Male Infertility Treatment Options

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Male Infertility Treatment: There are many potential causes for male infertility. Many of these causes have treatment options and some do not. Below is a discussion of common treatments Varicocele: Varicoceles are big veins around the testicles that may cause the testicles to have a higher temperature. This may affect the quality of sperm. Varicoceles are treated surgically by a urologist in a procedure called a varicocelectomy or by a radiologist in a procedure called an embolization. Surgery has lower risks and a greater chance of success; embolization has a quicker recovery.

A semen analysis and follow-up physical examination are recommended 4 months after the procedure. Improvement in the quality of sperm occurs in about 70% of treated men and pregnancy occurs in 30-35% of couples. Hormones: Two hormones, testosterone and follicle stimulating hormone (FSH) are necessary for the production and maintenance of sperm. Other hormones such as luteinizing hormone (LH), prolactin, and thyroid hormones, also play a role in sperm production. Each of these hormones can be checked by a blood test. Additional testing may be necessary if the hormone levels suggest involvement of the pituitary gland (located in the brain).

There are some injectable medications available that will often increase sperm production. These medications primarily work by increasing the testosterone level within the testicle (warning: do not take testosterone shots, patches, or use topical gel as this will increase testosterone in the bloodstream, but will decrease testosterone within the testicle which will decrease sperm production). Other hormones are available that can be used in specific situations to correct hormone deficiencies. It should be noted that women may also use the medications discussed above in their treatment. Antisperm Antibodies: Antisperm antibodies are antibodies that attack one’s own sperm. Treatment is aimed to reduce these antibodies with steroid medications and is often done along with intrauterine inseminations.

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There are risks associated with the use of steroids that you should discuss with your physician prior to the start of treatment. Another option for someone with antisperm antibodies is in vitro fertilization (IVF) with Intracytoplasmic Sperm Injection (ICSI).Blockages: Any obstruction in the sperm’s path can prohibit the sperm from getting from the testicle to the ejaculate. Blockages can be found in the vas deferens, epididymis, or ejaculatory duct. A complete evaluation with an expert will determine if and where there is a blockage. Once a blockage has been confirmed, outpatient surgery may be required to repair it. If it is in the vas deferens a vasovastomy will be performed. A vasovastomy is a microscopic procedure in which the vas deferens will be reconnected after the obstruction has been removed. If the blockage is in the epididymis a vasoepididymostomy will be performed.

A vasoepididymostomy is a microscopic procedure in which the vas deferens will be connected to the epididymis above the area of obstruction, thus bypassing the blockage. If the blockage is in the ejaculatory duct, a transurethral resection of the prostate may be advised to cut out the blockage. This is done with a telescope, not through an open incision.Infection: Since infections and white blood cells can be harmful to sperm, antibiotics may be prescribed to cure the infection.Problems with Ejaculation or Impotence: Approximately 5% of male infertility cases are due to problems with erections or ejaculation.

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