Male Infertility

• What is it?

Failure to have children despite regular and unprotected sexual intercourse for at least one year is defined as infertility. In cases where a male examination is required (this requirement will be decided by your Gynecologist and Obstetrician who performed your examination at the first interview), it is evaluated by our specialist Urologist-Andrologist physician on infertility. Semen analysis, hormone tests, microbiological and serological tests, pelvic ultrasonography (USG) and physical and genital examination help the physicians decide which treatment method to be preferred.

• What are the symptoms of a man with infertility?

There is no specific symptom of infertility. Failure to have children within 1 or 2 years despite regular unprotected sexual intercourse is considered as a sign of infertility. However, a number of additional symptoms may occur depending on the underlying disease that may cause infertility in the male. If these symptoms are not directly in the testicles, it is unlikely that the patient will associate them with infertility: such as pain, swelling in the testicles and discharge from the penis.

• What are the causes of infertility in men?

Any condition that affects testicular function and disrupts sperm production in the testicle is the cause of infertility: testicular infections, testicular traumas, surgical interventions for the testicle, undescended testicle, exposure to testicular toxic substances (radiotherapy/chemotherapy/lead-battery-mercury industry employees, etc.), high temperature, insecticides, chemicals; genetic disorders, inadequate release of testosterone,

Any condition that prevents sperm formed in the testicle from being expelled from the male genital system is considered to be the post-testicular cause of infertility: Sperm mobility disorder; absence of sperm channels, disruption of integrity as a result of binding/damage of sperm channels as a result of surgery or sexually transmitted infections; sexual dysfunction and inability to have intercourse with the penis due to deformity; prostate surgery and/or medication use or other causes such as absence of semen are the causes of infertility.

• How is infertility diagnosed in men?

First of all, a detailed anamnesis and a physical examination, have to be done before a semen analysis. Since it is difficult and laborious to evaluate women on infertility, the evaluation of men beforehand helps the couples proceed faster. After 3-5 days of sexual abstinence, first semen analysis of the man is important in terms of deciding for the appropriate treatment method and achieving a faster result.

• Male infertility treatment

The treatment process varies depending on the cause of infertility and whether the semen contains sperm or not. In case of an underlying and treatable condition, this should be corrected first.

The following treatments can be applied for infertility problems in men;

• Infertility medication treatment: for hormonal disorders
• Infertility injection treatment: faster treatment for hormonal disorders
• Infertility Intrauterine Insemination (IUI) method: recommended only for cases with borderline problems. It is the easiest method, but the probability of success is low. The chance of pregnancy success varies between 10-15%.

   Auxiliary reproductive techniques:

In-vitro Fertilization (IVF): the egg taken from the woman is combined with the sperm taken from the man, after washing off in a tube. The sperm reaches the egg at a closer distance, with its own movement and is fertilized with its own capacity.

Intracytoplasmic Sperm Injection (ICSI): we select sperm cells with optimal characteristics. Afterwards, these sperms are placed one by one in the egg taken from the woman under the microscope. This is the method generally applied in male infertility for the last 25 years.

Selected Sperm Microinjection with High Microscopic Magnification (IMSI): with this method, sperms are magnified 7200 times in special microscopes, while in classical IVF treatment, sperms are selected by a 400 times magnification. Therefore, main structure of the sperm can be detected and structurally and genetically healthier sperms can be selected. IMSI increases the chance and success of treatment and is particularly recommended to

• Patients with severe sperm problems and a limited number of eggs can be obtained
• Couples who have experienced repetitive IVF failures

Micro TESE: It’s a microscopic operation performed under general anesthesia, by opening the testicle and by collecting sperm from the tissue. By this method, the sperm can be obtained in 40-60% of patients with azoospermia

Prepared by the Medical Editorial Board. Our health library contents have been prepared for informational purposes only and with the scientific content on the registration date. For all your questions, concerns, diagnosis or treatment about your health, please consult your doctor or health institution.