Infertility in couples can be caused by men, women, or both. Men are sterile
Is the inability to produce or produce sperm in small quantities is not enough to carry. Those who do not make sperm at all in semen or that few sperm are involved in this article.
In our study in Jordan, it is now possible to diagnose the condition and degree of infertility of men by needles instead of opening the testis and taking samples of them by surgery. The process of needle sampling has begun to spread in Europe in recent years because of the characteristics lacking in the process of sampling by surgical procedures. In this procedure, we take the needle and under local anesthesia multiple samples of the testicle and then examined under the microscope to determine the cause of infertility in men. Therefore, this process has become the basis for the diagnosis of male infertility in Europe, rather than the operation of the testis.
This procedure is performed with adequate local anesthesia without feeling the patient and without the need for general anesthesia. We usually take 10 samples of the testis five samples from each hand and several sides of the testis and this is a great advantage since in cases of opening the testis surgically, it can not usually take more than two samples. Since testis is different in production from one place to another, needle sampling is the only way to ensure adequate sampling of different testes. The complications of this process if taken needles are almost negligible, when compared to the process of opening testis. The adhesions of the walls and the buttocks and infections that occur in many cases after the operation of testicular opening surgery can be very much avoided in the process of needle sampling, which benefits the group, which already suffered from problems in the testis and taking samples of surgery may lead to increased testicular problems Already plagued with many problems. As for the accuracy of the process of sampling of testicular needles compared to the process of opening testis. Needle sampling is much more accurate than surgery by surgery. We can read each cell separately to determine its degree of maturity and sperm shape, whether intact, defective or deficient, and this usually does not come with the same precision in surgical samples.
Diagnosis of the patient’s condition: With the process and reading the samples we can give the patient a clear idea of the problem of infertility. We can determine if it produces sperm and what is its quantity and any area of the testis come out. If there are no sperm, we can determine what the problem is or whether there is a chance of a response. We can also determine whether there are infections or tumors in the testicle.
And some wondered why the presence of sperm in the testis and lack of sperm? As we know that the testis is a sperm factory. But this plant even produces sperm to the semen must be sufficient quantity and the path leading to the exit is impassable. If these methods are closed (as in cases of infections or congenital anomalies), the sperm will not go out with normal ejaculation. Although sperm in the testis are few, they may also not appear in semen. The most recent method used in our laboratory is to take 10 samples of the testis from different places identified and marked in the testis (ie, they are not random samples). If we find sperm anywhere, this place is specific and known to us, we can in the case of the need for sperm again (as in the case of the couple entering the syringe program in the child of the tube) go back to the same area and take the new sperm or frozen Sperm from this area if needed in later days.
It was previously (ie several years ago) can not take advantage of sperm if not appear in the semen. Now, it has become possible with the progress of science to benefit from sperm, no matter how few in the testis, and if we get out of the testicle and injected in the egg. This process has solved many infertility problems in infertile men with sperm (no matter how few) within the testicle. Infertility problems have also been solved due to sexual impotence and nerve injury or other causes. The current research is whether it is possible to take advantage of primary cells that precede sperm in the injection and fertilization of oocytes.
The disability resulting from traffic accidents, which may be detrimental to infect the spine, leading to the inability to erect permanent disability and sexual. These patients can benefit greatly. Can the sampling of the testicle by the needle and pull the sperm and then injected into the eggs of the wife by ICSI tube baby in the process. Many children have been born to men who are sexually impotent in this way.
In cases where we have no sperm at all in the testicle, there is hope in some cases and treatment with different drugs that may stimulate the testis to produce sperm. Although research is still at the beginning of such a class of men and the chance of success is few but not none.
As for those who are next to marriage, men are advised to do semen examination to see if there is a problem in the number or movement or shape of the sperm and what is the possibility of solving them. It is very useful to mention that in the laboratory we have developed some means to solve the problems of a large group of men who have a few sperm in semen. Where we focused on the sperm and the removal of impurities to give to the wife by injection into the cervix wife (of course in collaboration with the doctor of the woman’s patient). We also succeeded in segregating sperm carrying the female chromosome from the sperm of the female chromosome. The preferred septal sperm is injected into the wife’s cervix. Accurate results have been obtained reaching more than 80% of the total cases.
In difficult cases, which do not have sperm in the testicle, we recommend testing chromosomes to ensure that the patient does not suffer from a lack of chromosomes necessary for reproduction. In a study we conducted on these patients in Jordan: abnormal chromosomes accounted for about 25% of the total loss of sperm in the testis. The condition of these patients is usually intractable. The most abnormal changes are a decrease in part of the Y chromosome, a decrease or increase in the X chromosome, or even an increase in a complete chromosome, such as X chromosome (Clenfelter cases).
From the above, we find that the key to solving such infertile men is to have needle-operated testicles without surgery and to study these samples for possible entry into the IVF program.