Paediatrics Urology Unit
Prostate Growth And Greenlight Method
Premature Ejaculation (Early-Fast-Rapid Ejaculation)
Penile Prosthesis İmplantation
Sexually Transmitted Diseases (Venereal Diseases)
Testicle And Epididymis İnfection
• Assoc. Prof. Ömer ÖGE, MD
• Işık H. ÖZGÜ, MD
• Uğur SARAÇOĞLU, MD
Infertility and Male Factor
Infertility problem is commonly encountered among young men. Approximately 15 % of couples do not have a child after a regular and unprotected sexual intercourse within a year. All couples who cannot have a child generally have male reproduction capability in half of them.
What is male infertility and how often it is observed?
• Infertility is one of the most difficult experiences that couples desiring to have a child confront. Couples may fall in despair or may remain in suspicion. What is important here is that couples should refrain from blaming one another and they should take a decision together.
• Infertility occurs as a result of factors depending on both male and female in 30-40 % of couples.
• The problem completely results from male factor in approximately 20 % of infertile couples.
• Female factor is solely the source of the problem in approximately 30-40 % infertile couples.
• Any problem is not detected in both couples in approximately 10-15 % of infertile couples.
• Since infertility problem may arise from either of couples or both of them, couples should be evaluated together at the same time.
What Are Some Common Types of Male Infertility?
Male infertility has possible several types. Some common types are as follows:
• Azoospermia: This refers to no present sperm in semen. This is seen in 15 % of men having infertility problem. Causes:
• Failure of producing sperm or very little sperm. This case can be seen together with genetic or hormonal anomalies.
• Clogging in any place of structures carried by sperm in tube shape. Infertilities due to clogging may be treated with special microsurgical methods.
• Oligospermia: This is a source of low sperm count. Usually depends on the specific reduction in sperm production. Oligospermia may accompany with varicocele disease (scrotum in varicose veins). Causes:
• Problems with ejaculation (sperm production is present but semen cannot be thrown out)
• Problems relating to erection or sexual functions.
• Timing of sexual intercourse and/or problems relating to technique of sexual intercourse
Testicular infections: Infertility may arise in mumps infection having undergone after puberty and in cases where testis get smaller following acute infection in chronic infections especially continuing for a long time.
What is the purpose of investigation conducted for male infertility?
Male infertility has several causes. Some of these causes can be revealed with a simple preliminary study. In some phenomena, while male infertility can be corrected, causes are put in the other but they cannot be corrected. Some of the causes of male infertility not corrected can be treated by using auxiliary reproduction techniques such as irrecoverable intrauterine insemination (IUI) and in vitro fertilization (IVF).
When should you be treated?
If pregnancy does not occur despite 1 year regular and unprotected sexual intercourse, this should be evaluated in terms of male spouse infertility. Furthermore, this view has started to be change and in case of any of the following situations, investigation should be conducted 1 year in advance.
• Existence of a factor known to man, for example, story of undescended testis
• Risk factors depending on female infertility, for example, female spouse is over 35
• In case of suspicion of a problem relating to fertility capacities of couples
• Men not having a wife yet but desiring to know how their fertility capacity is
• In addition to this, that a man has had a child before does not guarantee that his fertility capacity will remain in the same way. Men start to decline in terms of sexual function in 35-40 years of age but age does not constitute a serious problem for men in terms of fertility. However, there is a likelihood that this disease can have adverse effect over testis together with growing of age in the persons with varicocele.
Who should be subject to more advanced investigations?
If pregnancy does not occur yet in women treated, male spouse should be subject to more advanced investigations. In cases where both couples are investigated and there is not abnormal finding, this is called no-specific-reason infertility. Advanced studies may be required in couples having no-specific-reason infertility.
Men with no sperm cell in his eggs do not have a child in our today's conditions. In addition to this, it seems that this problem will be overcome with development of stem cell and advancing technology. Purpose herein is that stem cell obtain transforms egg into sperm cell that can fertilize the egg.
In cloning technique, since material of only one of couples is used, the child to be born will not be a mutual product but will be the genetic copy-identical- of any of the couples.