Treatments For Male Factor

This can be divided into either medical or surgical. Of course what we use will depend on what the abnormality is

MEDICAL TREATMENT :

Medical treatment has a small place in treatments of male infertility. Thyroid, prolactin estimates are important when the analysis is abnormal.

HYPERPROLACTINAEMIA

In patients with this condition, after an MRI scan, simple treatment with drugs like Cabergoline will rectify the defect

ANTI-OXIDANT TREATMENT:

Excess Reactive Oxygen species (free oxygen radicals) can be found in patients who have poor sperm morphology. This leads to DNA damage in the sperm. This can be improved by the use of anti-oxidants like Vitamin C and E.

ZINC, FOLIC ACID AND SELENIUM:

Are also thought to help, but randomized clinical trials in infertility are lacking. Zinc and folic acid act as co-enzymes in DNA and RNA synthesis

ERECTILE AND EJACULATORY PROBLEMS:

Erectile problems can be treated by phosphodiesterase type 5 inhibitor like Sildenafil, Tadalafil, etc Ejaculation problems can be treated by the use of alpha-adrenergic stimulation using sympathomimetic agents like Sudafed. Alkalinization of the bladder urine with oral sodium bicarbonate and retrieval of sperm from the bladder after ejaculation can also be used

INTRA UTERINE INSEMINATION :

The principle, With borderline sperm profile, sperm washing with culture medium can improve motility while removing dead sperms and unwanted debris. This simple and inexpensive procedure, when coupled with ovulation induction can be tried for at least six months if the tubes are patent. This will increase the chance of conception to5- 15% on an average depending on the cause.

ASSITED REPRODUCTIVE TECHNOLOGIES FOR MALE FACTOR :

TREATMENTS FOR AZOOSPERMIA

The options are:

Testicular sperm aspiration (TESA)
Testicular sperm extraction (TESE)

TESA - TESTICULAR SPERM ASPIRATION :

This procedure is done under anesthesia. The testis is cleaned and the epididymis identified. A 21-gauge butterfly needle attached to a 2ml syringe is inserted into the testicular tissue. The fluid is aspirated and given to the ART LAB to identify spermatozoa.

MICRO TESE - TESTICULAR SPERM EXTRACTION :

The scrotal skin is incised and a small piece of testicular tissue is obtained and passed on to the ART for identification of spermatozoa. In all these procedures spermatozoa obtained are cryopreserved and then the ICSI procedure carried out.

ICSI - INTRACYTOPLASMIC SPERM INJECTION :

The eggs are collected from the female partner after hormonal stimulation. The sperm obtained by ejaculation or surgical methods are injected into the egg after careful selection (a normal looking moving sperm is chosen; however the genetic normalcy cannot be checked even by techniques like IMSI (ICSI with morphologically normal sperm). The success of fertilization is about 75% and the clinical pregnancy rate is about 40% as per international standards when no other causative factor is present