Male factors Infertility

  • Intra-Cytoplasmic Sperm Injection
  • Percutaneous Epididymal Sperm Aspiration (PESA) and Testicular Sperm Aspiration (TESA)
  • Rectal Electro-Ejaculation
  • Intrauterine Insemination

Intra-Cytoplasmic Sperm Injection (ICSI)

Male factor infertility results when the sperm count is extremely low or the sperm quality is very poor. Conventional In Vitro Fertilization (IVF) has never been completely satisfactory in treating this problem, and often the only alternative was the use of donor sperm. With the development of ICSI in Belgium several years ago, a powerful new tool is now available for what had been an intractable problem. ICSI is also used when previous conventional IVF cycles have been unsuccessful without explanation, and when sperm is obtained by surgical means (see below).
The steps leading to ICSI are identical to IVF until the eggs are retrieved. Instead of mixing the sperm and eggs in a dish and waiting for fertilization, individual eggs are isolated and, with the use of sophisticated micromanipulation techniques, a single sperm is injected into each egg. The fertilized eggs are then incubated as in IVF until they are ready for transfer.

Percutaneous Epididymal Sperm Aspiration (PESA) and Testicular Sperm Aspiration (TESA)

Some men have no sperm in their semen either because of vasectomy or illness. In such instances, sperm may be obtained by extracting it through a needle placed in the testicle or epididymis under local anesthesia. Sperm obtained by these means must be used in conjunction with ICSI because they are too immature to fertilize the eggs on their own.
We do not perform these procedures at F.I.R.S.T., but we do collaborate with specialists who have extensive experience with them.

Rectal Electro-Ejaculation

Men with spinal cord injuries or other conditions that prevent ejaculation are incapable of producing a semen specimen. In conjunction with the world renowned Miami Project to Cure Spinal Cord Paralysis, we have successfully treated these patients. This involves electrically stimulating the prostate through the rectum to induce an ejaculation. The sperm are then used for IUI, IVF or ICSI depending on their concentration and quality.

Intrauterine Insemination

Many women with infertility do not require high technology treatment. If one or both of her fallopian tubes is open and free of surrounding scar tissue, and there is adequate quality sperm consistently available, a patient may be a candidate for IUI. Though IUI is often used to treat male factor infertility, it is not very effective unless the female partner's ovaries are stimulated. The female's fertility is enhanced by using medication to make more eggs available to the sperm at the time of insemination.
The woman's ovaries are stimulated to produce multiple eggs (superovulation) by using clomiphene (pills) or gonadotropins (injections). The progress of egg maturation is monitored by blood tests and ultrasound examination of the ovaries. Ovulation is triggered by a final injection that will cause the woman to release the eggs in about 36 - 40 hours. The male partner produces a semen sample, by masturbation, shortly before the time the woman will be ovulating.
For IUl, the sample is processed to yield a specimen containing a high concentration of sperm with normal activity and configuration. The final volume of the specimen must be very small because the uterine cavity cannot accommodate the entire volume of the ejaculate. Also, chemicals present in the semen must be separated from the sperm, since placing unprocessed semen directly into the uterine cavity will cause the woman to have violent, painful uterine cramping. Bacteria and debris are removed from the specimen by the processing as well.
The specimen is mixed with a sterile culture medium and placed into the uterine cavity through the cervix. This is done vaginally, similar to the procedure used to take a Pap smear. It is rarely painful or very uncomfortable, but some women will experience a mild cramping sensation at the time the thin tube (catheter) containing the semen specimen is placed into the uterus by the doctor. Typically, the success rate for this method is about 10-25% depending on the patient's age.

 

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For appointment with us call 9999494092,
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Phone: +91-9999494092

Address: Dr. Indira Ganeshan IVF & Fertility Centre, A-11(Basement),
South Extension Part 2, New Delhi, India, Pincode-110049

 
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