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Treatment of the Infertile Male

Oligospermia

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. 
 

Retrograde Ejaculation

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. 
 

Bacterial Infection

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 beneficial. 
 

Antibodies

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.
 

Hormone Disorders

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.
 

Sperm Dilution

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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