There are many reasons for the late pregnancy of the couple, and before entering the tests of the wife, which requires a blood test and an ultrasound image and a color image color, preferably start a man, which is easy and direct examination and accurate.
The only way in which sperm dysfunction is diagnosed is through semen examination. Where the man abstains from the marital relationship between 3-5 days before giving the sample and the examination of the number of sperm that should be more than 20 million in mm.
The percentage of sperm activity should be checked. More than 50% of them should be moving and active in front of the body and the proportion of the sperm must be less than 80%. It should be stressed that there is no relationship between sexual ability in men and the number of sperm, we often see men who have a regular marital relationship, but there are no sperm in the ejaculation, so the examination of liquid as a first step in medical examinations of cases of delayed pregnancy.
Often, the cause is unexplained, but one of the known causes, the most important is the delay in the descent of testicular in the age of childhood (testicle migraine), as this delay significantly affects the development of testicular and its future work, so we advise parents to check the presence of testicles in the scrotum At the time of birth, an operation to remove the testicle to its normal place before the age of one year saves the testicle from damage. Other causes include the expansion of the veins around the testicle or what is known as varicose veins. This leads to a decrease in testicular function and low sperm efficiency And the incidence of mumps disease (Abu Ka’ab) in boys May be accompanied by pain in the testicle and this causes permanent damage to the testicular tissue. And other causes such as severe infections that lead to blockage in semen channels. And there are genetic cases due to a defect in genes that cause a severe weakness in the sperm. An important reason to use hormonal needles to enlarge the muscles that are often used by young people in bodybuilding clubs. The use of it for more than 6 months to 12 months leads to permanent infertility.
There are two therapeutic methods, the first is artificial insemination (intrauterine injection) and the other method is the IVF with microscopic fertilization.
Certainly each method has its own advantages. The uterine injection is a simple method of treatment without side effects. The general idea of artificial insemination is to sort the sperm sample and wash it until we get the best sperm and concentrate it in a smaller size in an appropriate fluid that promotes movement and activity of these sperm cells. This sample is then injected into the uterus of the wife’s uterus at the time of ovulation, and thus we have brought as many sperm as possible to the closest to the egg.
And there are very important features of this method, because sperm are secreted vaginal secretions and cervical secretions that may be fatal or harmful to sperm. It can also benefit from this procedure in cases where it is not possible to have intercourse between the spouses, either because of erectile dysfunction or because of The severe pain in the wife.
In vitro fertilization is carried out in cases of low sperm count, decreased activity, or increase in the proportion of deformed sperm. Until this procedure, we need to pull the eggs out of the body and remove the outer shell of the egg and then fix it and inject it with a normal active sperm. The fertilized egg or embryo is returned to the uterine cavity after 3-5 days.
Some are worried about pregnancy caused by pipe children. Is it different from normal pregnancy?
There is no difference at all. In the past years, about 3 million children worldwide have been born of IVF. At least 100,000 children have been studied from around the world. There is no strong scientific evidence of any increase in major congenital malformations or differences in IQ of children For IVF babies, IVF and IVF can be considered a safe process, and pregnancy resulting in pregnancy is similar to normal pregnancy.
On the part of the wife must have a uterus and activity in the ovaries. As for the husband can be used sperm sperm (ejaculation) or sperm for the husband frozen in advance or even the sperm of the husband taken from the testis by surgical procedure. Note that there are no significant differences between the results of pregnancy if sperm were obtained in any of the procedures mentioned.
The chances of success of IVF with micro-fertilization are very excellent when the cause of delayed pregnancy is male and the age of the wife is less than 38 years. Because the wife’s ability to pregnancy is often normal. Once a fetus is formed by microscopic fertilization and the embryo is reintroduced to the uterine cavity, the chances of pregnancy are excellent. As for artificial insemination, the chances of success are lower because sperm can not be guaranteed to fertilize the egg.
Yes, and the most important things are smoking and obesity, smoking leads to a low probability of pregnancy by at least 10% as it leads to a decrease in the number and activity of sperm. Obesity also leads to atrophy in the testicle and a decline in its work, causing the lack of sperm production.
It is important to keep in mind that people with a very small number of sperm (less than 5 million) are prone to a decline in the number of sperm over time until semen does not contain sperm, so I recommend freezing sperm and Can be used later if there is no sperm in the ejaculation.
Cases of weakness or delay in childbearing are due to organization in men in 50% of cases, and may require a proportion of men resort to IVF technology or microscopy to reach paternity. The two most common groups of men who need this technique are those who have a very low or missing sperm ratio in semen analysis or who have a blockage in the sperm delivery channel.
In order to complete the vaccination, a sperm from the man must be obtained. A biopsy or sample of the testis is usually done by a needle or a small hole in the testis wall. A small amount of testicular tissue is taken. However, with the progress in this area, the most recent and most accurate method is the surgical microscope For intracellular examination in areas where the risk of a live semen is higher. Channels containing spermatozoa usually have different characteristics than others and can be observed under the magnification of the microscope, which is 10 times the naked eye.
One of the advantages of this method is the increase in the success rate of research and the capture of live sperm, especially after the failure of the traditional method mentioned above. It also shows the surgeon the sperm-free sites that can be preserved.
But it should be noted that this process requires more time in the operating room with anesthesia for about an hour and a half, and requires a surgical microscope and an expert surgeon in use to carry out this delicate process
Dr.. Rami Hamza