As a result of the sperm analysis requested at the end of a 2-5 day sexual abstinence, the sperm number, movement and deformity In cases where a male problem is diagnosed, a detailed evaluation and action is required accordingly.
In very rare cases, male infertility may be the first sign of a serious underlying and life-threatening disease, such as testicular tumors. For this reason, when significant male infertility is encountered, an examination by a Urologist is required.
As a result of the research conducted, the most important causes of male infertility are, in medical terms, infertility in childhood. “cryptorchism” calledundescended testicles, infections in the reproductive organs and 'varicocele' encountered in older ages.
Other, less common causes of male infertility are: testicular tumors, testicular injuries, high fever diseases, obstruction in the reproductive ducts, retrograde ejaculation, nervous system causes, genetic disorders, hormonal and sexual dysfunctions. In cases of infertility caused by genetic problems, genetic anomalies that will affect the health of the child resulting from in vitro fertilization may also be detected.
THE IMPORTANCE OF GENETIC EXAMINATION IN MALE INFERTILITY:
In recent years, advances in the field of genetics have enabled us to obtain very important information about the causes of male infertility. from sex chromosomes Y chromosome Deletions in the genes on it cause a situation such as decreased sperm production in the testicle or no sperm being produced, although the body structure and functions are normal. Likewise, number anomalies in sex chromosomes, such as the most common 47XXY Klinefelter syndrome In genetic diseases such as testicular development may be inadequate and sperm production may be reduced.
In addition, if the ducts that carry sperm from the testicles are not present at birth, although there is normal sperm production in the testicle, sperm cannot be seen in the semen because there is no way out. This is genetically Congenital Bilateral Vas Deferens Agenesis (CBAVD) It is due to a disease called. Some men with infertility problems can be treated by replacing the hormones that are found to be deficient or by increasing sperm production with some drug treatments.
Patients who have no sperm cells detected in the sperm analysis (azoospermic) are evaluated with detailed examinations to determine whether there is actually sperm production in the testicles or whether there is a blockage in the channels through which sperm passes. In addition, varicocele (enlargement of testicular veins, varicose veins), which is seen in 15% of men in the society and detected in 40% of men applying with a diagnosis of infertility, is one of the factors that disrupt sperm production. varicoceleIt may impair sperm production and especially their motility properties by affecting the intratesticular microcirculation following the increase in temperature in the testicles and the backflow of used blood in the veins to the testicle. The diagnosis of varicocele, which can be seen in different degrees, can be made by examination and various radiological tests.
It has been shown that there is no benefit in performing surgery on varicoceles that are not detected by a specialist's examination and are only shown by Doppler ultrasonography, that is, they are only present at a low level.
Varicocele, which can sometimes cause pain, is not generally a health problem and is only important if it is detected in men who want to have children. Varicocele that begins in adolescence may also prevent the development of the testicles, and this should be treated without delay. Varicocele can show its effect on sperm production over many years.
varicocele can be treated using microsurgical methods; It is the most common cause of male infertility. In varicocele cases diagnosed correctly and treated with the successful application of microsurgical methods, a 60-70% improvement is achieved in spermiogram values. However, there are conflicting studies about the extent to which this improvement in sperm improves pregnancy rates.
Generally, cases who cannot become pregnant despite the improvement in spermiogram results within 6 months following the varicocele operation must definitely proceed with intrauterine insemination (IUI) or in vitro fertilization (microinjection). In mild but not extreme sperm disorders sperm washing process and insemination It is possible to achieve pregnancy with . If necessary, the opinion of a Urologist is taken. In severe sperm disorders, insemination cannot be beneficial and in vitro fertilization-microinjection treatment must be applied. If there is no sperm in the sperm sample given and if no blockage is detected upon testing, that is, if there is a lack of sperm production, then sperm obtained from the samples taken from the testicles (man's ovaries) is used (TESE). in vitro fertilization treatment It is necessary to do.
Naturally, the most frequently asked question about male infertility is what causes it.
But unfortunately In most of the cases where sperm count, movement and shape abnormalities are detected, it is not possible to reveal a clear reason neither in the history nor in the examination..
This is called male infertility of unknown cause. The procedures to be performed are still the same, that is, insemination if there is a certain amount of sperm, if not, in vitro fertilization-microinjection treatment.
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Frequently Asked Questions About Men's Problems