Male Infertility Treatment in udaipur

What is Male Infertility?

Male infertility is a male sexual health problem that reduces the chances of a partner becoming pregnant.

13 out of 100 couples cannot conceive through unprotected sex. There are many causes of infertility in men and women. In more than a third of infertility cases, the problem is in men. This is usually due to issues related with sperm production or sperm delivery.

Male fertility depends on the natural production and delivery of sperm in your body. Sperm enters the partner’s genitals. Sperm travels through the cervix to the fallopian tubes in the uterus. Fertilization occurs when sperm and egg meet there.

This system only operates when the hormone levels, genes, and environmental conditions are all in place.

Book An Appointment

Treatment

Treatment depends on the cause of infertility. Many problems can be treated with medication or surgery. This allows conception through normal sexual intercourse. The following treatments fall into three categories:

Non-surgical treatment of male infertility

Surgical treatment of male infertility

Unexplained treatment for male infertility

Causes

The production of mature, healthy sperm that can migrate depends on a number of things. The problem is preventing the cells from becoming sperm. Problems can prevent sperm from reaching the egg. Scrotal temperature can also affect fertility.

The main causes of male infertility are:

  • Sperm Disorders
  • Retrograde Ejaculation
  • Varicoceles
  • Obstruction
  • Immunologic Infertility
  • Medication
  • Hormones

The most common problem is the production and cultivation of sperm is: The sperm may:

  • not grow fully
  • not move the right way
  • be oddly shaped
  • not be made at all (azoospermia)
  • be made in very low numbers (oligospermia)

Sperm problems can be due to innate traits. Lifestyle can reduce sperm count. Smoking, alcohol consumption and taking certain medications can decrease sperm count. Other causes of low sperm count include long-term illness (such as kidney failure), childhood infections (such as mumps), and chromosomal or hormonal problems (such as low testosterone).

1. Medical & Hormonal Therapies for Low Sperm Count

To manage male infertility, a doctor may recommend medications to correct hormonal imbalances.

Medication

Medications can improve sperm count in some men who are infertile. An oestrogen receptor blocker, like clomiphene citrate, which enhances the hypothalamus and pituitary gland in the nervous system, may be prescribed by your doctor. This can increase sperm production by causing the production of hormones and the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). This medicine is given orally. Your doctor will recommend how often you should take it.

Assisted Reproductive Techniques

Your doctor may recommend an assisted reproduction technique called IUI, which is assisted insemination. It is generally recommended for men with low sperm concentrations, which means low sperm count or sperm motility or motility. It can also be recommended if the cause of infertility is unknown and the number of sperm is normal.

2. IVF/ICSI for Low Sperm Count

ICSI-IVF is a special form of In Vitro Fertilization, usually used after severe male infertility, failed IVF fertilization attempts, or after egg freezing (oocyte preservation). It is also very commonly used for preimplantation genetic testing or PGT testing. In fact, performing a PGT test will be required by most clinics. The concept behind this condition is that any sperm that tries to fertilize an egg during normal fertilization can damage the lining of the embryo and can give erroneous PGT results.

How Does ICSI Work?

The treatment is the same as during IVF. The only difference is that instead of fertilizing a mixture of sperm and egg, an experienced embryologist (embryologist) injects a single sperm into the egg.

This avoids the problem of sperm entering the egg, thus increasing the chances of fertilization.

Why It is Done?

ICSI-IVF is often used in cases of severe male infertility, such as:

Very low sperm count (also called hypospermia)

Abnormally shaped sperm (also called sperm)

Poor sperm motility (also called sperm ataxia)

If a man does not have sperm in the ejaculate, but produces sperm, he can recover by  (TESE) testicular sperm extraction. TESE-derived spermatozoa require ICSI. It is also used for retrograde ejaculation, which collects sperm from a man’s urine.

3. IVF/ICSI/TESA/PESA/ Micro TESE for obstructive Azoospermia

Azoospermia is a condition in which the testicles do not produce sperm, called non-obstructive azoospermia. Another is when the testicles produce sperm, but it is blocked and the sperm cannot ejaculate. This type of azoospermia is known as obstructive azoospermia.

In men of reproductive age, the average number of sperm per ejaculation is 96 million, but azoospermia is always considered a lack of sperm during ejaculation of unknown cause, accounting for 1% of men, two-thirds of whom are spermatogenic dysfunction. Azoospermia is often considered as incurable and the most serious form of male infertility. IVF/ICSI treatment is the most effective method of collecting sperm for men with azoospermia. The quantity and quality of sperm collected from the testis directly affects the IVF/ICSI results.

TESA, or sperm aspiration, is done by inserting a needle into the ovary and aspirating body fluids and tissues under negative pressure. The aspirated tissue is processed in the embryology laboratory, and the extracted sperm are used for ICSI.

This procedure involves needle and syringe techniques, but the needle is inserted directly into the epididymis. ESDP or percutaneous epididymal sperm aspiration (ESDP) does not require a surgical incision. A small needle is inserted directly into the fetal skin to aspirate the fluid. The embryologist removes the sperm from the body fluid and prepares it for ICSI.

Microdissected testicular sperm extraction is a surgical procedure of sperm extraction used to treat infertility in men who do not have sperm in the ejaculate due to testicular insufficiency (non-obstructive azoospermia). It is used to determine the location of the tissue to be removed. The goal is to affect the structure of the testicles less, so there are fewer side effects, such as cutting small blood vessels and causing blood supply problems. It also seems to increase the number of sperm that can be recovered.

4. Surgical Sperm Extractions

Men who do not have sperm in their semen and want to have children may need treatment to remove surgical sperm. There are four types of treatment.

  • Microsurgical aspiration of epididymal sperm (MESA)
  • Testicular Aspiration of Sperm (TESA)
  • Sperm ejaculation (TESE) - one or more places
  • Microscopic sperm extraction (MicroTESE).

In men with azoospermia obstructive, epididymal sperm can usually be obtained by percutaneous epididymal sperm aspiration (PESA). If PESA fails, testicular sperm is obtained by microscopic sperm extraction (MicroTESE). Men with azoospermia do not have sperm in the epididymis, so the sperm must be removed. Percutaneous NAB extraction can be attempted first. Otherwise, sperm extraction (TESE) from an open microsurgical biopsy is performed using either a single seminiferous tube (SST) or the TESE microdissection technique. The simplest and least invasive procedure must be performed first.

5. Varicocele Surgery

Varicoceles are veins in the expanding scrotum or skin sacs that contain enlarged testicles. This is a very common problem because about 10-15 out of 100 men have varicose veins.

What is Varicocele Surgery?

Varicoceles surgeries are performed to remove swollen veins in the scrotum called varicoceles. There are no medications to treat or remove varicoceles, so your doctor may recommend surgery to remove them.

There are 2 Types of Varicocele Surgery

Microsurgical Resection

In microsurgical resection of the varicose vein, the surgeon uses a microscope to locate the correct vein. This process facilitates the identification of roots to be destroyed and their separation from those to be preserved.

Laparoscopic surgery

Another option is laparoscopic surgery, which is the removal of varicose veins using a thin tube called a laparoscopy. This small, lighted tube allows your doctor to make several small incisions during the procedure.

Testicular Biopsy

A testicular biopsy takes a sample of testicular tissue for laboratory analysis.

Both testicles are male reproductive organs. Produces sperm and the male hormone testosterone. The testicles are located in a bag of fleshy tissue under the genitals. A testicular biopsy can be used for the following purposes:

  • Diagnosis of the location and condition of the testicles
  • Identify the causes of male infertility
  • Sperm recovery for in vitro fertilization (IVF).

There are two different procedures for a testicular biopsy:

1. Percutaneous Biopsy

In a percutaneous biopsy, a thin biopsy needle is inserted through the skin. At the tip of the needle is a syringe to collect ovarian tissue. This procedure does not require incisions or sutures. Also called fine needle biopsy.

2. Open Biopsy

An open biopsy is also known as a surgical biopsy. Doctors start by cutting the skin. An incision is also made in the testicles. Then a small piece of tissue is removed from the incision and the incision is closed using sutures.

Diagnostic Uses of Testicular Biopsy

Testicular biopsy is an important tool for diagnosing male infertility. But this is not the first step. In the first step in assessing fertility, your doctor will analyze your medical history and order blood tests and semen analysis.

Sperm analysis analyzes the quantity and quality of sperm. The first sample of semen is usually obtained by masturbation.

Sperm analysis can identify the following problems:

  • Abnormally low sperm count
  • Low quality sperm
  • Azoospermia (lack of sperm)
  • Blood and hormonal tests often identify the cause of low sperm counts. However, if these tests are not conclusive, a testicular biopsy may be required.

A testicular biopsy can be used for the following purposes:

  • Sperm collection for use in IVF. This is done when sperm are produced in the testicles, but do not contain sperm.
  • Check if the sperm production problem is due to a blockage.
  • Diagnosis of testicular cancer
  • Determine the cause of the testicular nodule.

7. Circumcision

Circumcision is the surgical removal of the foreskin that covers the tip of the penis. This procedure is very common for newborns in some parts of the world, including the United States. Circumcision is possible after newborns, but the procedure is more complicated.

Sometimes it is medically necessary, such as when the foreskin is too tight to be pulled back (pulled) over the head. In other cases, especially in some parts of Africa, circumcision is recommended for older boys or men to reduce the risk of certain sexually transmitted diseases.

Circumcision can have several health benefits, including:

Easy hygiene: Circumcision makes it easier to wash the penis. However, uncut boys can be taught to wash under the foreskin regularly.

Reduces the risk of urinary tract infections: Although men have a lower risk of urinary tract infections, these infections are more common in uncircumcised men. A serious infection at an early age can lead to kidney problems later in life.

Reduces the risk of sexually transmitted diseases: Circumcised men may be at a lower risk of developing certain sexually transmitted diseases, including HIV. However, safe sex is still important.

Prevention of penis problems: Sometimes it can be difficult or impossible to remove the foreskin of an uncircumcised penis (circumcision). This can cause irritation of the genitals or scalp.

Reduces the risk of penile cancer: Although rare, penis cancer is rare in men who have been circumcised. Also, cervical cancer is rare in female sexual partners of men who are circumcised.