Male Infertility Treatment In Bangalore | India
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Transcript of Male Infertility Treatment In Bangalore | India
Male factor 40%Female factor 40%Both 20%
16-18 million new couples / yearSperm count on the decline A decade ago 60 million Now 20 million
Pesticides, Chemicals, heavy metalsAir and water pollutionRadiation ‘Cell phone’
Environmental
SmokingAlcoholPreservatives ‘fast food’Genetically Modified foodHormonesTestosterone and EstrogensTight Dress
Life style
Food additivesProtein SupplementsHormones and Steroids Varicocele
Body Building
Hypogonodotropic HypogonadismCryptorchidismKline feltersMaturation arrestSartoli only cell syndromeAbsence of Vas and Seminal vesicles
Congential
Epididymo OrchitisMumpsSeminal VasiculitisGu Koch's
Police,Guards, Post men, Sales menHMT, Athletes and Body BuildersCooks, Bakery, Foundry, SmithyFarmersDrivers-‘Bangalore Bike Riders’
Occupation
Infection
Defective sperms is the most commoncauseSperm is highly sensitive tooxygen radicals
Infection Aging Environmental
Oxidative stress
Poor Semen is significantlydue to three factors
Oligospermia
Low sperm count < 15 mlAsthinospermiaPoor motility < 32 %Teratospermia
Poor morphology <4%
Varicocele
Dilated Pimpiniform plexus
Increases Testes TemperaturePoor testes function 1O C increase- 14% reduction
Commonest cause of male infertility
15% General population35% Primary infertile Men75% Secondary infertile Men
Common among...
People who work standing(PostMan, salesman, guards, police)People work hard HMT, Bodybuilders, Jym goers, sportsmanPeople work in hot areas (Smithy, Foundry, cooks, drivers)
DiagnosisClinical
Grade 1: Felt on ValsalvaGrade 2: Felt on restGrade 3: easily visible
Scrotal Doppler
Improves testicular function 80% Repair will halt any further damage
Why Surgery
VaricocelectomySurgery Varicocele ligation
Scrotal approach: damage to artery PALAMO’S:
High Recurrence
Microsurgical: Gold standared Best results, least
recurrence, hydrocele
Embolisation and Scelrotherapy: High
complications
Laparoscopic Varicocele ligation
Early surgery Better resultsGrade 23 better recoveryMicrosurgical best resultsLeast complications
Obstructive AzospermiaVasectomyHernia and Hydrocele SurgeryChronic EpidimytisScrotal injuryEjaculatory duct obstructionGenital Koch’s
VasographyRadiological study: Obstructive AzospermiaDone at time of corrective surgery.Complication: Stricture at the puncture site.Commonest: Ejaculatory duct obstruction
TURED: Ejaculatory duct obstructionVasovasostomy: Vas obstructionVasoEpididymostomy: Epididymal obstruction
Sperm Retrieval
Sperms retrieved Surgically from Vas or testesObstructive AzospermiaPoor semen quality
Cryptorchidism
Klinefelters
Maturation arrest
PESA Epididymal Open Microsurgical Better results Percutaneous: Less reliableEpididymal ducts opened microscopy Sperms aspirated with pipette
Testes TESA Failure of PESA Non Obstructive Azospermia Testes opened Microscopy Sperms aspirated from testes tubules
Male Infertility is on riseQuality of Sperm is down
Environment and Life styleVaricocele commonest cause