The main cause of male infertility is the changes in sperm parameters due to the decrease of sperm count, mobility and quality caused by different factors. There may be more than one cause behind the sperm parameter change, but the most common cause of this change is the enlargement of the ovary veins called “varicoceles”.
Before the infertility treatment is performed, the reason why the men can’t have any children must be determined. After determining the causes, it is passes to the treatment stage by considering the general health status of the patient.
In order to determine the treatment of male infertility, first of all special examinations are made for males. Not every infertility treatment is the same; the factors such as illnesses in the past, lifestyle, genetic predisposition, age and the presence of previous treatment of infertility are evaluated by specialist andrologists. At this stage, the dialogue between the patient and the doctor is quite important. Acquiring sufficient information about the patient will affect the dynamism of the treatment period. Afterwards, the tests will be performed in order to clarify the treatment method to reach the specific data.
Spermiogram (Sperm Test): The results of sperm test provide quiet important information in the process of determining the causes of infertility. The sperm samples are taken form the male patient with an interval of 3-4 weeks and the basic elements such as the count, shape and mobility of the sperms are evaluated in the taken samples.
Hormone Assessment: Follicular stimulating hormone (FSH), Luteinizing hormone (LH), Prolactin (PRL) and Testosterone hormones are assessed in order to determine hormone-induced male infertility. Determination of the treatment method after the hormone test increases the success of the process.
Testicular Biopsy: Testicular biopsy, considered as the golden standard as it gives the most accurate results in assessing the function of the testicles is performed under local anesthesia. It can be applied to both testes depending on the health condition of the patient. Since the anesthesia is given, the patient does not feel any pain. Testicular biopsy applied in the absence of sperm in the semen, although there is no problem in their hormonal values, gives important clues about whether sperm production is normal or not.
Physical Examination: It can be determined by physical examination whether the testicular arteries are enlarged or not and whether the deformities occur or not. Physical examination is important in understanding whether the infertility is caused due to varicocele or not. However, it can’t be continued to the treatment stage according to the results of physical examination alone.
Scrotal Color Doppler Ultrasonography: Scrotal color doppler USG performed to diagnose testicular diseases; is a method of monitoring that clarifies the presence or absence of varicocele disease in men who want to have children but who have the doubt of infertility. With this monitoring method, the anomalies occured in testes and surrounding tissues can be easily detected.
Medical treatment can be used to increase the sperm count, improve quality, and increase sperm motility. If hormone imbalance is the main factor that causes male infertility, it’s aimed to eliminate the problems with hormone medications. If there is a problem in the sperm quality, a treatment is administered with the support of antioxidant and multivitamins in order to increase the sperm quality of the patient. Medical treatment must have definitely positive effects in the patient’s lifestyle in order to be successful. If he smokes, he needs to quit, if he is overweight, he needs to lose weight, eat healthy, stay away from the stress as much as possible, do sports and protect his ovaries from excess heat. When the medical treatment is applied and the lifestyle is changed, it is known that the sperm quality may be increased by approximately 50% even if the sperm quality changes from person to person.
The most common treatment of varicocele disease, which can be described as the enlargement of the veins around the ovaries and reaching of more harmful agents to the testes, is the “microsurgical varicoselectomy” operation. The suffering of the patients of varicocele disease, decrease of the sperm quality over time and decrease of excretion of testosterone can be treated by this operation.
During the operation performed under the microscope, the veins are reached from 3-4 cm of cut opened in the inguen. The enlarged veins are monitored and tied in detail under a microscope. After an average of 40 minutes of operation, the patients need to stay under the control of a doctor for one day. After performing all the controls of the patient, the andrologists determine the discharge time. Patients may also need vitamin supplements to increase the sperm quality after varicocele treatment. After the operation, the patients are checked in every 3, 6 and 12 months; the improvement in sperm values is followed.