For a long time it was considered that the reason for infertility is hidden only in a woman’s body. However, today there is no doubt that male forms of infertility also exist. Male infertility is a disease of a male body that doesn’t allow men to cause pregnancy in a fertile female.
We have a special approach to overcome male infertility – in year 2014 the first Micro TESE surgery ever done in Latvia was performed in our clinic. And healthy children were born as the result of this operation – the first ones in the Baltic region.
The male infertility factor is the primary cause of infertility for couples in about 30% of all infertility cases.
There are several forms of male fertility disorders:
Secretory form of male infertility
In this form, testicles are not capable to produce healthy and active spermatozoa in quantity sufficient for successful fertilisation of an oocyte. Reasons could be the following: hormonal misbalance, genetic factors, avitaminosis, testicular injuries, harmful occupational factors (ionizing radiation, high temperature, exposure to any toxic substances etc.).
Obstructive form of male infertility
In this form, there are some obstacles on the way of spermatozoon getting from testicles to uterus. Those obstacles could be the following: congenital absence or narrowing of the deferent duct, commissure remaining after inflammatory or infectious process, cyst or tumor of the reproductive or nearby organs, scar after the surgery.
Immunological form of male infertility
This form of infertility, as a rule, can develop as the result of testicular injury. In this form, organisms produce antibodies against testicular tissue. Normally, tissues of the testicles and reproductive system are not contiguous. As the result of injury, the mentioned systems come in contact with each other and body’s immune system starts to perceive testicles as an allogenic formation. Antibodies can be produced directly against sperm.
Modern laboratory studies help to determine the reasons for infertility, as well as monitor changes in the body during the stages of treatment.
Basic examinations for the diagnosis of male infertility:
- Careful anamnesis collection;
- Complete examination;
- Detailed inspection of the ejaculate;
- Inspection to determine low-intensity inflammatory process of the uterus and prostatovesical junction;
- Determination of the hormonal status;
- Complete analyses of the received data.
One of the basic examinations to diagnose male infertility is detailed inspection of the ejaculate. We offer an opportunity to undergo these sperm tests:
- Spermogram and MAR test – defines sperm volume, sperm concentration, mobility and morphology. MAR test can detect the presence of an immunological infertility component.
- HBA test – defines sperm’s functional quality, structural maturation and fertilization potential.
- DNA fragmentation test – defines the index of DNA fragmentation that fertility potential depends on.
- Oxidative stress test– defines the level of oxidative stress in the ejaculate.
- Sperm seeding for bacteria – defines the presence of microorganisms in the ejaculate.
- Ejaculate examination for herpes viruses – efines the presence of herpes viruses in the ejaculate.
- FISH – defines the frequency of spermatozoon with a chromosomal anomaly in the ejaculate.
- Electron microscopic examination of sperm – defines changes in sperm cells, the presence of herpes viruses in spermatozoids and disorders of spermatozoa.
It is also important to investigate the presence of sexually transmitted infections in the urine and to determine the level of hormones in the blood to discover the causes of male infertility. Sometimes genetic tests are also required:
- Karyotype – evaluates the number and structure of a person’s chromosomes.
- Molecular testing of the AZF region of the Y chromosome – defines genetic abnormalities of the Y chromosome.
- Common CFTR mutations– determines the adverse changes in the CFTR gene.
All required tests to determine male infertility can be done at our clinic.
We offer different kinds of urological surgeries to treat male infertility:
- TESA – Testicular sperm aspiration using aspiration needle.
- Microsurgical testicular Sperm extraction (Micro Tese) – minimally invasive microsurgical method, during which spermatozoa are obtained directly from the testicle.
- Microsurgical subinguinal varicocelectomy – the extraction of enlarged abnormal blood vessels in cases of small pelvic blood flow disorders.
Anaesthesia is required to perform all of these surgeries.