Assisted reproductive methods are the techniques used to treat male infertility; the inability of a male to make his partner pregnant.
Male infertility is the inability of a man to make a fertile woman pregnant. This occurs either due to a decrease in the quantity or the quality of the semen produced.
Understanding Assisted reproductive methods
Assisted reproductive methods give those who have been infertile, a chance to conceive. Men with a low sperm count can opt for ICSI (Intracytoplasmic Sperm Injection), which is explained below. Those with totally no sperm count can go for the surgical collection of sperms directly from the testes and then injecting this into the woman’s womb.
This is also done in men whose sperms do not have enough movement to reach the female egg. This is among the commonest cause of infertility in men.
How are Assisted reproductive methods Performed
1.Intracytoplasmic sperm injection
ICSI is done by injecting a single sperm directly into the woman’s egg to cause artificial fertilization. This technique is expensive and is used in cases of low sperm count with a success rate of 20-40%.
2.Testicular extraction of sperm
If when performing the ICSI there is a lack of sperm being produced by the male, or no sperm at all, this surgery is used to obtain the sperm directly from the testicles. This is a minor surgery using a needle to extract the semen while the patient is under local anesthesia. Thus even if a man has a sperm count of next to zero they can have a child.
The varicoceles are elegantly corrected by identifying the dilated testicular veins and either clipping it or tying it. Procedure takes about 20 mins, can be discharged in day and the patient can get back to normal life in 2 days.
Some patients have normal sperm production, but nothing emerges out because of a block in a tube that carries the sperm (vas block). This is rectified by joining the part of the tube before the block to the part of the tube after the block. This is known as epididymovasostomy. Procedure takes about an hour, shall be discharged next day and shall return to normal life in 3 days.
Any surgery performed in the scrotum is usually scarless due to the corrugated skin of scrotum, practically making it invisible.
Assisted Male Reproductive Methods FAQ’s
We know that the presence of the varicocele is going to increase the temperature in your testes, and decrease your sperm motility. If your sperms are not motile that is if your sperms cannot move well enough, you might have a failure of conception. Correcting the varicocele will certainly decrease the temperature of the testes, and increase the movement hour of the sperms. Whether this translates into fertility definitely, is difficult to say, as infertility, male or female is multi factorial. This is only one of the factors that we are correcting.
Actually after the veins are clipped laparoscopically, within a day or two, a doppler is done, and this will show absence of reflux, that is so typical of a varicocele. A Doppler of the scrotum will demonstrate shrinkage of the varicocele.
Well, if it is a small varicocele, and fertility is not an issue for you and you have no dragging pain or such symptoms, you could wait and watch until symptoms supervene. Otherwise it is probably better to have it fixed as it is such a quick affair.
Yes, rarely, a tumor of the kidney could go into its vein (renal vein), and as the testicular vein runs into the renal vein, this could sometimes present as a varicocele. Fortunately this is very rare but the association is definite.
There might be a tiny incidence of recurrence, but it is generally an exception, rather than the rule.
Dr. J. S. Rajkumar
M.S., F.I.C.S., Dip. N.B. (SURG.), F.R.C.S. (ENG.), F.R.C.S. (EDIN.), F.R.C.S. (GLASGOW), F.R.C.S. (IRELAND), F.I.M.S., F.A.I.S., F.R.M.S. (LONDON), F.A.E. (GASTRO), F.A.C.G. (USA), F.I.C.A. (USA), F.I.A.G.E.S., Dip M.I.S. (FR.)
Dr. Ilamparuthi Chennakrishnan
GENITO- URINARY SURGEON
M.B.B.S., M.S. (General surgery), M.Ch. (Urology), D.N.B. (GUS), F.I.C.S.