Diagnosis and Treatment
of Male Infertility
When a couple remains infertile after a year of free sexual intercourse, their first required examination consists of a spermiogram. If the problem is visible, then a physical examination is conducted by an Andrologist, who might directly identify the cause (Varicocele, Cryptorchidism, Phimosis, Hypospadias, etc). The Andrologist can also decide if other tests are necessary for the accurate diagnosis of the male patient. These may include the cultivation of typical and non-typical bacteria in the semen, hormonal and biochemical screening, ultrasound examination of the genital system, genetic tests (karyotype, etc.) and other more specialized tests (chromosomal and other genetic tests). There are also a few cases when the cause of infertility cannot be detected; these are called Idiopathic Deficiency of Seminiferous Epithelium (Idiopathic Male Infertility).
Male Infertility can be treated through pharmaceutical treatments and surgical procedures, or a combination of both, which presents significant results. Recent scientific tendencies, approach the sensitive subject of Infertility, as a problem of the couple and not as an individual male or female disfunction. With a holistic treatment and the combination of microsurgery and In Vitro Fertilization techniques, we have recorded great results on the treatment of infertile couples.
Infections of the Reproductive System
These require pharmaceutical treatments, mainly with specific antibiotics depending on the results of various Culture tests (semen, urine and prostatic secretions). The duration of the treatments vary from 15 days up to 2 - 3 months, and present 80-90% success.
They refer to diseases of the endocrine glands (i.e. Hypogonadism), metabolic disorders (i.e. Diabetes Mellitus), immune factors, renal failure and other diseases and can cause different degrees of damage to the sperm. Pharmaceutical treatments fight the main disease, which also contribute to the improvement of the sperm.
The surgical procedure performed under the magnification of a surgical microscope is called Microsurgery. It is considered to be a more beneficial technique, compared to classic surgical methods, since it focuses and magnifies the surgical field to a degree that the surgeon can perform more targeted and detailed operations. Furthermore, this benefits the patient, as it involves a less traumatic surgical procedure, with lighter anesthesia and without requiring an overnight stay in the clinic. It also contributes to a shorter and relatively painless post-operative recovery, which allows the patient to be fully functional, in just a few days. Dr A.Karanikas performs microsurgical procedures for over 20 years and exclusively uses this technique for the treatment of Varicocele, Cryptorchidism and Azoospermia (obstructive or non).
Find out more information and answers to frequently asked questions.
Pre-operative and post-operative instructions
for microsurgical procedures in the genital area.
The operations which are performed with microsurgery do not require an overnight stay in the clinic, since the anesthesia is usually light (combined with local anesthetics). The patient proceeds to the clinic early in the morning, having dined lightly the previous night.
Pre-operative laboratory screenings
1. Chest Radiography
2. ECG - Electrocardiograph
3. Simple blood test, including 'Prothrombin Time' (PT) and ‘Partial thromboplastin time’ (PTT)
4. For testicular Biopsy, there are certain required tests for Infectious Diseases: Hepatitis B (HbSag), Hepatitis C (Anti-HIV), AIDS (HIV I, II), Syphilis (VDRL)
The patient needs to remain in the clinic for a few hours, until he recovers completely, from the procedure. Afterwards, he can return home normally, avoiding driving a vehicle.
a. On the same day the patient is recommended to rest, apply ice pads over the operated area (once every hour) and dine lightly in order to ingest his prescription drugs.
b. The next day the patient can bathe by removing the original gauze. Regular care of the wound is required, with the use of an antiseptic (i.e. Betadine) and frequent change of gauze until it appears clean.
c. He may eat normally and progressively return to his normal activities.
d. During the first days the patient may experience swelling around the operated area, light bruising and a mild pain, which will subside gradually. The sutures do not need to be removed, since they are absorbable.
‘Microsurgery’ is the surgical procedure performed under the magnification of a surgical microscope.
Microsurgery is considered to be a more beneficial technique, than the classic surgical methods, as it focuses and magnifies the surgical field.
The surgeon can perform more targeted and detailed operations with the assistance of a surgical microscope.
Microsurgical procedures are more beneficial for the patient, as they involve a less traumatic surgical procedure, with lighter anesthesia and without requiring an overnight stay in the clinic.
Testicular microsurgical biopsy (microTESE) was initially introduced and performed in Greece, in 2004, by Dr A.Karanikas, who continues to apply it, with over 65% successful cases.
In Vitro Fertilization is the process where ovules are fertilized by spermatozoa, outside the female body and under specially designed laboratory conditions.
During the procedure of ICSI, each spermatozoa is ‘planted’ into one ovum, and the best 1-2 fertilized ovules (zygotes) are then introduced into the uterus.
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