Male Infertility

Male infertility can be caused by many factors; these are disorders in sperm (male reproductive cell) production or transportation, development of antibodies against sperm, testicular injuries, disorders related to hormone production, varicocele, bad habits, such as drinking, smoking, drugs, and some medications. All of these reasons impair sperm number and quality. However, no reason to explain infertility can not be found approximately one third of patients.

Sperm number, motility, forward moving and shape are important factors in egg fertilization. All these factors can be easily detected by analysis of sperm to be performed. A sexual abstinence before 2 to 6 days of such an analysis and repeating the analyses at different times will ensure obtaining more healthy outcomes. If needed, hormone analysis and testicular biopsy can also be used as the diagnosis method.

Varicocele is often treated surgically. Hormonal disorders, presence of anti-sperm antibodies and infections indicate a need for medication. Although some drug treatments are tested for sperm abnormalities with no reason, there is no consensus on this issue yet. The assisted reproductive techniques are the most important treatment opportunity for male infertility. The simplest among these techniques is intra-uterine insemination, i.e., vaccination, practiced for many years. In this method, sperms from her husband are washed, concentrated and given directly into the uterus. In this way, sperms easily reach the egg, and the possibility of pregnancy is increased due to the increased fertilization capacity of the egg. This method is easy use and painless. The success rate is between 10% and 15%. If sperm quality is low so that intra-uterine insemination cannot be applied, in vitro fertilization is the treatment method that should be administered. In this method, eggs, retrieved from the woman after hormone therapy, are brought together with the husband's sperms in the laboratory. Thus, it can be observed whether the sperms fertilize the eggs. The fertilized eggs are placed directly into the uterus. In general, the possibility of conception with in vitro fertilization method in the world's major centers is 35% to 40%.

We have not had any option and chance until 1992 for cases where the above-mentioned methods are ineffective or sperm count or quality are extremely low. However, intracytoplasmic sperm injection (ICSI), i.e. microinjection, which has being implemented in medicine in recent years and almost has become a routine, has allowed to obtain successful results even for patients with sperm counts which are limited to small numvers like 10 (ten). In this method, developed in Belgium, a single sperm is injected into the egg cell with a very fine glass needle. Contrary to popular belief, deterioration of the integrity of the egg and accordingly, death of the egg cell is extremely rare in this method. Fertilization even with sperms that are not capable of fertilizing normally and so that, occurrence of pregnancy is possible with this procedure. The eggs are expected to be fertilized after the ICSI and the resulting embryos are transferred into the uterus. If there is zero-sperm in the semen obtained through masturbation, sperm can be obtained from testicles. Immature sperm cells are taken from the testis with a minor surgical intervention. Sperms obtained with this method are inert, but have the ability to fertilize.

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