Male infertility treatment
A decrease in male reproductive function underlies infertility in about 50% of cases, so if pregnancy does not occur within a year of active sexual life without the use of contraceptives, both spouses need to undergo a thorough examination.
The main causes of male infertility
As for men, reduced reproductive function may be caused by:
- the process of sperm formation and maturation is disrupted, which can be associated with both congenital (for example, cryptorchidism) and acquired pathologies (for example, orchitis);
- the process of movement of sexual gametes along the VAS deferens is disrupted. In this case, the doctor diagnoses obturation infertility, which often develops due to the formation of adhesions after surgical interventions on the organs of the scrotum or transferred infectious diseases. Also, neoplasms can affect the patency of the VAS deferens. In some cases, it is based on congenital abnormalities of development (for example, the absence of the epididymis-the appendage of the testicle);
- sperm is not ejaculated and does not reach the female genital tract. This situation occurs due to sexual-ejaculatory disorders (for example, with retrograde ejaculation, when sperm is thrown into the bladder);
- in a man's body, antibodies to his own sperm are formed. Normally, immunity cells are not only reliably separated from the reproductive gametes by the so-called blood–testis barrier, but they are not even aware of their existence. However, under the effect of negative factors, this barrier can be violated. In this case, the cells of the immune system perceive the sperm as strangers to be destroyed. In the body of a man, special antibodies (ASAB) are formed, which attach to the tail or head of the genital gamete, preventing its movement and penetration into the egg.
Male fertility can be reduced due to certain medications, exposure to radiation, alcohol abuse, a sedentary lifestyle and poor nutrition.
Since the number of overweight people in the country is constantly growing, it makes sense to separately highlight such a cause of reproductive dysfunction as obesity. Infertility in this case is due to the fact that the concentration of testosterone in the blood decreases, and this directly affects the process of spermatogenesis. In obese patients, both the number and quality of germ cells are markedly reduced.
Methods for the diagnosis of male infertility
First of all, the doctor prescribes a spermogram - a basic study that allows you to assess the state of the male reproductive system. If the analysis reveals violations, it is necessary to repeat it after 2 weeks and 72 days.
MAR-test is also required to exclude the immunological factor of infertility. The specialist estimates how many sperm cells are covered with antisperm antibodies, and also determines the localization of the ASAB.
If the indicators are within the normal range, the doctor may prescribe additional studies, including:
- HBA-test, which determines the degree of maturity of the reproductive gametes;
- TUNEL test to detect DNA fragmentation of spermatozoa;
- ultrasound examination of the scrotum, penis and prostate gland;
- tests to determine the level of sex hormones;
- genetic research for the carriage of mutations in the CFTR gene and the AZF factor;
- tests for STIs.
Male infertility treatment methods
To achieve pregnancy with a male factor of infertility, conservative therapy, surgery, or assisted reproductive technologies may be recommended.
The use of medications is usually effective in case of endocrine disorders or infectious and inflammatory diseases. Additionally, the doctor may recommend physiotherapy and vitamin and mineral complexes.
Surgical intervention helps to restore reproductive function if the patient is diagnosed, for example, with pathologies such as varicocele or cryptorchidism.
In more complex cases, ART methods are used.
In the IVF / ICSI program, specialists select the spermatozoa with the best characteristics and place each of them inside one of the eggs. For a more objective assessment of the quality of the reproductive gametes, PICSI technology is used.
In the absence of germ cells in the ejaculate, doctors can obtain them from the testicle or its appendage (epididymis) by biopsy.
The effectiveness of ICSI programs at Nova Clinic is about 80%.
In some cases, if it is not possible to achieve pregnancy using the patient's sperm, the doctor may recommend IVF with the donor's genetic material.