Infertility is a common reproductive disease and almost 40 to 50 percent of couples experience it. Infertility is diagnosed equally i.e. 35% either in women and men. The remaining 20% is when both experience hindrance due to hormonal factors and semen quality (erectile dysfunction), the last 10% is due to unexplained infertility. Male infertility is when a man is unable to have sexual intercourse or make his spouse pregnant. Male infertility is also due to lack in semen quality. The human fecundity determines the health condition and diseases throughout life. It is regardless of the intention of getting pregnant but rather the ability for reproduction in men and women. With the advent of new technology, new methods of male fertility treatments have been evolved. . The infertile men who were previously not capable of becoming fathers can now be treated using the latest treatment methods. The capacity to prepare eggs by specifically infusing sperm into an egg (intra-cytoplasmic sperm infusion) implies that not many sperms are expected to accomplish an effective pregnancy. Sperm is delivered in the gonad and transported to the penis where liquid from the prostate joins with the sperm to create semen. According to World Health Organization, the infertile males are prone to die earlier due to lack in semen quality or sexual dysfunction compared to fertile males’ lifespan.
Males experience infertility as a result of Antisperm antibodies (ASA). The main cause of antisperm antibodies is when the immune system reaction is contrasted due to an injury to the prostate gland and testicles. ASA makes the semen of men ineffective and the motility of semen is adversely affected causing problems in getting pregnant. This prevents the sperm to travel through a woman’s reproductive tract for capacitation and might causes acrosome reaction, causes problem in the growth of an embryo and implantation process. ASA also forms due to surgery’s scarring such as varicocele, failure of immunosuppression (after kidney’s transplant), infections ad breakdown of the blood-testis barrier. The blood-testis provides a pathway for a biochemical which is necessary for the process of mitosis (cell division process) in the humans. The anal and oral sexual intercourse between men leads to infertility. The couple who do oral sex should also know that it also hinders the sperm to reach the woman’s ovary. The saliva contains certain enzymes which harms the sperm and prevent it from fertilization according to the infertility specialists.
PESA (Percutaneous Epididymis Sperm Aspiration) is non-invasive procedure. It is used to retrieve sperms without making major or small incision on the body. A tiny needle is passed into the epididymis to collect the semen fluid. The purpose is to save the semen fluid for IVF cycle or ICSI, infertility treatment at sub-zero temperature. This procedure is carried out when the sterility condition of a man is diagnosed due to abnormal sperm production, HIV or other reasons.
Most of the infertility specialists tell the azoospermic male that they would not be able to have an offspring; it is a condition when a male is diagnosed with no sperm formation. They are mostly recommended to have a donor sperm. However, there are several doctors in Pakistan who would work hard to find an alternate solution or provide odds that would serve best in your interest. PESA is done usually under soporific effect of general anesthesia prescribed by the infertility specialists. After this process is carried out, the sperm-washing is done to increase the motility of sperm and make fertilization successful.
MESA is a process opted by an infertility specialist when a male patient has an epididymal (a cyst filled with fluid in the coiled tube above the testis) or vasa gel taken by many males as a contraceptive treatment. MESA is done when a male is unable to develop sperm due to congenital bilateral absence of the vas deferens. MESA is used to retrieve sperm and preferred to be collected on the same day when eggs are collected to obtain a fresh sample of both cells. The patients preserve the sperms for later use if the first attempt of IVF or ICSI fails. The method is generally preferred by the infertility specialist as there’s no medication involve which affects the testis or cause scarring.
This procedure is similar to MESA and used for the retrieval of sperm in azoospermic males. The azoospermic males are regarded as infertile men and have no sperm production. The latest techniques are used to harvest sperm after diagnosing the patient’s situation. TESE is performed under general anesthesia and might save sperm for later use in IVF or ICSI. The female’s eggs are also retrieved on the same day as cryopreserve lessens the motility of the sperm. It is a safe procedure, cost-effective and the patients don’t feel any pain. After the TESE is done, the patient can return to his normal routine. This is done by making a small cut in the testis and diagnosing the tubules for sperm retrieval. It can take up to 10 minutes in micro TESE and 20 to 30 minutes in TEST. The patients might take hours depending on the severity of the testicular problem. The success rate of this procedure is 65% whereas other traditional methods are at 20 to 45% successful.