Treatment of the Infertile Male
In cases of oligospermia, the man
should first try to control the known environmental causes of the problem.
Cutting down on heavy smoking and drinking and reducing work pressures
are a few steps that you can take. Obese men should go on a weight loss
programme. Do not have baths in scalding hot water. If intercourse
is very frequent, a reduction in the frequency of ejaculation is very advisable.
Absence of Testicles
There is no treatment for men who
do not have testicles or whose vas deferens is absent from both testicles.
The tying off of varicoceles by high ligation and the surgical removal
of hydroceles can bring about dramatic improvement in spermatogenesis,
but there is no guarantee that these operations will be successful. If
the testicles tend to lie in the groin region, the operation of orchidopexy
that keeps them in the cooler environment of the scrotum can also be beneficial.
Intercourse on a full bladder can
solve the problem of retrograde ejaculation. This will force the sperm
to move in the right direction. The alternative is to remove the sperm
from the urine that is passed immediately after ejaculation, and then by
artificial insemination introduce the sperm into the cervix.
Obstruction in Sperm Flow
If tests have shown that there is
an obstruction to the outflow of sperm from the epididymis of the testicles,
the operation of epididymovasostomy can be performed. This procedure removes
the blocked portion of tube and rejoins the open healthy tubes to each
other. Unfortunately the success rate of this form of microsurgery is poor.
Any infection indicated by a high
white cell count in the semen may be due to a chronic infection of the
prostate gland. Treatment with a long course of antibiotics can be very
When there is severe agglutination
of sperm in the semen sample due to antibodies in the sperm, the prognosis
is not good. Theoretically, it is possible to remove antibodies from the
sperm to prevent them from sticking together. Some doctors prescribe special
steroid therapy to reduce the sperm antibodies, but there are potential
risks to this form of treatment.
Save in the case of a hormone deficit,
hormone therapy in the male generally has disappointing results. Treatment
with clomiphene, Pergonal, H.C.G. and testosterone are associated with
a limited success rate. A weak male hormone, mesterolone is frequently
prescribed to men with oligospermia, but here too the results are poor.
If split ejaculate semen analysis
shows that there is a considerable increase in the sperm count in the first
part of the ejaculate, then the technique of split ejaculate intercourse
carried out only at the time of ovulation can be helpful. In split ejaculate
intercourse, your husband will have to withdraw after the first part of
the ejaculation has occurred. This will ensure that a higher than usual
sperm population is deposited in the vagina. This is not the most comfortable
and satisfying way of having intercourse, but to do it this way just once
a month is surely not too much to ask if you want a child. The alternative
is to use the first part of the ejaculate for artificial insemination.
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