Mere postponement of achieving pregnancy inspite of normal intercourse for one year or more can cause stress on the couple. Wife in despair, anxious and demanding. In our country with arranged marriages and joint family system , In-laws pressure on the couple makes their life worthless . Ideally the infertility is couple problem to be sorted out by them only without any need for third party intervention. Male sexual Dysfunction like performance anxiety could be a factor.
Urologists – Genito Urinary surgeons are duly qualified and ideally suited to treat all problems relating to Male genital organs. Andrology is subspecialition- in Urology., which deals with causes and treatment options for Male Infertility & Male sexual dysfunction.
Madras Andrology Research Centre (MARC) is one such centre at Chennai offering consultation for the Male partner in Infertility. Male sexual Dysfunction counseling for the couple and comfort them till they achieve parenthood.
Infertility – Symptoms , Causes, Diagnosis and treatment. The options are general measures and treatment for Male Sexual Dysfuntion With marginal count with actively motile sperm Intra uterine insemination (IUI).
Large significant varicocele only need surgical correction. Incidentally detected minimal varicocele on scrotal Doppler need not be treated. Scrotal scan not necessary test for all men.
In extremely low count and poor motility ICSI performed using ejaculate sperms .
In cases with no sperms and presence of sperms in Testis. Retrieval (Recovery) of sperms from testis by TESE / MICROTESE & ICSI . Male infertility treatment require Assisted Reproductive Technology – MARC is one such centre specially designed by Urologist ( Andrologist) to offer comprehensive and complete treatment.
Male Infertility Centre MADRAS ANDROLOGY & ASSISTED REPRODUCTION RESEARCH CENTRE offers three options to be chosen based on individual needs.
1. Borderline sperm count and motility – Medical / Drugs- Antioxidents/ Vitamins etc.,
2. Surgical procedure – Correction of varicocele
3. Micro surgical correction of blocks to epididymis ( VEA ) VAS ( VVA)in Obstructive Azoospermia.
4. Testicular Sperm Retrieval TESE / MICROTESE
5. Assisted Reproduction Technology
a. Sperm Retrieval
b. Sperm Freezing
c. Intracytoplasmic Sperm Injection( ICSI)
Sperms are microscopic structures swim in the seminal fluid to reach the site of the egg during ovulation of his wife. Ovulation is a brief process in women, whereas sperm could be alive and swim in female genital tract for 24 – 48 hours. The timing of intercourse becomes a factor. Some couple monitor the occurrence of ovulation by simple fertility thermometer or using Follicular study by ultrasound .Some of the Gynecologists treating the couple advice them to schedule intercourse to coincide with ovulation. MARC has met several of such anxious couple and advised them not to monitor ovulation period. Sexual activity for men should be on the desire and not on demand. Many married men who were otherwise normal , referred for Male Infertility evaluation . In some of them we have identified 'performance anxiety' in them in attempting to have sex strictly to coincide with during ovulation dates.
Medical treatment advised only in borderline problems viz lesscount or poor motility etc., No medical treatment for cases of blocks to sperms pathways ( Obstructive Azoospermia) – birth defects like ( Absence of Vas). Television and mass media tend to offer cure for all Male Infertility problem including Obstructive Azoopsermia. Many men are not aware of the sperm production and transportation to reach the site of egg. They fall a prey to medical treatment by quacks and drugs through alternative systems of Medicine.
Sperm production occurs in the testes. There is temperature difference of 4 degrees between Intra abdominal and scrotal temperature. The scrotum is a loose bag containing both testes. Any attempt to wear tight undergarments/ Jeans etc., could change the scrotal temperature and impair sperm production.
AT MARC we spend some time learning about the patients occupation . If it involves environmental heat , like welding , driving etc., causing marginally poor motility we advice them change of life style, and local cooling of the Scrotum – a simple measure to improve his sperm production.
For some men the Testes are not found in the Scrotum. They are undescended and continues to remain in the abdomen ( CRYPTORCHIDISM ) . Such adults often have no sperms. Localisation by Ultrasound and Orchidopexy ( Surgery for bringing both testes) should be done. Restoration of sperm Production is possible only if such operative procedures are done during childhood. Bilateral undescended testis in adults cause deterioration of sperm production (Spermatogenesis ). Such men are not considered suitable for ICSI.
MARC has successfully carried out ICSI using his own sperms retrieved form the ejaculate and if necessary by Testicular extraction . For ICSI we require only very few sperm. More then 60 -80 percent of cases are found suitable for TESE & ICSI.
Low count or 'No Sperm count'
Selection criteria for TESE & ICSI.
At MARC the Andrologist personally verify for the presence of sperm under Microscope to exclude the possibility of hidden sperms ( Crypozoospermia) missed during routine Semen Analysis in the laboratory. 'Sperm Function Test's performed only in selected cases and not as a routine. Hormone evaluation & Genetics ( Karyo typing) only in cases suspected Hypogonodism , Klienfelter syndrome.
1. Semen Analysis / Routine clinical examination for secondary characters growth of facial / Pubic hair – examination of genetalia.
2. Erectile Dysfunction can occur at any age –Marc has identified and treated large no of couple through married for several years, Inspite of living together, never had successful intercourse at any time in their married life ( Non Consummation ) . Many such couples are successfully treated at MARC by counseling and appropriate management.
3. Premature ejaculation – Anejaculation – Retrograde ejaculation . These are problems related to emission of Semen during intercourse. At MARC many of these problems are treated successfully.
Consult Male Infertility expert at MARC.
MICRO TESE / SPERM MAPPING
RETRIEVAL OF SPERMS FOR ICSI & VITRIFICATION ( CRYO FREEZING )