About Male Infertility
Male infertility is observed in 1 out of every 5 people in the society. But is it well known by the
public? Are enough examinations made towards men? We are going to give you some
informations regarding to this subject.
*Sperms capable of fertilizing mature eggs are produced in testicles. This production is
completed in about 80-90 days. Sperms capable of fertilizing eggs could be created from round
*The liquid released during ejaculation(semen), semen, doesn’t only contain sperm. The
majority of this fluid is a special fluid called seminal vesicle fluid. The remaining part is prostate
fluid, other fluids and sperm cells. When we analyse the semen, we check the number of the
sperm cells in 1 ml of the sample, and also in the whole sample. We also check their
movements and their shapes.
Normal values in the sample given after 3-5 days of sexual abstinence:
*Total number of cells is 40 million
*The number of cells in 1 ml is 15 million
*Total movement of at least 40%
*Forward movement (A + B) at least 32%
*Normal shaped ones at least 4%
We are talking about male infertility when there are problems in these values. If the number of
cells is less than 5 million in 1 ml, if the rate of movement is low or if normal-shaped sperms are
not observed, the male might need to be treated after a number of tests. We might also consider
treatments like intrauterine insemination or IVF.
The causes of male infertility are problems in hormones released from the brain, production
disorders in the testicles, problems with channels during ejaculation of produced sperms and
problems of unknown cause.
The most common causes of male infertility in daily life are:
*Y microdeletions: gene problem
*Varicocele: Expansion of testicular vessels
If there is no live sperm cells in the given sperm sample, we call it azoospermia. In these cases
we definitely repeat the sperm analysis after a few days. If azoospermia is detected again, we
should ask for some tests:
Azoospermia can be seen in 1% of the population and in 20% of the hospital applicants due to
infertility. We definitely perform a second test if there are no live sperm cells in the semen. If the
live sperm cell does not come out again, we make the diagnosis.
Is it possible to have a child in the event of azoospermia? Which tests should be done?
In 40% azoospermia cases, atresia of seminal duct is observed. In this case, investigations for
the cause are necessary. Non-existence of the seminal ducts or atresia of seminal ducts due to
infection are possible causes of azoospermia. In these cases it is possible to obtain mature
sperm cells. It is possible to have children by taking sperm from the testicle tissue with
microinjection if there are no seminal ducts, or if the there are ducts but they are engorged it
could be made by entering from the engorged vessels. In 60% of the azoospermia cases, there
is a production problem in the testicles. In these cases it may be a little more difficult to obtain
mature sperm cells. In this group there are people such as:
*Hypogonad (The people with problems in their brain hormones)
*Those with undescended testicles
*Those with production problems due to chemo-radiotherapy
*Individuals with Klinefelter syndrome
*Individuals with Y-microdeletion
*Those who have had testicular infection
*Those who have undergone testicular surgery.
In this case, a live-mature sperm cell may not be obtained in sperm analysis. After this stage,
hormones are controlled and hormone therapy can be given where necessary. A number of
techniques are used to obtain sperm in azoospermic cases.
TESE: Searching of sperm cells on the tissues taken from the testicles.
TESA: Obtaining sperm cells from the engorged seminal ducts.
With these methods, live sperm cells could be obtained from approximately 30-40% of