WHAT IS MALE INFERTILITY? WHY CAN'T I BECOME A FATHER?

Male infertility or male factor infertility is defined as a condition when the couple cannot conceive because there is some problem in the male partner or the father. Infertility is defined by the World Health Organisation as when a couple cannot get pregnant even after trying for 1 year without using any contraceptive.

In all cases of infertility, the male is responsible for 33 percent or one third of cases. The female or the woman partner in 33 percent and both in 33 percent. Male infertility will account for more than 50 percent of cases of infertility seen overall. But even then surprisingly the onus is always on the woman to get treatment.

WHAT ARE THE CAUSES OF MALE INFERTILITY?

Male infertility in Bengaluru is increasing rapidly. More and more men today are finding it difficult to get their wives pregnant and conceive a child.

Why is this?

There are many causes for the increasing prevalence of infertility in men in Bangalore. Some of them are:

• Higher age of marriage and conception – Men are getting married in their late 20’s and planning a child in 30’s
• High stress jobs
• High usage of tight jeans, laptops
• Smoking and Alcohol use
• Unhealthy dietary habits
• Lack of Physical Exercise
• Obesity and Overweight
• Chemical Additives and Pesticides in Fruits and Vegetables
• Estrogen, Oxytocin and Hormones in Milk and Food products

WHAT ARE THE TYPES OF MALE INFERTILITY TREATMENT?

There are several treatment options for Male Infertility treatment in Bangalore. Dr. Raju R is a Male Infertility specialist in Bangalore and provides the best Male infertility treatment in Bangalore. The therapeutic options depend on the type, and these types are discussed in detail in subpages.

• Oligospermia – Low Sperm Count
• Varicocele or Dilatation of Spermatic veins
• Unknown causes
• Hormonal Disturbance
• Genetic Factors
• Azoospermia – Nil Sperm Count
• Obstructive or Non Obstructive
• Testicular Atrophy
• Genetic Disorders
• Asthenospermia – Low Sperm Motility

Each of these conditions requires detailed evaluation and proper treatment. Male infertility, if properly treated, can yield fantastic results and provide couples with an option to avoid IVF and other expensive treatments.

WHAT IS AZOOSPERMIA? WHAT IS NIL SPERM COUNT?

Azoospermia or Nil Sperm count is the condition in infertile men in which the semen contains no sperms. The semen analysis shows absence of sperms. The report reads zero sperms in semen.

The normal sperm count in young healthy males is between 30 to 120 million sperms per ml of semen. In Azoospermia, this count is zero.

WHAT ARE THE CAUSES OF NIL SPERM COUNT?

There are many causes of Azoospermia in men in Bangalore, India. The common causes can be Obstructive or Non Obstructive. The obstructive causes are less common and can be cured with appropriate surgery. They are:

• Tuberculosis
• Seminal Vesicle disorders
• Epididymal Obstruction
• Absent Vas
• Testicular Surgery like Hernia repair

The Non-Obstructive causes are more common and treatment is less successful. These include:

• Hormonal Imbalance – Like Hypothyroidism, Altered T and E levels
• Genetic – Klinefelters, Super males extra
• Testicular Failure
• Sertoli Cell only Syndrome
• Maturation defect
• Mumps
• Testis infection, Trauma
• Chemotherapy
• Steroid abuse

WHAT ARE THE NATURAL REMEDIES TO BOOST NIL SPERM COUNT?

Unfortunately, there is no natural remedy to boost normal sperm count. Healthy diet and exercise can prevent this condition.

WHAT PRECAUTIONS DO I TAKE TO PREVENT NIL SPERM COUNT OR AZOOSPERMIA?

The precautions advised are:

• No smoking
• No Alcohol
• Healthy diet
• Exercise
• Avoid steroids

WHAT ARE THE TREATMENT OPTIONS FOR NIL SPERM COUNT IN BANGALORE, INDIA? (NIL SPERM COUNT TREATMENT IN BANGALORE, INDIA)

Unlike the past, today many excellent treatment options exist for Azoospermia treatment in Bangalore. Nil Sperm Count treatment in Bangalore is now successful.

The treatment options for Obstructive Azoospermia are:

1. TUR – resection of the ejaculatory duct
2. Vasoepidymostomy – If the obstruction is at the level of the epididymis
3. Vasovasostomy – If the obstruction is at the level of the vas
4. TESE or mTESE – Testicular Sperm Aspiration / Extraction – Where the sperms can be retrieved from the testis
5. MESE – Microscopic Epididymal Sperm Extraction – Where healthy motile sperms can be obtained from the epididymis

These surgeries are performed under anesthesia at my clinic. They are painless and affordable.

WHAT IS OLIGOSPERMIA? WHAT IS LOW SPERM COUNT?

Oligospermia or Low Sperm Count is a condition in which the sperm count in the semen is below the normal limit. The normal sperm count is 15 million per ml, but if the number is below 15 million, it is called oligospermia.

Oligospermia or low sperm count may be associated with slow-moving sperms or immotile sperms, and this condition is called asthenospermia. Usually, oligospermia is associated with asthenospermia. Low sperm count and motility problems usually coexist.

WHAT ARE THE CAUSES OF LOW SPERM COUNT?

There are many causes for oligospermia or low sperm count. The most common are:

1. Varicocele
2. Hormonal Disturbances
3. Steroid Use
4. Testis infection
5. Higher age of father

WHAT ARE THE NATURAL REMEDIES TO BOOST LOW SPERM COUNT?

The natural remedies are to lose weight and eat a healthy diet.

WHAT PRECAUTIONS DO I TAKE TO PREVENT LOW SPERM COUNT OR OLIGOSPERMIA?

The precautions needed to be taken to prevent oligospermia and low sperm count are:

1. Healthy diet
2. Avoid smoking
3. Avoid alcohol
4. Relaxing exercises
5. Avoid laptop and mobile use
6. Organic food
7. No steroid abuse
8. No outside medicines
9. Correct treatment of Varicocele

WHAT ARE THE TREATMENT OPTIONS FOR LOW SPERM COUNT IN BANGALORE? (LOW SPERM COUNT TREATMENT IN BANGALORE)

Nowadays, all men with low sperm count are directly counseled to get IVF. This is wrong. Newer drugs and therapies can boost low sperm count.

Low sperm count options are: The newer drugs available today for increasing sperm count are:

1. L Carnitine
2. Clomiphene
3. Aromatase Inhibitors
4. BHCG
5. Growth Hormone
6. Testosterone Boosters
7. Varicocele Microsurgery
8. Correction Of Estrogen
9. Lycopene
10. Zinc
11. Other Mitochondrial supplements

WHICH SPERM RETRIEVAL PROCEDURE IS RECOMMENDED?

There are numerous ways to harvest sperm from a man with normal sperm production and a blockage. The simplest and most cost-effective is an aspiration of sperm. This is routinely performed under local anesthesia and takes approximately 10 minutes. Harvesting sperm from a man with a testicular problem is much more difficult and often takes several hours. The ideal procedure, microTESE, is performed with the aid of a surgical microscope whereby the chances of finding sperm are increased and the amount of tissue taken out of the testis can be minimized.

It is important to understand that the microscope utilized in the operating room does not have sufficient magnification to see sperm but instead just helps sort out which tubules within the testis are more likely to contain sperm. Small amounts of tissue are sent to the IVF laboratory during the course of the procedure so that they can assess whether sufficient numbers of sperm have been harvested. A more powerful microscope is used by the IVF laboratory to evaluate this tissue. Repeated biopsies from one or both testes are obtained until sufficient sperm has been harvested for that IVF cycle. Extra sperm may be harvested to preserve for future cycles of IVF in case the current cycle is unsuccessful or the couple desires more children in the future. This procedure can take as long as four hours depending upon how quickly sperm are found.

Percutaneous Epididymal Sperm Aspiration (PESA)

PESA is a procedure performed for men who are having sperm retrieved for IVF/ICSI who have obstructive azoospermia from either a prior vasectomy or infection. It is done with local anesthesia in the operating room or office and is coordinated with their female partner’s egg retrieval.

Testicular Sperm Aspiration (TESA)

TESA is a procedure performed for men who are having sperm retrieved for IVF/ICSI. Testicular sperm aspiration (TESA) is done with local anesthesia in the operating room or office and is coordinated with their female partner's egg retrieval. A needle is inserted in the testicle and tissue/sperm are aspirated. TESA is performed for men with obstructive azoospermia (s/p vasectomy).

Testicular Sperm Extraction (TESE)

TESE involves making a small incision in the testis and examining the tubules for the presence of sperm. It is either done as a scheduled procedure or is coordinated with their female partner’s egg retrieval. TESE is usually performed in the operating room with sedation, but can be performed in the office with local anesthesia alone. Patients usually cryopreserve sperm during this procedure for future IVF/ICSI. MicroTESE has replaced this as the optimal form of retrieval for men with no sperm in their ejaculate (azoospermia) from a problem with production.

Microepididymal Sperm Aspiration (MESA)

MESA is a procedure performed for men who have vasal or epididymal obstruction (s/p vasectomy, congenital bilateral absence of the vas deferens). It is either done as a scheduled procedure or is coordinated with their female partner’s egg retrieval. MESA is performed in the operating room with general anesthesia utilizing the operating microscope. Patients usually cryopreserve sperm during this procedure for future IVF/ICSI. MESA allows for an extensive collection of mature sperm as compared to aspiration techniques, and it is the preferred method of retrieval for men with congenital bilateral absence of the vas deferens as it does not impact steroid production of the testis.

Microdissection TESE (microTESE)

MicroTESE is a procedure performed for men who have a sperm production problem and are azoospermic. MicroTESE is performed in the operating room with general anesthesia under the operating microscope. MicroTESE is carefully coordinated with the female partner’s egg retrieval, and is performed the day before egg retrieval. This allows for each partner to be there for the other’s procedure. Patients frequently have donor sperm backup in case sperm are not found in the male partner. MicroTESE has significantly improved sperm retrieval rates in azoospermic men, and is a safer procedure since less testicular tissue is removed. Patients cryopreserve sperm during this procedure for future IVF/ICSI.

What is Obstructive Azoospermia?

Obstructive azoospermia means the absence of sperms in the semen due to blockage. Obstruction can be at many levels in the genital tract. The blockage can be at the level of the:

• Testis head – Rete testis aplasia
• Epididymal tubules
• Vaso Epididymis junction
• Absence or fibrosis of vas
• Seminal vesicle obstruction
• Ejaculatory duct obstruction
• Prostatic cysts

Obstruction can be primary or congenital. It can also be secondary to infections and surgery. Vasectomy is a secondary cause of azoospermia and may require a vasectomy reversal.

What are the Surgical Options for Treating Obstructive Azoospermia?

Once we confirm that there are live mature sperms in the testis, a thorough search is made for the level of obstruction. Depending on the level and cause of blockage, the surgical options include:

1. Vasectomy Reversal – In men with prior vasectomy
2. VEA or Vasoepidymal Anastomosis (AKA Microsurgical Vasal Anastomosis (MVA) or Vasoepidymostomy)
3. TURED or Transurethral resection of Ejaculatory duct

What is Microsurgical Correction of Obstructive Azoospermia? (LIVE / VEA / Vasoepidymostomy)

If the blockage is at the level of the testis head or the epididymis, then these obstructions can be bypassed. The surgery to bypass the obstruction is called VEA or Vaso Epididymal Anastomosis. The surgical techniques for this have gone through several modifications. Currently, LIVE or Single Suture Double arm needle Longitudinal Instussusception technique is the most successful technique for this difficult surgery.

In this, the patent vas is disengaged from the blocked portion, flushed, and then joined to a healthy tubule in the epididymis.

What are the Surgical Steps of Vasoepididymostomy / LIVE Technique (Vaso Epididymal Anastomosis)?

The surgical steps are as follows:

1. The testis is delivered out under sterile conditions.
2. The vas is dissected and disconnected from the vaso–epididymis junction.
3. The vas is flushed to confirm patency.
4. The junction is flushed and aspirated to confirm no sperm are present.
5. The epididymis is assessed. The blocked portion is identified either in the caput or the tail. Usually, identification is done under magnification and with sperm aspiration under a microscope.
6. The epididymis is opened, and healthy epididymis tubules are selected for anastomosis. Using a double-armed nylon 10–0 suture, the LIVE technique is used to intussuscept the tubule inside the vas.

Why Choose Genesis Superspeciality Hospital for the Treatment of Male Infertility?

Genesis Superspeciality Hospital always prioritizes patient safety, comfort, and satisfaction throughout the treatment process. Dr. Raju R possess a remarkable history of achieving successful results and holds substantial expertise in the treatment of male infertility. With exceptional surgical outcomes and competitive pricing, our facility offers prompt surgical scheduling, minimizing patient wait times.