12 Dec Common treatable male fertility solutions in IVF lab
Here at IIRFT, a renowned IVF training institute in India, we aspire to become the leaders in IVF industry. Today, we are going to discuss the most common treatable male fertility solutions in IVF lab.
Major segment of male infertility patients are spontaneous in nature. The clinical classification of reproductive disorders may be done on the basis of prognosis. Unfortunately, many identifiable disorders are not flexible to the available forms of therapy.
The disorders can be classified as follows:
Treatable: Ejaculatory an Erectile dysfunction, Hyperprolactinemia, Hypogonadotropic Hypogonadism, Infection, Obstruction and Variocele
Potentially treatable: Pediatric Cryptorchidism, Immunologic problem, Idiopathic difficulty, Maturation arrest, Testicular Torsion, Vasal Agenesis, Kartagener Syndrome
Untreatable Causes: Adult Cryptorchidism, End Stage primary testicular failure, Genetic disorders, Sertoli Cell only syndrome, Anorchia
Varicocele is the commonest surgery correctable anomaly in an infertile male. 40% of the patients and 15% of the general population is diagnosed with Varicocele disorder.
It occurs due to poorly functioning valves usually present in veins or may be from compression of veins or vein of a nearby structure.
The Palomo (High Ligation) operation is the first line of treatment.
The obstructive lesions are either Acquired or Congenital. The sites of obstruction can be the Ejaculatory duct, Vas deferens, Epididymis and efferent ducts. The most common congenital lesion is vassal agenesis.
The treatment options are limited. The success rates after Spermatocele surgery and Epididymal Micro puncture coupled with IVF are low, while MESA/TSA with ICSI has higher success rate
Patients with ejaculatory dysfunction usually have absence of sperms or low volume of sperm per ejaculate. Detection of abundant sperms in the post-ejaculatory urine sample is pathognomonic of retrograde ejaculation.
If medical treatment fails or is not tolerated then sperm retrieval from the bladder in association with alkalinization of the urine, adding buffer protective to the spun semen sediment and artificial insemination may be successful.
Hypogonadotrophic Hypogonadism (secondary testicular failure) is treatable. Patient with Kallman Syndrome (Anosmia, Cleft Palate and HG-Hg) may require treatment due to infertility and delayed puberty. Patients with low Serum testosterone should undergo Serum prolactin level evaluation; GnRH stimulation test and radiological evaluation of the Sella turcica in post-pubertal patients.
Previous history of trauma, infection, vasectomy, torsion and cryptorchidism is relevant for antisperm antibodies. Oral steroids may be used for therapy after weighing the risks and benefits.
The high dose short course therapy timed to the wife’s menstrual cycle gives the best results.
Bacterial infection, especially affecting Prostate or Epididymis will decrease fertility invariably. The first line of treatment is Doxycycline. Longer course of therapy, prostate massage and frequent ejaculation are other actions.
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