Male infertility using drugs, surgery or assisted reproduction?

This is an automatically translated article.

The article was written by Dr. Nguyen Ba Hung - Doctor of Orthopedics, Reproductive Support Center - Vinmec Times City International General Hospital.
Male infertility is a disease when a man of reproductive age, having regular sex for a year without using contraception, cannot make his female partner pregnant (the time to expect a child) despite the condition. This woman's fertility is normal.

1. Manifestations of male infertility

Male infertility can be a disease of the genital organs, can be the result of many different diseases and syndromes affecting the genital organs, so the manifestation of physical symptoms is very diverse. However, the most important sign is: Decrease in sperm quality and quantity (accounting for about 90%) or no sperm (accounting for about 10% of infertility cases).
The current rate of male infertility is reported to account for about 50% of the causes of infertility in general, equivalent to the rate of infertility from women, the trend of male infertility is increasing due to low sperm count. combination from environmental factors...

2. Causes of male infertility

There are many different causes, currently more than 40-50% have not found the cause (idiopathic), the rest are divided into other causes with the following frequencies: Varicose veins (about 27%), obstruction (about 15%), endocrine disorders (about 2%), sexual disorders (about 3%), poisoning, radiation poisoning (about 1.5%), genetic diseases (about 1.5%). ..

3. Male Infertility Treatment

Based on the length of time to expect a child over a year and the cause of male infertility.
Causes that can be treated by using drugs:
Endocrine disorders, sexual disorders, genital infections, lack of micronutrients... The main cause of the disease will help increase the number and amount of healthy sperm significantly after about 2-3 months of treatment. This can lead to a natural pregnancy, or an increased success rate if assisted reproduction, and more importantly, this method improves the quality and quantity of sperm from the body's own power. will help the baby born will have a better chance of being healthy and easy to take care of.
Drug treatment is also focused even in cases where surgery or assisted reproduction is indicated, with the aim here being nutrition for healthier sperm.

4. The causes of infertility treated with surgery

varicocele is a common cause of low sperm count, however, only about 40% of men with varicocele are reproductively affected. normal. Therefore, careful consideration should be given before performing surgery. Currently, the most commonly applied surgical method is microsurgery, other surgeries such as laparoscopic, open surgery, or embolization are rarely used in infertility treatment because of many complications and high recurrence rate. . Obstruction of the vas deferens: Only applied to cases of blockage in the scrotum, including: Surgery to connect the vas deferens with the vas deferens, and to connect the vas deferens with the epididymis. The success rate depends on the joint location and the time of occlusion. Undescended testicle: Testicular reduction surgery is applied from early on with children under 2 years old to preserve fertility, in cases of late detection, lowering testicles is applied as soon as possible. Surgery, sperm collection procedures: Apply to cases of azoospermia due to blockage or pathology in the testicles (cases where sperm are not found but due to extra-testicular causes (hypothyroidism). still, hypothalamic, drug treatment is very effective and surgical intervention is not allowed.) Currently, the storage of immature sperm removed from the testis epididymis has not been completed, many cases later If these samples are disintegrated, the sperm will not survive to fertilize, so the application of spermatozoa procedures and surgery should be applied on the right day of the wife's egg collection to ensure fresh and highly effective sperm. Surgery, spermatozoa surgery and collection include: PESA epididymectomy for spermatozoa, TEFNA orchiectomy for spermatozoa, microepidermal microsurgery (MESA), testicular tissue extraction surgery (TESE), Testicular microsurgery (Micro TESE).

Assisted reproductive interventions: In cases of failure of drug or surgical treatment, unexplained male infertility, Primary testicular failure, those who wish to have children soon... Advantages of This method is fast, selects the best and strongest sperm and then injects directly into the egg cytoplasm to create fertilization. Therefore, sperm do not need to swim to meet the egg and do not need to puncture the egg shell to fertilize it. This method can use both weak and immature sperm obtained from the epididymis and testes to fertilize an egg and still create a normal embryo and baby later.
At Vinmec, we have successfully treated many cases of infertile men who have qualified sperm for IVF and natural conception. With a team of leading experts in male infertility treatment, reproductive support and a synchronous modern equipment system, comprehensive and professional medical examination, consultation and treatment services; civilized, polite, safe and sterile medical examination and treatment space.

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