What causes fertility problems in men?Basically, there are two types of problems that affect men.
These include transport disorders caused by infections, inflammation or surgery, or congenital physical abnormalities that prevent the natural flow of sperm. These problems can rarely be treated with medication. As a rule, an operative therapy is required here in order to make the spermatozoa through again.
More common causes of male infertility are disorders in sperm production. This is often due to a deficiency or dysbalance of the hormones that trigger and control sperm production. Surprisingly, in both men and women, these are the same sex hormones, but in a different concentration. Therefore, men with fertility problems are given the same sperm production stimulants as women to induce ovulation.
The catch of the matter is that the success rate in men is not nearly as high as in women and the drugs can only be used on some specific problems.
What fertility drugs are there for men and how do they work?The drugs most commonly used for men are sex hormones called gonadotropins that are injected. Gonadotropins occur in two forms:
- HMG (human menopausal gonadotrophin)
- HCG (human chorionic gonadotrophin)
Gonadotropins are used to treat men who have no sperm due to primary hypogonadism (HFEA 2009, NCCWCH 2004: 52) to produce. This happens when the testes from the pituitary get no signals for hormone production. Gonadotropins cause the testicles to produce testosterone and sperm via the brain. The sperm production-inducing gonadotropin must be continuously supplied to the body through access to subcutaneous fat tissue for weeks.
Are other medications needed?Some men suffer from a so-called back ejaculation. The ejaculate is not thrown into the penis, but backwards into the bladder. This may be due to diabetes, medication or surgery. Hormones are of no use here, but occasionally, imipramine can help, because its active ingredient strengthens the inner bladder sphincter and thus solves this problem.
Antibiotics are prescribed for infections or inflammation of the genital area.
Are fertility drugs applicable to all men?The most important thing in treating a problem is finding the exact cause. Your doctor will use a variety of examinations to make an accurate diagnosis. A back ejaculation z. B. can be triggered by certain drugs. Leaving these out can be the solution to the problem (Vovick 2009).
Sex hormones are prescribed only in case of hormone deficiency or hormonal dysbalance associated with low sperm count. Sometimes with poor sperm quality or reduced sperm motility.
How long does sex hormone treatment last?One cycle of HCG takes six months in men and consists of two to three injections a week. If this is not enough, the dose may be increased or additional HMG injected.
How successful is the treatment?No-one can guarantee you success, but treatment can help start your sperm production and increase the sperm count to 20 million / milliliter or more. (A count below 20 million / milliliter or m3 is considered low.) For men diagnosed with hypogonadotrophic hypogonadism (Farhat et al 2010, NCCWCH 2004: 52), a 60-80% success rate is expected.
According to a study, 40 percent of patients achieve at least one pregnancy after treatment (Farhat et al 2010).
If the treatment does not help, the doctor can also use a small operation to take a testicular tissue sample and examine it. This may provide insight into another cause of the problem or allow for an ICSI as an option. Therefore it is advisable to extract sperm from such a tissue sample from the testicle in parallel from the extracted tissue, if any, and to freeze it for possible later artificial insemination.
SourcesThis article was written using the following sources:
Farhat R, Alzidiali F, Alzahrani AS. 2010. Outcome of gonadotrophin therapy for male infertility due to hypogonadotrophic hypogonadism. Pituitary 13 (2): 105-10
HFEA. 2009. Fertility drugs. www. HFEA. gov. uk [as of March 2014]
NCCWCH. 2004. Fertility: assessment and treatment for people with fertility problems - full guideline. National Collaborating Center for Women's and Children's Health. London: RCOG Press. www. rcog. org. uk [pdf file, as of March 2014]
Vovick LJ. 2009. Retrograde ejaculation. MedlinePlus. www. nlm. nih. gov [as of March 2014]
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