Treatment of male infertility:
The treatment of male infertility depends on the cause of the problem. Treatment of male infertility can broadly be classified into 3 types:
- Non-surgical therapy for male infertility
- Surgical therapy for male infertility
- Treatment for unknown causes of male infertility
Non-surgical therapy for male infertility is suggested if the man suffers from any of the following condition.
Anejaculation is when there’s no semen. It’s not common, but can be caused by:
- spinal cord injury
- prior surgery
- multiple sclerosis
- abnormalities present at birth
- other mental, emotional or unknown problems
Drugs are often tried first to treat this condition.
Congenital Adrenal Hyperplasia (CAH)
CAH is a rare cause of male infertility. It involves congenital problems in certain enzymes. CAH causes abnormal hormone production. CAH is most often diagnosed by evaluating the steroid level in the blood and urine. CAH can be treated with hormone replacement.
Retrograde ejaculation is a condition in which the semen flows back instead of going out of the penis. It can be caused by:
- prostate or bladder surgeries
- spinal cord injury
- certain anti-hypertensives
- medications used to treat prostate enlargement (BPH)
Retrograde ejaculation can be treated with drugs.
Surgical treatment for male infertility is recommended in case of infertility caused due to the following conditions:
- Varicocele Treatments: Varicocele is a condition in which the veins in the scrotum become enlarged. The condition can be fixed with minor outpatient surgery called varicocelectomy. Fixing these swollen veins helps sperm movement, numbers, and structure. If you are suffering infertility issues due to varicocele, you can get in touch with our vascular experts.
- Azoospermia Treatments: If your semen lacks sperm (azoospermia) because of a blockage, there are many surgical choices. TESA, PESA, MESA can be used to retrieve sperm.
- Microsurgical Vasovasostomy: Vasovasostomy is used to undo a vasectomy. It uses microsurgery to join the 2 cut parts of the vas deferens in each testicle.
- Transurethral Resection of the Ejaculatory Duct (TURED): Ejaculatory duct blockage can be treated surgically. During the surgery, a cystoscope is entered into the urethra and a small incision is made in the ejaculatory duct. Thereafter, the doctor successfully unblocks the ejaculatory duct obstruction.
Treatment for unknown causes of male infertility
While most cases of male infertility can be diagnosed and treated, there are also conditions, where it becomes difficult to tell what is the exact cause of infertility in a man. Such conditions are known as ‘idiopathic’ or ‘non-specific’ male infertility. In cases where the cause is not clearly determined, or where no other forms of treatment work, infertility specialists suggest the patient undergoes the following infertility treatment techniques.
Assisted Reproductive Techniques
If all other infertility treatment fails to provide desired results, there are ways by which a couple can get pregnant without having sex. These methods are called assisted reproductive techniques (ARTs). Based on the specific type of infertility and the cause, the infertility specialist may suggest any of the following ARTs.
- In Vitro Fertilization (IVF): IVF is the most common and trusted ART in which the egg of a female partner or donor is fertilized with sperm of the male partner or sperm donor in a lab petri dish. For IVF, the ovaries must be efficiently stimulated. This is often done with drugs as the first step of the whole procedure. It allows multiple mature eggs to be retrieved. After 3 to 5 days of growth, the fertilized egg (embryo) is implanted into the uterus. IVF is used mostly for women with blocked fallopian tubes. But the procedure is also relied upon in cases where the man has very severe and untreatable oligospermia (low sperm count).
- Intrauterine Insemination (IUI): IUI or intrauterine insemination is a fertility treatment where the sperm is directly placed in the uterus. The chances of conception in IUI fertility treatment are more since the process allows a higher concentration of healthy sperm to come closer to the egg. IUI is often suggested for couples where the male suffers low sperm count and movement problems, retrograde ejaculation, and other causes of infertility.
- Intracytoplasmic Sperm Injection (ICSI): ICSI is a variation of IVF. It has revolutionized the treatment of severe male infertility. A single sperm is injected into the egg with a tiny needle. Once the egg is fertilized, it’s implanted in the female partner’s uterus. Your infertility specialist may recommend ICSI if the male partner has very poor semen quality. It is also used if you have no sperm in the semen, a block or testicular failure that can’t be fixed. Sperm may also be taken from the testicles or epididymis by surgery for this method.
- Sperm Retrieval for ART: Many microsurgical methods can remove sperm blocked by obstructive azoospermia (no sperm). The goal is to get the best quality and number of cells. This is done while trying not to harm the reproductive tract. These methods include:
- Percutaneous Epididymal Sperm Aspiration (PESA): PESA is a low-cost treatment done by most experienced urologists under local or general anesthesia. The urologist sticks a needle attached to a syringe into the epididymis. Then he or she gently withdraws fluid from the testicle ducts. PESA is often a successful treatment but in case sperm is not retrieved through this technique, the doctor may recommend open surgery.
- Microsurgical Epididymal Sperm Aspiration (MESA): MESA helps in retrieving sperm from the epididymal tubes. This method uses a surgical microscope. MESA yields high amounts of motile sperm. They can be frozen and thawed later for IVF treatments. This method limits harm to the epididymis. It keeps blood out of the fluid. Even though MESA calls for general anesthesia and microsurgical skill, it has a lower problem rate. It’s also able to collect larger numbers of sperm with better motility for banking.