MALE INFERTILITY - Urology


What is the infertility? Infertility is defined as pregnancy not occurring in a year despite regular sexual intercourse of couples without contraception.

What are the causes of infertility?

The cause of infertility may be male or female related. Ovulation disorders, damaged or obstructed tubes, endometriosis, cervical problems and allergenic reasons are among the causes of female infertility. The causes of male infertility principally include production disorders that affect number and quality of sperms or obstruction in the canals that carry the sperm outside.

Is infertility a common condition?

According to the studies conducted in the US, the prevalence of infertility is around 15 percent.

What are the main factors that affect the shape, number and mobility of the sperm?

Varicocele, previous surgery due to undescended testicle during infancy or current undescended testicle, swelling or shrinkage in testicles following the diseases such as mumps etc., some hormonal conditions leading to pathologies in production of testosterone hormone, x-ray or medication used for treating cancer are the main factors that adversely influences the shape, number and mobility of the sperm.

What does Varicocele mean?

The most significant causes of the male infertility, varicocele is the enlargement of testicular veins. Decrease in the number of sperm, defect in the shape of sperm and reduction in the sperm mobility may occur due to Varicocele.

Is there a treatment for Varicocele?

Varicocelectomy (tying the testicular veins) is the most common operation carried out for the treatment of male infertility. Today, micro-surgical approach is preferred in varicocelectomy operations. Through the use of micro-surgery, possible complications of varicocelectomy are minimized and the rate of pregnancy is increased.

What is the rate of success in the post-varicocelectomy period?

Improvement is observed in sperm parameters in around 60-80% of the patients who were undergone to varicocelectomy and the pregnancy rates vary in the range of 20-60 percent.

What are the complications of varicocelectomy?

Low rate of hydrocele (accumulation of fluid around the testicle), relapse, shrinkage of the testis and distortion in the sperm production may occur in the post-varicocelectomy period.

Can medication be used for the treatment of male infertility?

When the cause of defect in the quality of the sperm cannot be found, some medications are used. However, the effectiveness of such treatments is still controversial.

Which tests are performed for evaluating the male infertility?

The semen analysis, also referred as spermiogram, has a significant position in the evaluation of the male infertility. At least two semen analyses must be done in order to evaluate the infertility in at least 7-day intervals, since sperm production is subject to daily fluctuations. Semen analysis should be done following a sexual abstinence of at least 48 hours and duration of abstinence should not exceed 7 days. Some hormonal tests may be asked from some patients to evaluate the male infertility. Radiological evaluation such as transrectal ultrasound and scrotal color doppler ultrasound may be required in some cases.


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