Treatment for male infertility
The treatment of male infertility in different depending on the cause. When the cause is unknown (idiopathic), the urologist / andrologist recommends various lifestyle changes, as well as multivitamin supplements, which can help improve sperm quality. It is also recommended that the partner be subjected to tests and investigations to find the cause.
In the case of a man, the treatment can be:
Medication
antibiotics to treat a reproductive tract infection, but which fail to always restore fertility. Medications for sexual problems such as erectile dysfunction or premature ejaculation may be prescribed. If infertility is related to low levels of hormones or an imbalance in the hormonal system, hormone replacement therapy or medication may be recommended (usually gonadotropins or antibiotics).
Surgery
the most common health problem that can be solved surgically is varicocele, the associated operation is called varicocelectomy. If the man has undergone a vasectomy, vasovasostomy may be helpful (join the two cut portions of the vas deferens in each testicle). Vasoepidimiostomy involves the joining of the vas deferens of the epididymis and it is the most common method for treating epididymal blockage. Last but not least, the transurethral resection of the ejaculatory ducts should be mentioned; it involves inserting a cystoscope through the urethra and making a small incision in the ejaculatory duct; 65 out of 100 men end up having sperm in their sperm by this method.
Also, in the cases where drug treatment is insufficient / fails / inappropriate, assisted reproduction techniques (intrauterine insemination, in vitro fertilization, intracytoplasmic sperm injection) that require sperm sampling are required. There are many microsurgical methods by which sperm can be extracted, but the goal is to extract as many cells as possible, of the best quality, without damaging the reproductive tract. These include:
Testicular sperm extraction (TESE) – is a common technique used to diagnose the cause of azoospermia, through which a sufficient amount of testicular tissue can be extracted. Sperm collected in this manner can be used fresh or frozen.
Micro-TESE – a more refined form of the TESE procedure, which also involves a low degree of bleeding, respectively complications, as well as a faster recovery. It takes 30 minutes to an hour and involves the use of a high magnification microscope to identify small regions where sperm production occurs in the testicles of men experiencing azoospermia. A small incision is made in the testicles through the scrotum and seminiferous tubules are collected, which are then analyzed in the laboratory to identify viable sperm. Micro-TESE has the highest sperm sampling rate (60% success rate) and the fewest testicular lesions; through it the surgeon can directly biopsy the most favorable regions.
Fine testicular needle aspiration with a testicular tubule sample (TESA or TEFNA) – this procedure was first used to diagnose azoospermia, sometimes being used to collect sperm from the testicles. A needle and a syringe penetrate the skin of the scrotum to extract sperm from the testicle.
Percutaneous epididymal aspiration of sperm (PESA) – the surgeon inserts a needle attached to a syringe into the epididymis to extract fluid from it. It is possible that sperm cannot be collected through this method
Microsurgical aspiration of epididymal sperm (MESA) – this method involves that the sperm are taken from the epididymal tubes, using a surgical microscope. Mobile sperm can be collected, which can be frozen and later used for assisted reproduction techniques, reducing epididymal damage.
What is male infertility?
Symptoms for male infertility
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Causes for male infertility
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Diagnosis for male infertility
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