatment options.

If a varicocele is diagnosed, a microscopic surgical option is a day surgery with minimal effect on your daily life, may improve the sperm problems. 

If there is an obstruction of the sperm channels, a corrective surgery may be necessary. 

Even in those patients where no sperm is seen in the analysis (azoospermia), it does not mean that your testicles are not producing any sperm. Using a procedure called micro-TESE, sperm production is directly sought for in the testicular tissue with about 50-65% success.