Treatment of motility disorders of sperms.

Clinical examination, Smking, alchol, tight undegraments, Life style, good diet,. Exckude infectin , MAGI

Medical treatments for Male Parameters defects:

A)        Limited numbers of drugs which are available for medical treatment of compromised or suboptimal seminal parameters. These are either antioxidants or Vitamins in nature. There are as yet another class of agents which cause improvement of mitochondrial Respiratory chainàthereby augmenting mainly motility of sperms and thereby its speed of movement & other functions.

B)        Such drugs are used either in isolation or as combination. In fair number of cases a short trial can be offered for six months if couple is young and trying time is less. But, for elderly couple say, where age of female partner is  > 35 yrs and repeated semen exam reveal low counts < 10 million  or motility is  of grade 1 (< 10% ) --in such set up one should ideally proceed for IUI or ICSI. 

C)        Nevertheless a local or systemic cause  have to be evaluated for suboptimal  semen ,including diseases of thyroid, DM,PRL and diseases of epididymis or vas deferens. Urologist and or Andrologist   consulation will be of immense help if affordable and available in local area.

Endocrine treatment of male factor infertility:-Aims of medl TR aim at either to increase serum testosterone or to promote functions of germinal cells lying at seminiferous tubules.

 Type A:-1) to increase serum testostetne->Medical management may be tried in cases of male subfertility-so that at least IUI can be done. Dose is HCG à 2000-5000 twice a week- This increases serum Testosteroneàand indirectly promotes functions of S. Tubules.

2) For idiopathic normogonadotrophic oligozoospermia but with less bioactivity: - Serum RIA/ELISA reports of gonadotrophins are normal but for some reason or other bioactivity of these   hormones are less. Dose schedule is HMG r-FSH: - 75-150 i.u.  3 times a week and later HCG 5,000 IU-IM on weekly basis.

3) Vitamins –adjunct Ry:-Most effective are Vitamin E-300-600 mg & C 1000 mg. The other vitamins and minerals may be of some help like B12 (1000 -1500 mcg.)  FA (5mg), Pentophyllixine 1-2 mg, Selenium(225 mcg.),  Glutathione(600 mg but IM), Arginine 4000 mg; L-Carnitine & L-carnitine- 3000 mg & Co Q- which improves mitochondrial resp. chain( 100 mg BD) & Zinc(100-200 mg). Combination of Carnitine and L-carnitine also exert their action   by synthesis of acetyl co A at the mitochondrial level.