1. What type of information can we receive from a Spermiogram
and when is it recommended?
Semen Analysis records the number, motility and morphology of the sperm. It also provides information about the function of auxiliary genital glands (prostate, seminal vesicles) and must be requested by the male patient, who has had free intercourse with his partner, for a year, unsuccessfully. It is preferable for the sperm sample to be collected at the laboratory, via masturbation and after three days of sexual abstinence.
3. How can a male patient detect Varicocele and what are the
Varicocele is a condition that does not present any symptoms (except in rare cases). The only way to diagnose it, is via preventive clinical examination by the Andrologist, especially at young ages. It is also possible to diagnose Varicocele, at early stages, with an Ultrasound examination (Triplex).
5. How can a male patient detect Azoospermia and what are the
Azoospermia cannot be self-detected by the patient, since it does not affect the quantity and appearance of the sperm.
In order for Azoospermia to be diagnosed, a spermiogram is required.
7. What is the difference between a regular Biopsy (TESE) and
Biopsy using a microscope (microTESE) and which one is
The case of Non-Obstructive Azoospermia is specifically treated with IVF (ICSI), which requires acquiring sperm directly from the testicles. With the standard techniques, the success of finding spermatozoa in the extracted sample is 20-30% with FNA and 40-45% with the classic Biopsy (TESE). The method of Microsurgical Biopsy (microTESE), which is also preferred by
Dr A.Karanikas, presents 60-70% success rates. In addition,
due to the fact that during the procedure, only a small amount
of testicular tissue is extracted (almost 10 times less that the standard techniques), it is less traumatic for the testicles and can also be applicable in cases of testicular atrophy.
9. Are there any cases when the method of microTESE cannot
No, even in cases with very high FSH or atrophic testicles (<5 ml), spermatozoa can be found with microTESE.
11. Is there a reversible method of male contraception?
Apart from the most common and unreliable method of contraception; the condom, experimentation on the development of a male contraceptive pill was proven unsuccessful; thus leaving Vasectomy the only confirmed method of permanent male contraception. It is a simple and painless procedure where the Vas Deferens of the testicle is dissected under local anesthesia. Vasectomy is recommended to males who do not wish to have offsprings and do not want to burden their partner with potentially harmful female contraceptive methods. If a male patient wants to restore his prior fertile state, it can be achieved with a microsurgical procedure (Vasovasostomy), presenting
80-90% success rates.
Frequently Asked Questions
2. When is it appropriate to treat the Cryptorchidism and what is
recommended if not operated in time?
The surgery of Cryptorchidism should ideally be performed during the second year of age of the male patient. Otherwise it should be performed at any age that is diagnosed, in order to prevent a higher risk of cancer generation. The surgical procedure involves the mobilization and stabilization of the testicles at at their normal position in the scrotum. If this is not possible, then the testicles should be removed and replaced by non functional artificial testicles, for psychological reasons.
4. What are the results of the operation of Varicocele and when
are they visible?
The post-operative results of Varicocele can become visible after three months of the operation, followed by gradual improvement for up to twelve months. Statistics have recorded that by the end of the first post-operative year, there is 60-70% improvement of the sperm of the operated male patients and almost 40-45% pregnancy.
6. Why is Microsurgery preferred for the treatment of infertility,
over older classic surgical methods?
Microsurgery is a less traumatic surgical technique, which contributes to a shorter and less painful post-operative recovery. Of course it provides with better treatment results, due to the use of the surgical microscope that allows more accurate and delicate manipulations.
a. The treatment of the Varicocele, as performed with conventional techniques, present 15-20% complications, such as Hydrocele (liquid concentration around the testicles) and Relapse of Varicocele, which may require a new operation. On the other hand Microsurgery presents only 1-2% complications.
b. The results of the surgical treatment of Obstructive Azoospermia without the use of the microscope are rather disappointing, thus conventional methods have eventually been abandoned. Microsurgery displays a success rate of 40-50% for Epididymovazostomia and 80-90% for Vazovazostomia (i.e. restoration of voluntary sterilization - Vasectomy).
8. Can sexual activity be affected after a testicular Biopsy?
No, when performed by an experienced surgeon, in order to avoid complications such as Hematoma, Inflammation or Injury to the arteries of the testicles
10. What medical experts should an infertile couple visit and
in what order?
When the cause of infertility of the couple has not yet been diagnosed, both female and male partners are recommended to visit a Gynecologist and an Andrologist respectively, in order to take the necessary screening tests and detect the origin of the problem. If the cause of infertility has already been targeted through the appropriate treatments, but without any results, then the method of IVF is recommended. In this case, the couple can consult with the experts of an IVF centre, who can guide them up to the point of conception. Infertility is not a problem of a single partner, but rather of the couple, thus nor is it a case that requires consulting one expert only. Experience has proven that the collaboration between expert doctors and lab specialists can lead to great results for infertile couples.