Infertility is the inability of couples to have children despite 1 year of unprotected sexual intercourse. It is recommended that both partners should be evaluated.
Roughly, about one-third of infertility is caused by male factor, one-third by female factor, and the remaining one-third is due to idiopathic (unknown) causes. Although there are many factors for men, the most common cause is varicocele.
Varicocele; is the name given to the enlargement of the veins in the testicles. It is frequently seen in the left testis (90%).
While the incidence of varicocele in men in the community is about 15-20%, this rate reaches up to 40% in patients presenting with infertility.
Infertility: Infertility is defined as the inability of a sexually active couple to get pregnant despite one year of unprotected sexual intercourse. Varicocele is the most common cause of correctable male infertility.
Swelling and swelling in the testis: Excessive expansion of the testicular veins may manifest itself as swelling and swelling that can be seen even from the outside after a while.
Pain in the testis: It can manifest itself as an annoying blunt pain in the testis.
Reduction in testicular dimensions: Since varicocele causes testicular damage, a decrease in testicular dimensions may also be seen in the future.
The diagnosis of varicocele is mainly made by physical examination by an experienced urologist. Scrotal Doppler Ultrasonography can be done to support the diagnosis and to see parameters such as testicular size more precisely, but it is not absolutely necessary for the diagnosis.
In addition, it may be necessary to perform Semen Analysis (spermiogram) under appropriate conditions to evaluate the need for treatment.
Varicocele causes progressive testicular damage and ultimately reduced fertility. Varicocele has also been shown to cause DNA damage, again leading to decreased fertility. This negative effect can be reduced with appropriate surgical treatment.
After the diagnosis of varicocele, it is evaluated whether the patient has testicular dimensions decrease, reduction of semen parameters, and infertility problems; If there is no problem in these, the patient can be followed up with supportive treatment.
Surgical treatment of varicocele is recommended in cases where there is a significant decrease in testicular size and decrease in sperm parameters.
Varicocele surgery can be performed with many techniques. Among these methods, Microsurgical Varicocelectomy has come to the fore with higher success rates, lower complication and recurrence probability. With this method, a small incision of 2 cm is made in the inguinal region (groin) and a more sensitive and successful surgery is performed under microscopic magnification.
Microsurgical varicocelectomy; It is an operation performed under an advanced microscope and is the gold standard treatment method in the treatment of varicocele.
In this technique, it is aimed to connect the enlarged veins. By entering with a 2 cm incision from the inguinal region, arteries, lymph vessels, and veins are more clearly selected under the advanced microscope. Structures that need to be protected, such as lymph vessels and arteries, are protected much more safely, and all enlarged veins are ligated.
Depending on whether it is unilateral or bilateral, the average operation time is 30-45 minutes. Patients can be discharged on the same day and can return to normal daily activities 2-3 days later.
After varicocelectomy, sperm parameters are evaluated at 6 months. The chance of spontaneous pregnancy after surgery increases significantly. In addition, even in cases where pregnancy is not spontaneous, thanks to the improvement in sperm parameters, the pregnancy rate increases with assisted reproductive techniques.
Insemination (IUI- Intauterine insemination) is the process of placing the sperm cell taken from the man into the uterus of the woman at the appropriate period. In order for this process to be implemented successfully; At least one of the women's tubes must be open, and the characteristics of sperm cells such as number, movement and appearance must be within the appropriate limits for insemination.
Insemination success is between 5-20% on average, depending on the reason for the procedure. In cases where there is no or very little sperm in the semen, this method should not be applied in cases where both tubes are closed in the woman, and in vitro fertilization treatment should be started directly.
In IVF treatment, fertilization is achieved by combining female reproductive cells and male reproductive cells in a laboratory environment.
This process; It can be in the form of leaving the sperm next to the eggs and waiting for these sperms to enter the eggs by themselves and fertilize (classical in vitro fertilization-IVF) or to ensure fertilization by injecting them directly into the egg with the help of a pipette under the microscope (microinjection- intracytoplasmic sperm injection, ICSI).
Micro Tese (Testicular Sperm Extraction under Microscope); It is a surgical method used in male infertility. In cases where there is no sperm or the sperm quality is seriously impaired, it is the process of opening the testis with a small incision and searching for suitable sperm for fertilization so that people can have children with assisted reproductive techniques.
The procedure is usually performed with general or spinal anesthesia. A small incision is made into the scrotum. The anatomical structures surrounding the testis are passed in order and the testis is exposed. Tissue samples are taken from the tubules, which are seen as the most alive and full in the testis tissue, under an advanced microscope. If viable sperm are found in these tissues, the procedure is terminated.
In the micro TESE procedure, the risk of damage to the testicular tissue is lower than in the classical TESE procedure. In addition, the probability of finding live sperm is higher in this method, thanks to microscopic vision.
Note: Page contents are for informational purposes only and a doctor's application is required for your diagnosis and treatment.