WHY DO THE SPERM COUNT AND CHARACTERISTICS DIFFER IN DIFFERENT TIMES?

There are many factors that affect the parameters of semen. Diseases, drugs used, chemical and environmental factors, all affect the characteristics of semen. Therefore, evaluation of at least two semen samples and making the decision according the average of the values of these two evaluations 3-4 weeks apart, provided that no diseases associated with fever have been suffered and no drugs have been used in that interval, is the method adopted in our center.

WHAT ARE THE FACTORS THAT CAUSE COMPLETE ABSENCE OF SPERMS IN SEMEN?

Complete absence of sperm cells in the semen sample is called "Azoospermia" . In general, there two factors that cause this complete absence of sperms,. There may be either a decrease in sperm production in testes, or else problems in canals that ensure discharge despite normal sperm production. These two factors can be discriminated by the physical examination of the patient and by hormone tests. In the recent years, genetic studies have gained great importance through the disclosing of new genes that play roles on male infertility.

WHAT IS THE TREATMENT IN CASES OF INFERTILITY DUE TO REDUCED TESTICULAR SPERM PRODUCTION?

Cases with high levels of hormones that are secreted by the brain, and with testes of small dimensions can have children by finding sperms in the testes and performing microinjection. Our center has achieved the first pregnancy and live birth of Turkey with sperms obtained from the testes. In past, attempts were done to acquire sperms by taking multiple biopsies from various areas of the testes randomly. We search for sperms in the testes by using a new surgical method performed under microscope, and our center again being the first center in Turkey in this field. We are performing this new method successfully in our center, which was first used in NY Cornell Medicine School. This new operation technique is carried out by uncovering the testes with one single cut, magnifying 20 folds with the help of the microscope, determining the areas of sperm production, and taking tissue samples from those areas. Therefore, the chance of success is higher than the random method performed in the past, and it is possible to obtain sperms of greater numbers. The tissue loss is very small in this micro surgical method. This in turn ensures minimal damage of the testes because of the operation, and affects the secretion of testosterone from the testes minimally. Another advantage of the microsurgery method performed under microscope is actually seeing the vascular structure of the capsule surrounding the testis, and making the cut accordingly without damaging the veins feeding the testis. This minimizes the probable post-operational complications. We manage to find sperms with ratios as high as 60-65% in patients that the conventional operations were unsuccessful, or patients with azoospermia due to certain genetic structural factors.