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Book NowTreatment Options for Male Infertility: From Medication to IVF & ICSI
Reproduction requires healthy eggs and sperm in order to be successful. There are cases where people who are in good health still experience challenges in building their families. Male infertility is common and there are many reasons why a person may experience infertility when trying to build their families. Typically, before any treatments are explored, the cause of infertility must be investigated through fertility evaluation. Different causes of infertility are addressed using different treatment approaches. Let us look at the different ways infertility treatment gives men the opportunity to still build their families.
Medications and Lifestyle Changes for Sperm Health
Lifestyle Changes
One advantage that men have in their fertility is that they produce fresh sperm regularly. If a man is healthy his sperm will also be healthy. A person’s diet is central to proper hormonal regulation and balanced hormones are key to producing healthy sperm. With a good diet, lifestyle, exercise, sufficient sleep and stress management, a person can expect to have a healthy reproductive system. Lifestyle changes are usually recommended where there are minor infertility markers, and this is referred to as improving fertility naturally. So let us see the ways that are recommended for improving fertility through lifestyle changes:
- Reduce or stop taking alcohol.
- Quite smoking, using nicotine-based products or recreational drugs
- Exercise regularly
- Stress management
- Get sufficient sleep
- Manage sexual health by avoiding contracting an STI
- Eat nutritious food supplement where necessary
- If working with toxic substances, wear protective gear
- Wear breathable clothing particularly around the scrotum
Medical Intervention
It is possible to treat male infertility with medications. These are typically used to regulate hormones, improve sperm production and sperm health. Hormone therapy helps to restore the balance of hormone production in the body which can be affected by chronic disease, use of opioids and steroids, poor nutrition or high stress. Medication is typically used to improve low sperm parameters such as erectile dysfunction or challenges sustaining an erection. Again, poor nutrition, drug and alcohol abuse, medical conditions or stress can be the source of this.
Nutritional supplements are used to cover areas where a person’s diet still lacks sufficient nutrients. Consider a vegan who does not get Vitamin B12 that is normally found in red meat. A supplement containing B12 is necessary to help their bodies make red blood cells and sustain nerve function. Key to reproduction, B12 facilitates DNA synthesis, which is crucial in embryo formation. DNA damage is one of the key causes of pregnancy loss and birth defects.
Surgical Treatments
When a person has severe infertility that does not improve with a better lifestyle or medications, fertility experts will explore surgical options to treat male infertility. Surgical treatments extract the sperm directly from the testicles and these are then used to build families using fertility treatments. Severe infertility may be as a result of blockage in blood vessels or reproductive tubes such as the ejaculatory duct, seminal vesicles or the epididymal duct.
Varicocele Repair
Varicoceles are blood vessels that are located within the scrotum, whose function is to provide nutrients and oxygen to the testicles. Sometimes, the blood vessels become blocked creating discomfort, pain and impairing the production of healthy sperm. In order to treat varicoceles, a varicocelectomy, a surgical procedure for varicocele repair is conducted. Varicocele repair is done in different ways based on the location of the varicoceles. Varicoceles are also graded depending on how swollen they are; zero grade varicoceles would require an ultrasound to be seen, while a grade three varicocele can be clearly seen underneath the scrotum. Varicocelectomies can be done as open surgery or minimally invasive procedures, under sedation.
Open Surgery
There are three different ways that open surgery is conducted, depending on the location of the varicocele. Typically, open surgery is a ligation of the varicocele and they are accessed from different parts of the groin.
Inguinal Ligation for varicoceles is done by accessing the varicocele from the lowest part of the groin which is called the inguinal canal.
Subinguinal Ligation is a ligation done by accessing the varicoceles from the subinguinal part of the inguinal canal.
Retroperitoneal Ligation the peritoneum is the inner lining of the abdominal wall. A retroperitoneal ligation accesses the varicocele from the rear part of the peritoneum.
Minimally Invasive Surgery
Laparoscopic Varicocelectomy:
A laparoscopic varicocelectomy is done by making small incisions along the abdomen where a laparoscope and surgical instruments are inserted through. The surgery is observed using a monitor.
Microsurgical Varicocelectomy:
A microsurgical varicolectomy also employs small surgical instruments and a specialized surgical microscope to perform the procedure.
Sperm Retrieval Procedures
When a person does not produce enough sperm in their ejaculation, it is possible to retrieve sperm directly from their testicles. In these cases, the retrieved sperm will be used in fertility treatments such as IVF or ICSI. The four main techniques of sperm retrieval are:
- Testicular Sperm Extraction (TESE) is a procedure that directly retrieves sperm from the testicles.
- Micro-Testicular Sperm Extraction (Micro-TESE) is a procedure that retrieves sperm from the smaller regions of the testicles, using a high-powered microscope.
- Percutaneous Epididymal Sperm Aspiration (PESA) is, as the name suggests, sperm retrieval from the epididymis.
- Microsurgical Epididymal Sperm Aspiration (MESA) is similar to PESA, but using a microscope to magnify visibility.
IUI & IVF for Male Factor Infertility
Sperm retrieval addresses male factor infertility such as low sperm count and poor motility, in directly fertilizing eggs using the sperm. Assisted reproductive technologies (ARTs) such as IUI and IVF are some of the solutions available to address this type of infertility.
Intrauterine Insemination - IUI
IUI is a non-invasive procedure that places a sperm sample into the uterus during the woman’s ovulation window in her menstrual cycle.
In Vitro Fertilization - IVF
IVF is a process that has several steps and fertilizes eggs in a controlled lab environment using retrieved sperm.
How ICSI (Intracytoplasmic Sperm Injection) Works
Intracytoplasmic Sperm Injection (ICSI) is a procedure whereby one sperm is injected into the cytoplasm of an egg in order to fertilize it. The advantage that ICSI has as a result is that it has a higher success rate than regular IVF. It has increasingly become a preferred choice even when male factor infertility is not severe enough to require sperm retrieval.
Choosing the Right Treatment Path at Dallas Fertility Center
The right treatment can only be decided upon after consultation and diagnostic testing where need be. For some people natural fertility improvement may be the solution, for others, it may require medication, and for others some medical procedures. Whatever your circumstance, the fertility experts at NCFMC are well able to assist you in coming to the best option based on your circumstance and family building goals.
FAQs:
Who needs a sperm retrieval procedure?
Sperm retrieval is usually done on patients who may have genetic conditions that are prevening them from building their families naturally, patients who do not have sperm in their ejaculation, or patients who have had a previous vasectomy.
Is sperm retrieval painful?
Sperm retrieval is typically not very painful or uncomfortable, because it is done carefully under sedation. When the sedative wears off, one may have discomfort or pain that can be managed with painkillers. After a sperm retrieval procedure, it is recommended that one rest for a few days, avoiding any intense activity, including sex, to ensure a full recovery.
What is the success rate of sperm retrieval procedures?
Sperm retrieval has a success rate ranging between 50 and 90 percent. This however is based on what the cause of fertility was to begin with, as well as the procedure used to retrieve the sperm.