Men’s health – infertility – infertility frequently asked questions

Frequently Asked Questions

1-What is varicocele?
Varicocele is varicose veins that drain the blood in the testicles by enlarging for various reasons.

2- How is varicocele detected?
Varicocele can be noticed by the pain spreading from the egg to the leg and the curved vascular structure that becomes evident in the bag in a warm environment. It can also be detected by hand examination during the treatments for infertility. The incidence of varicocele is highest in the 20-30 age group.

3-What causes varicocele disease?
Varicocele alone does not constitute a health problem. It needs to be treated because it affects sperm cells and causes infertility and sometimes pain. There is no need for varicocele treatment in people who do not have pain problems and do not cause infertility.

4-How is varicocele treated?
First of all, microsurgical varicocele surgery should be recommended to the person diagnosed with varicocele for infertility problem. Medication or in vitro fertilization should not be recommended to people with varicocele first, because statistically up to 80% improvement in spermiogram values ​​after surgery has been achieved. way they can have children.

5-What is azoosperm?
It is the Latin name given to the absence of sperm in a man.

6-What is the number of sperm required?
Sperm count is expected to be 15 million or more in 1 volume.

7-What are the causes of azoospermia?
Pretesticular (pre-testicular) causes: Hormonal disorders related to sperm production.
Testicular (related to the testicles) causes: Congenital disorders, past infections,
past surgeries related to testicles, tumors of testicles, testicular traumas etc.
Postesticular (post-testicular) causes: Dysfunction or obstruction of the ducts.
The inability of the produced sperm of the man with sperm production to mix with the semen.

8-Is only seeing the spermiogram test enough to diagnose infertility?
It is wrong to make a decision just by reading your spermiogram test. In medical studies, infertility
Only 17% of patients whose decision is made by reading the sperm test are correctly diagnosed.
was found to be placed. In 83 of 100 patients without testicular examination, the doctor misunderstood
it gives. There are many diseases that affect the testis. However, it can be detected by testicular examination.

9-What kind of treatment methods are followed if there is no sperm as a result of the sperm?
If there is no sperm in the given sperm sample and there is no obstruction as the reason for this, that is, if there is low sperm production, then it is removed from the testicles.
In vitro fertilization treatment is required with sperm to be obtained (from the ovaries of the man) (PESA/TESA/TESE/MESA/microTESE surgeries).

10-What kind of treatment methods are followed in male infertility of unknown cause?
If there is a certain amount of sperm in the infertility whose cause is unknown, that is unexplained, in vitro fertilization, that is, microinjection method, is applied if there is no vaccination.

11-How are sperm retrieval surgeries performed and how long does it take?
Local anesthesia is applied, and in some cases general anesthesia may be preferred. The operation varies between about ten minutes and two hours.

12-Where can surgical sperm retrieval operations be performed?
It is done in centers with an IVF center or an andrology laboratory, and the samples taken are examined in the laboratory at the same time to see if there is sperm.

13-Can sperm be stored for a long time?
Sperm can be frozen for a long time under suitable conditions. The viability rates of the sperm found by surgery may decrease after the freezing-thawing process, but the pregnancy rates obtained with the use of these sperms are the same as using the sperm obtained by surgery on the same day, and cryopreservation can be safely applied.

13- In which patients is TESA applied?
In the TESA procedure, a sample is taken from the testicular tissue by entering the testicles with a needle inserted through the skin without opening the sac in which the testicles are located. If sperm cannot be obtained with this method, the TESE method is used. In cases where there is occlusion-induced azoospermia and the occlusions are not corrected, in vitro fertilization is a simple procedure performed with lacal anesthesia, which may be sufficient to collect sperm from the testis.

14-How is TESE surgery performed?
In the TESE method, the sac containing the testicles and the sheath surrounding each testis are opened with a small incision. Small pieces of testicular tissue are taken. The cut sections are stitched and the process is terminated. It is the form of the testicular biopsy procedure to search for sperm in the andrology laboratory. It is done under general or local anesthesia. He is discharged on the day of surgery.

15-How is MICRO TESE surgery performed?
Micro TESE procedure is the name given to the TESE procedure performed under the microscope. It is still the last surgical technique, especially in the absence of sperm. Male infertility treatments with microsurgical methods are performed by trained specialists. Anesthesia is required.
The sheaths around the testis are opened as in the tese procedure. The testicular tissue is examined with a microscope and samples are taken from the large parts. Thus, all testicular tissue and healthy sperm are searched with less sampling. The cut sections are stitched and the process is terminated. It is known that this method causes less damage to the testicular tissue.

Op.Dr.Abdullah Arman Ozdemir

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