This disease, which is called infertility in the medical literature, is defined as the failure of pregnancy within 1 year despite the regular and unprotected intercourse of the couples. On the other hand, if pregnancy does not occur despite regular unprotected intercourse in women over the age of 35, the necessary tests for infertility and then the treatments can be started earlier.
A normal couple has a 20-25% chance of conceiving within a month, 75% within 6 months, and 90% at the end of 1 year. Most pregnancies occur as a result of sexual intercourse on the day of ovulation or within 6 days before ovulation. Fertilization potency for both male and female is at its peak at the age of 24. As age progresses, these rates gradually decrease for both sexes. In infertile couples, the problem is caused by 1/3 of men, 1/3 of women and 1/3 of both.
In the evaluation of an infertile man, the goal is to identify correctable conditions, major underlying diseases, genetic or chromosomal disorders, and causes that can be treated with assisted reproductive techniques. A detailed history should be obtained from an infertile man.
The physical examination should be general and focused on the genital area. Semen analysis collected at intervals of several weeks provides important information. Blood hormone analysis should be performed in patients with suspected hormonal disorders. In special cases, antisperm antibodies, leukocyte staining, semen cultures, radiological examinations, ultrasonography, sperm function tests, genetic tests, testicular biopsy should be added to the examinations. Treatment is planned as a result of examinations and tests.
Men’s lifestyle also disrupts semen parameters. Alcohol addiction, using drugs to build muscle in body sports, heavy physical activity, working in hot environments, some drugs can cause infertility. Therefore, it is necessary to make the necessary adjustments in the lifestyle.
Medical, surgical and assisted reproductive techniques are used in the treatment. Reproductive assistive techniques can be used in cases of unknown, unexplained infertility or in cases where there is no cure or medical surgical methods have not been successful. Fertilization can be done either inside the female body or in a laboratory setting.
Varicocele
Varicocele is abnormal varicose enlargement of the veins of the testicles of men. 15% of all men and 40% of men with child problems have varicocele. The most common cause of male infertility is varicocele. When the dirty blood from the testis cannot return to the circulation and accumulates, there is an increase in temperature in the testis, nutrition is disturbed, toxic residues accumulate and it can disrupt sperm (seed) production in the testis. Diagnosis is made by palpation of the urologist in both standing and supine positions in a non-cold environment.
It is not necessary to treat all varicocele cases. However, a man with an infertility problem should be treated. It is the process of connecting and canceling the vessels with a small surgical incision made in the groin. It can usually be done with local anesthesia.
Microscopic surgery is the best method. After varicocele surgery, 60-80% of the parameters that are impaired in the semen improve in 3-12 months. Spontaneous pregnancy rates increase by 20-60%.