Male Fertility Test and Treatment in Indore
Various Male infertility- Treatment and Testing in Indore at Yaami Fertility and IVF Center Indore
Male Fertility Test
It is very important that every fertility clinic should have facilities for male fertility We offer detailed testing of semen including semen analysis, post centrifugation semen analysis for azoospermia, sperm survival test to note the quality of sperms and sperm viability testing to differentiate between dead and alive sperms in men who have very low motile sperms. These testings guide us to offer the best quality male infertility treatment. Many times, we can do IUI instead of IVF with help of these tests.
These testings are necessary for men with no sperms in semen testing (azoospermia). It is important to get these testings in men with no sperms in the semen testing due to low sperm production (Non obstructive azoospermia) since they guide the fertility specialist regarding male infertility treatment. There are 2 main type of genetic tests for male infertility : Y chromosome microdeletion (YCMD) and Karyotyping or chromosomal analysis. In certain type of abnormalities in YCMD, there is no chance of getting sperms even with surgery like TESA or Micro TESE and so, there is no point in wasting one’s money in these surgeries. Karyotyping can help us diagnose a condition known as Klinefelter’s syndrome in which, even with small size testis, there is good chance of getting sperms with surgery.
The DNA of the sperms can get damaged in various conditions like men who smoke, men with varicocele, couples with repeated miscarriages or repeated IVF failures and in many people without any known problems. If the DNA gets damaged, the chance of natural pregnancy and the pregnancy through IUI treatment or IVF treatment goes down. So in such cases, the infertility doctor or the infertility specialist needs to correct the cause of high DNA damage to Sperms, give medication to improve DNA damage and in certain cases, use the sperms directly from the testis as these Sperm are known to have lesser DNA damage. These corrections in DNA damage are important for couples who are undergoing IUI treatment, IVF treatment or IVF cycle (also known as test tube baby treatment) as well as ICSI
This is one of the correctable causes of male infertility and so the best fertility clinics or the top fertility specialists would always look for this condition in men who are coming for infertility treatment.It is a condition in which the blood vessels which take the blood from the testicles to the heart become dilated due to which the blood is not carried away from the testicles in adequate amount. This leads to pulling of blood around the testicles and rise in the temperature of the testicles. Since the testicles require a lower temperature for proper functioning, the sperm production gets hampered leading to lower sperm count ,lower quality of sperm along with lower motility. This condition can be diagnosed by a proper physical examination during the male fertility testing and also ultra sound of the scrotum. In our fertility clinic at Indore, we routinely see men who have had failed IUI or failed IVF or test tube baby treatment having varicocele and this may contribute to the failure of fertility treatment.
Male Fertility Treatment
Low Or Nil Sperm Count
Issues pertaining to sperm quality can be sole cause of infertility in 20-30% of infertility cases and contribute to 40- 50% of cases of infertility overall.
Further evaluation when sperm count is low :
- 1 more repeat semen analysis as per WHO 2021 guidelines
- Post-ejaculation urine analysis ( in few cases )
- Male hormones evaluation : Testosterone, FSH,LH, TSH, Prolactin
- Specialized test Sperm vitality (to check if the sperms are alive when the sperm motility is low)
- Genetic test
- Karyotype , Y chromosome microdeletion
- Parallel evaluation of wife for fertility status
When a couple tries for natural pregnancy, Sperms need to be motile ( have movement ) to reach till the egg. Only then, the pregnancy can happen. It is becoming extremely common to see men with reduces sperm motility. As a Reproductive Medicine specialist, we need to first find out the reason for the lower or nil motility of sperms. This may include genetic causes, varicocele, infections and smoking among many other things. We also test for the hormonal parameters and give targeted therapy to improve the sperm motility. It is a known fact that this condition can reduce the IUI success as well as IVF success. It is common to see such couples going for more than 1 IVF cycle. Such issues may increase the IVF cost and hence should be tackled beforehand.
Intracytoplasmic Sperm Injection
- ICSI is advanced modification of IVF to fertilise egg with sperm
- During ICSI each oocyte is held & injected individually with selected sperm by trained embryologist
- That is why the term ICSI- Intra Cytoplasmic ( of oocyte here ) Sperm Injection is used
ICSI is preferred over IVF in following cases:
- Woman with low number of eggs.
- Men with very low number of sperms.
- Men with poor sperm quality.
- Men with poor sperm motility.
- Men with perm retrieved after TESA / micro TESA in cases of azoospermia.
- Couple with previous partial or total fertilisation failure.
- Couple using frozen sperms.
The semen sample can be frozen by vitrification which is the method of fast freezing and has very good chance of sperm survival. There are many conditions which might require semen freezing. Few examples are - if the husband is not able to collect the semen sample (erectile dysfunction) and if the husband is going to be out of the town during IUI or IVF treatment. In such cases, the frozen sample can be utilized for the procedure. One should always discuss about these with their IVF doctor or IVF expert if they are undergoing an IVF or in vitro fertilization cycle.
These are methods of surgical sperm retrieval. Both the procedures are done under anaesthesia and are usually very well tolerated by the patient. In PESA, the needle is put into the epidydimis, which is the storage area of the sperms and the fluid of the epidydimisis aspirated and checked under the microscope for the presence of sperms. In TESA, a needle is put into the testicle and the testicular tissue is aspirated and checked for the presence of sperms. If sperms are present, these can be utilized for ICSI.
This is an advanced method of surgical sperm retrieval. This is typically done for the most difficult cases of non obstructive azoospermia. If done properly, this gives a very good chance of getting sperms in such men and to get their own genetic child. This type of surgery is a complex one, needs an experienced and very competent Embryologist to look for sperms. It is offered only at very advanced level or top IVF centers. We are one such top IVF center in Indore whose fertility specialists have the experience of Micro TESE since 2012 and have achieved excellent success rates. We have published 2 research papers on this as well.
The sperm production is dependent on the blood hormone levels. Manipulating these blood hormone levels by giving correct medication is a very good ploy to increase the sperm production in men with low or nil sperm count. We might need to give more than one medications and sometimes injections to achieve success. We have achieved success in more than 1000 men with such male infertility treatment protocols.The IVF treatment cost can be kept low in many couples since we can get sperms for IVF cycle in the ejaculate itself and thus avoid the operation to get sperms. For this reason, each infertility clinic and infertility specialist should offer such treatment to their patients.