Fertility Treatment options for men at Medicover
Today fertility problems are not just related to women. When we mention the word infertility the first thought we get is female infertility. But this is not so any longer. A large percentage of men also face fertility issues. The ratio gap between men and women with fertility inconsistencies is closing in at a fast pace.
Among the modern generation male fertility problems are more common place. Young couples are finding it increasingly difficult to conceive. As is the usual assumption the young men send their wives for a thorough medical check-up to diagnose the cause of infertility. Sometimes there may be a problem with the woman’s fertility and the doctors may find something amiss, but sometimes she comes back with all her tests clear. Then comes the big moment when the doctor recommends a series of tests for the man to assess his fertility.
Men play a vital role in pregnancy by contributing a sperm. Without a sperm there will be no embryo. Hence male infertility is half the fertility problem. An embryo has 46 chromosomes of which the male sperm contributes 23 chromosomes and the female egg contributes 23 chromosomes. So a man is not let off the hook so easily when it comes to fertility issues.
Male infertility can be quite a blow to the ego of a man. The last thing a macho man expects is to be infertile. The stud has a problem with his seed. This is something hard to digest. The greatest consolation that a man can seek now days is the fact that he is not alone. There are many men who are dealing with similar challenges behind the scenes. Even though nobody talks about it or comes out in the open about this issue, but fertility clinics have the statistics and the figures are in black and white. Male infertility is a cause for concern and needs treatment.
Male fertility problems
Male infertility begins with an evaluation. The most common being a semen analysis test. There are many causes for male infertility and the problem may stem from the quality of the sperm to the ability to ejaculate the sperm. From puberty onwards men continue to produce sperm.
The semen analysis test can open up a whole myriad of issues that one never even knew existed. It not only determines the quality of your sperm but highlights minor issues like sperm abnormalities. Sperm count is one factor of major concern. Men are often plagued with other issues rather than the production of sperm. Concerns like the ability to ejaculate the sperm and blockages along the way.
In general male infertility revolves around the sperm. That is his only contribution to the pregnancy. Even though it is a significant contribution the male role in reproduction ends there.
Based on the type of the infertility problem we have divided the types of treatment for male infertility into different categories.
Nonsurgical Fertility Treatment
There are many male infertility problems that can be rectified with therapy and medication. Some of the more common problems and their solutions are:
Spinal Cord Injury: Injury to the spinal cord can affect male fertility in several different ways. It could hinder the normal ejaculatory ability of a man, affect the production of the sperm, cause a blockage of the passage through which the sperm needs to travel or lead to infections in the ejaculatory tract. Therapy and medication can help to treat the spinal cord injury.
In some of the cases the infertility problems caused due to this injury may be permanent and require other techniques such as sperm retrieval or surgery. The Electro Ejaculation Therapy (EEJ) is a successful technique that can be used to retrieve sperm in various conditions of spinal cord injury. Other techniques can also be used to harvest sperm from the vas deferens or the epididymis.
Electroejaculation Therapy (EEJ): Somemen have a problem with ejaculation due to a problem with their nerves. The Electro Ejaculation Therapy (EEJ) is an effective method of helping to retrieve sperm in cases of males who are not able to ejaculate sperm. Men who suffer from problems like diabetes, multiple scierosis, pelvic surgery or retroperitoneal lymph node dissection are generally not able to ejaculate sperm and have been greatly helped by the EEJ therapy. Some men have a loss of orgasm which also leads to the failure to ejaculate. The EEJ therapy also helps in this kind of condition. With the EEJ therapy sperm has been retrieved in up to 90% of the patients. This sperm once retrieved can be used for fertility treatment with IUI or IVF techniques. Doctors also recommend fertility preservation by freezing some portion of the sperm for future use.
Hormone Deficiency: Some men do not produce sperm due to a hormone deficiency. The production of sperm is triggered by a male hormone. When this hormone is absent or in very small quantities the male reproductive system is not impelled to produce sperm and it results in a sperm deficiency. This hormone deficiency can easily be treated by externally administering the required hormone to prompt the reproductive organs to start producing sperms.
Sperm Abnormality: In a very few rare cases we find some men who have a high concentration of abnormal sperm. The treatment in this case involves a prescription of clomiphene citrate. It has been found that Clomid has made a significant improvement to the sperm quality as well as the sperm count. An increase in sperm motility has helped to increase the chances of conception to quite an extent. Clomid is prescribed in many cases of unexplained low sperm count. Clomid stimulates the pituitary gland which is responsible for the release of the male hormone.
Some cases of low sperm count and poor sperm motility are genetic and medication will not help to improve this condition. Gene therapy is a trial treatment and gives hope to future generations that this problem could be rectified in time to come.
Most men who suffer from low sperm count and poor quality sperm are recommended fertility treatment. Fertility treatment is the most successful way for a couple to conceive successfully.
Surgical Treatment for male fertility
Some conditions of male infertility need surgery to restore or rectify the problem that is hindering the release of the sperm or semen. This problem could be due to an obstruction or blockage in the ejaculatory tract. Surgical retrieval of sperm is also a procedure used in cases where the male is not able to ejaculate sperm or has an irreparable problem that will not allow his sperm to be ejaculated.
Varicocele Ligation: Varicocele is a condition in which the veins above the scrotum get enlarged and this hampers fertility by inhibiting the sperm movement to theejaculatory duct. Surgery to ligate the varicocele veins improves the sperm movement and this can help increase the chances of conception if the sperm quality is good.
Surgical Sperm retrieval: In some cases where the semen has no sperm due to a blockage in the passage or in cases where the person has had a vasectomy, the surgical sperm retrieval technique is used. This is a minimally invasive minor surgical procedure in which the sperm is extracted directly from the testes. There are several types of sperm retrieval techniques that can be used depending on the case history and the severity of the problem. Sperm retrieval is performed under local or general anaesthesia. This depends on the type of retrieval technique to be applied. The sperm that is retrieved can be used for an IVF procedure using the ICSI technique or the sperm can be frozen for future use. Some of the sperm retrieval techniques are:
- MESA (Microscopic Epididymal Sperm Aspiration) Is a microsurgical technique in which the sperm is extracted from the epididymis by making a small opening in the skin. This is the place where the sperm is stored after it is produced.
- TESE (Testicular Sperm Extraction) is a microsurgical technique in which testes tissue samples are removed. A small incision is made in the testes, which allows the removal of the tissue. The sperm are then removed from the tissue.
- Micro TESE is a procedure in which high magnification is used to search for the sperm in the tissue. This is required in cases where the sperm concentration is very low and the person has a very small quantity of sperm available.
- PESA (Percutaneous Epididymal Sperm Aspiration) is a technique in which a needle is used to extract sperm directly from the epididymis.
- PTBX (Percutaneous Testicular Biopsy) is a procedure in which small cores of the testes tissue is removed. This is performed using a hollow needle.
Transurethral Resection of Ejaculatory Duct: Sometimes a man is not able to ejaculate sperm which could be due to a blockage in the ejaculatory duct. He may ejaculate semen or a reduced quantity of semen. His semen may contain a reduced concentration of sperm or no sperm at all depending on the location of the blockage and the extent of the blockage. The transurethral resection of the ejaculatory duct is a procedure in which the obstruction is surgically removed allowing the free passage of the semen and the sperm for ejaculation.
Ajay had a blockage in his ejaculatory duct which was detected in the early days of his marriage 11 years ago. He and his wife had resigned themselves to the fact that they would never be able to have children due to his condition of azoospermia. Last year Ajay read about having a transurethral resection of the ejaculatory duct. He decided to check it out and visited a specialised doctor. Tests revealed that Ajay had a small blockage which could easily be rectified. This was a great revelation for the couple who were brimming with joy. Ajay had the surgery and it was successful. His wife was 37 and the doctor suggested IUI for conception. The couple visited Medicover for their fertility treatment. Due to certain issues Ajay’s wife was not able to conceive after 3 IUI cycles. The doctors suggested IVF treatment as the next option. After nearly 12 years of bareness today they have a lovely baby.The transurethral resection surgery for ejaculatory duct and seminal vesicles has enabled many men to have their fertility renewed.
Transurethral Resection of the seminal vesicles
The seminal vesicles are glands which contain some of the seminal fluid. It is located in the pelvic region. The transurethral resection of the seminal vesicles is a technique in which any cysts or obstructions are removed from the gland allowing it to produce the seminal fluid and it also clears the way enabling it to flow out into the seminal tract.
Medicover Fertility Clinic offers a number of different surgical retrieval techniques for male patients who have no sperm concentration in their semen. This could be due to an obstruction or some other problem. The type of treatment is determined after conducting a thorough diagnosis with a number of different tests.
Once the sperm is retrieved it can be used directly for fertility treatment or it can be frozen for use in the future. After sperm retrieval most patients opt for some of their sperm to be frozen while a portion of the sperm can be used for the fertility treatment the couple would like to undergo.
ART male fertility treatment options
There are a number of different assisted reproductive fertility treatment techniques. The type of fertility treatment used depends on the type and the severity of the male infertility problem. Infertility treatment is also decided based on the female fertility condition. If the female partner suffers from some kind of fertility issues like ovulation problems or blocked fallopian tubes then the type of treatment recommended is IVF.
Before the fertility treatment can be advised to the patients a semen analysis test is carried out to determine the quality of the sperm. Some treatment options are not effective for poor sperm quality. The type of fertility treatment is recommended based on the sperm quality.
In cases where the male partner has a low concentration of sperm in the semen or no sperm in the semen the sperm is retrieved by a sperm retrieval technique. This sperm now needs to meet the female egg for conception.
The Intra Uterine Insemination is one of the most common techniques used for addressing male fertility problems. This technique is successful when the female partner has no fertility issues and the male sperm is healthy. If the sperm is of a good quality and the concentration of the sperm in the semen is above 15 million per millilitre the IUI procedure is the most suitable assisted reproductive fertility technique. IUI is also recommended for a low sperm count where the quality of the sperm is good.
The IUI procedure is a process in which the sperm is injected into the female partner’s uterus few days prior to ovulation. The sperm injection is done through a catheter which is inserted into the uterus through the cervix. This is a simple and non-invasive procedure. It is a quick and painless treatment that needs no special preparation or infrastructure.
The IVF treatment comprises of out of body fertilisation of the female egg and male sperm. The mature eggs are extracted from the female partner’s ovaries. The egg is placed in a dish with about 50,000 sperms. The heathiest and best sperm will penetrate and fertilise the egg. The embryo that is formed after the fertilisation is then transferred to the female partner’s uterus after a few days.
The IVF treatment is recommended in cases where the female partner may have fertility problems like ovulation problems, hormonal imbalance, blocked fallopian tubes or some other problem that is hindering her from conceiving through the IUI technique.
There are some cases of sever male infertility where the number of sperm are limited or the quality of the sperm is very poor. In these cases fertilisation does not happen naturally by placing the sperm together with the egg in a dish. These patients require a more specific fertilisation technique like the ICSI. The Intra Cytoplasmic Sperm Injection is a technique in which one good sperm is selected and injected directly into the female egg. The sperm does not need to penetrate the egg himself and just needs to proceed to the next step of fertilisation. The sperm is left to fertilise the egg by itself. The ICSI procedure has a high fertilisation success rate as the sperm is placed inside the egg itself.
Conceiving through an assisted reproductive technique is one of the most successful ways in which many couples have been able to have their own biological child.
“I had tried sperm retrieval earlier but that process was a failure as the doctors were not able to find many sperm and I contacted an infection after that. Two years later we came to Medicover for fertility treatment. After many tests and medication the doctors said that I can have a sperm retrieval procedure. The sperm retrieval procedure was so quick that I was able to even able to go to the office for half a day after that. My family and I were quite impressed. My wife had the IUI procedure which was also conducted the same morning and we were home for lunch. According to the doctor’s advice we had some of my sperm frozen for future use.”
Medicover Fertility Clinic in India
Medicover is a leading fertility solution provider in many countries around the world. It is a European brand with a strict adherence to international quality and service standards. All the Medicover doctors are internationally certified and many of them have many years of international experience before returning to work at Medicover Fertility Clinic.
Medicover offers some of the best infrastructure and facilities that are available for fertility treatment in India which is in accordance to the global standards. Medicover offers a range of different Treatment options for men with various infertility conditions. Sperm retrieval techniques and sperm preservation facilities are available in house at Medicover.
Men with severe infertility conditions who have lost hope after visiting numerous fertility clinics can come to Medicover to have their hope renewed. Medicover specialises in advanced fertility treatments and using the latest technology procedures to help childless couples with extreme infertility conditions to have children.
Q: I have varicocele veins; will surgery help to improve my fertility?
A: A surgical procedure to ligate the varicocele veins will help to improve the sperm concentration in your semen.
Q: I had a PESA sperm retrieval, however the quantity of sperm retrieved was less for the IUI procedure. Doctors have advised me to have a Testicular Sperm Extraction. Is there any other solution option?
A: If the sperm retrieval process resulted in a small quantity of sperm being retrieved you can opt for ICSI treatment. It is a newer technology advanced fertility treatment with a high fertilisation success rate.
Q: What is Micro TESE? Is it a safe treatment to have?
A: Micro TESE is a surgical procedure in which a small incision is made in the testes to check for the presence of sperm. This type of sperm retrieval is recommended only in cases with very low sperm presence. It is a safe treatment to have and will help to retrieve any sperm that you may have.
Q: Can we do IUI procedure after sperm retrieval?
A: If the quality of the sperm is good and the sperm are healthy an active IUI is recommended.
Q: The doctor said I have azoospermia. What are my options to have a baby?
A: Azoospermia is the total lack of sperm in the semen. You can have a sperm retrieval procedure to retrieve the sperm directly from the testes. Most men who do not ejaculate sperm still produce sperm. Donor sperm is another option available to you.
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07 January, 2018
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