Poor seminal parameters Medical Tr

 

Q. 15: What Treatment pitons we have for Male Subfertility?--

Unlike females the defects in males are difficult to ameliorate. Many infertility specialists therefore jump on to  IUI procedure . However the recognized methods of treatment which have been discussed at length at morning session are A) Life style modifications, Hormones like gonadotrophins, Antioxidants. Presence of ROS has seminal fluid is being recognized fast . Surgical Tr are 1) Repair of hernia, hydrocele, Repair of varicocele (? Questionable effect), Vasal block reapir & anastomosis  (? Again questionable effect) , Fixing the retractile tetsis in scrotum, excision of abd testis, phimosis excision .

What are the medical Treatment for OAT??

A)                :- Antioxidants, Vitamins, Life style changes, Timing of coitus, Treatment of systemic diseases(DM, Thyroid, Hypertension, Psychiatric disorders), Occasionally Inj testosterone ,better still inj. HCG 2000  i.u. at the dose of   weekly three time. But in that serum testosterone have to be measured 3 monthly. Some use Gonadotrophins  for development of small testis but it will be prudent to  combine HCG along with HMG as it is the hCG which stimulate Leydig cells to promote intratesticular production

 In case of Azoospermia:-One has to diagnose the kind of azoospermia. Is it Obstructive (FSH and LH are normal and possibly absence of Fructose in  semen)  or NOA(nonobstructive azoospermia).In cases of Obstructive azoospermia problem have to be solved by  surgical reconstruction of the blocked segment of vas/ Seminal vesicle. But question is will reconstructive operation will restore? If not ICSI/TESE(Sperm retrieval methods)  are the solutions.,