MALE INFERTILITY TESTING

In male infertility assessments, a semen analysis, ideally on the third or for day of abstinence (no sexual activity), is the first step. The capacity of the sperm to fertilize the egg is measured through a sperm sample which reveals parameters like; sperm count, concentration, motility, morphology, round cell count, pH and more. Without a doubt, some other tests might be required as well depending on patient's personal history of infertility, testing and or treatment

The WHO criteria for normal sperm values is listed as follows;

Volume: > 2.0 ml

Concentration: >20 million/ml

Motility: > 50%

Morphology: >30% with normal morphology

White Blood Cells (Round Cells): < 1 million/ml

pH: 7.2-7.8

Please feel free to contact us in case you need any further assistance. We will be glad to help. 

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Azoospermia and Surgical Sperm Extraction Methods

One of the main factors of infertility is Azoospermia and has been estimated to effect 15% of all male infertility cases.

This factor which is in essence the complete absence of live sperm cells in the ejaculation can be split into two groups : obstructive azoospermia and non-obstructive azoospermia. The former suggests that there is a blockage along the sperm delivery system as where the latter suggests a problem in the production of sperm. 

The reasons behind this can be due to testicular failure but further investigation should be carried out by a urologist for a full diagnosis. 

We offer a few different options for treatment in such cases including : 

PESA - Percutaneous Epididymal Sperm Aspiration
MESA - Micro Epididymal Sperm Aspiration
TESE - Testicular Sperm Extraction

The diagram below shows how each of the surgical sperm retrieval methods are administered:

Please click on the link below for further detailed information
http://www.lowcostivf.net/tese-microtese-tesa-surgical-sperm-extraction.htm#.U0BlAlG1Zck


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La cryoconservation

La cryoconservation des ovocytes
Les progrès récents dans le dans le processus de fécondation in vitro ont permis d'assurer le succès congeler , stocker et décongeler plus tard et féconder des ovules humains cryoconservés . Cryoconservation des ovocytes s'adresse à trois groupes particuliers de femmes : les personnes atteintes d' un cancer qui n'ont pas encore commencé la chimiothérapie ou la radiothérapie , et ceux en cours de traitement avec les technologies de reproduction assistée qui ne considèrent pas la congélation des embryons une option , et ceux qui voudraient préserver leur capacité future d'avoir des enfants , soit parce qu'ils ne possèdent pas encore un partenaire , ne sont pas prêts à avoir un bébé encore, mais voudrait garder cette option pour l'avenir , ou pour d'autres raisons personnelles ou médicales . Le procédé de récupération d'oeuf pour la cryoconservation d'ovocytes est la même que celle pour la fécondation in vitro . Cela inclut plusieurs semaines d' injections d'hormones et à la contraception hormonale afin de stopper l'ovulation , suivie par plus d'injections d'hormones pour stimuler les ovaires et mûrir plusieurs ovules . Quand les oeufs ont mûri , hormone supplémentaire est donné et les oeufs sont enlevés avec une aiguille guidée par échographie par voie vaginale . La procédure est réalisée sous sédation . Les œufs sont immédiatement congelés . Ovules congelés peuvent être conservés aussi longtemps que le patient souhaite , mais cela doit être indiqué avec précision , sinon , les oeufs congelés qui ne sont pas utilisées dans un délai de deux ans sont déchargées.


La cryoconservation d'embryons
La cryoconservation d'embryons ( congélation des embryons ) est la congélation des embryons «excédentaires» pour une utilisation dans des cycles de FIV ultérieures. Cette option est souvent explorée par les couples en traitement de FIV où les embryons surnuméraires qui ne seront pas transférés dans l'utérus sont congelés pour une utilisation future si la tentative de FIV échoue. Même lorsque la tentative de FIV ne manque pas et le couple est capable de concevoir , les embryons congelés peuvent être utilisés pour la seconde grossesse. Le principal avantage de l'utilisation d'embryons cryoconservés dans les futurs cycles de FIV est que la femelle n'a pas à subir une induction de l'ovulation , ce qui réduit aussi considérablement les coûts des médicaments. Les taux de réussite sont variables en fonction des caractéristiques des patients et la qualité des embryons .
Cela pourrait aussi être une option pour les couples qui ne souhaitent pas tomber enceinte tout de suite mais je voudrais préparer leurs embryons à l'avance pour une utilisation future . De cette façon , ils peuvent éviter des taux de réussite inférieurs de conception à un âge avancé .

Cryoconservation du sperme
La congélation du sperme ( cryopréservation ) est une méthode utilisée pour les patients masculins qui suivent un traitement de chimiothérapie pour un cancer ou de maladies similaires . Cela permet au patient de conserver leur sperme pour une utilisation future et éviter les risques d'infertilité associés à la chimiothérapie .


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Sperm Donation

1- Who is a good candidate for sperm donation?
Patients with male factor infertility such as azoospermia or other sperm defects, or males with prior cancer treatment are potential candidates for sperm donor IVF treatment. Patients with genetic disorders that inhibit sperm production or patients with high risks of passing genetic disorders onto their children are also good candidates for sperm donation. Prior to sperm donation, we offer our patients the option of a surgical sperm retrieval option where sperm is retrieved surgically from within the testes to see if any live sperm cells can be found that may not make it to the ejaculate.

Single female patients who do not wish to seek treatment with a partner are also good candidates for our sperm donor IVF treatment program.
 

2- Who are your sperm donors?
The sperm we use come from an international sperm bank with their certificates. We only use certified sperm as certification process requires an extensive testing on the sperm to be repeated at certain intervals. This way, we can guarantee our patients that there are no testable defects on the sperm used in the IVF process.

3- What are your success rate with sperm donation?
Success rates with sperm donation tend to vary depending on the age and hormone profile of the female patient. If the female patient is young with a good hormone profile, then the success rates will be considerably high. However, women after 35 years of age tend to experience a decline in their fertility levels, therefore, the success rates tend to decline. For more information on our success rates, please view our 2011 success statistics page.

4- What is the cost of sperm donor IVF at North Cyprus IVF Clinic?
For a comprehensive cost information with alternative accommodation packages, please contact us using the contact form.
 

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Sperm Retrieval

The usual way of producing sperm for use in Assisted Reproductive Technology is manual stimulation.  In cases where medical or religious factors prevent this, surgical methods can be used:

PESA
PESA (percutaneous epididymal sperm aspiration) is a method, performed under local anesthesia, which involves extracting sperm with a fine needle from the epididymis or testes.  The sperm is then implanted into the egg through the process of ICSI (Intracytoplasmic Sperm Injection) to be used in IVF.

TESA & TESE

In cases where the epididymis does not contain any sperm, because of impaired sperm production, the method of TESA (Testicular Sperm Aspiration) or TESE (Testicular Sperm Extraction) may be used.  TESE involves a surgical biopsy of the testis, while TESA is performed by sticking a needle into the testis and aspirating fluid and tissue with negative pressure.

MESA The most invasive of the surgical sperm retrieval procedures is MESA (micro-epididymal sperm aspiration), which is performed under general anesthesia. MESA involves the cutting open of the scrotum to retrieve sperm. The wound is closed with dissolvable stitches. Swelling and pain subsides within a few days, during which prescribed painkillers may be taken to ease the pain...

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Cryopreservation

Oocyte Freezing

Recent advances in the In Vitro Fertilization process have now allowed us to successfully freeze, store and later thaw and fertilize cryopreserved human eggs. Oocyte cryopreservation is aimed at three particular groups of women: those diagnosed with cancer who have not yet begun chemoterapy or radioteraphy; those undergoing treatment with assisted reproductive technologies who do not consider embryo freezing an option; and those who would like to preserve their future ability to have children, either because they do not yet have a partner, are not ready to have a baby yet but would like to keep this option for future, or for other personal or medical reasons.

The egg-retrieval process for oocyte cryopreservation is the same as that for in vitro fertilization. This includes several weeks of hormone injections and hormonal contraception in order to stop ovulation, followed by more hormone injections to stimulate ovaries and ripen multiple eggs. When the eggs have matured, additional hormone is given and the eggs are removed with an ultrasound-guided needle through the vagina. The procedure is conducted under sedation. The eggs are immediately frozen.

Frozen eggs can be stored for as long as the patient wishes, but this must be stated precisely, otherwise, frozen eggs that are not used within a two-year period are discharged.

Embryo Freezing

Embryo Cryopreservation (embryo freezing) is the freezing of "excess" embryos for use in future IVF cycles. This option is often explored by couples undergoing IVF treatment where the excess embryos that will not be transferred into the uterus are frozen for future use if the IVF attempt fails. Even when the IVF attempt does not fail and the couple is able to conceive, the frozen embryos can be used for the second pregnancy. The major advantage to using cryopreserved embryos in future IVF cycles is that the female does not have to undergo ovulation induction, which also dramatically reduces medication cost. Success rates are variable depending on patient characteristics and embryo quality.
 

This could also be an option for couples who do not wish to get pregnant immediately but would like to prepare their embryos in advance for future use. This way, they can avoid lower success rates of conception at older age. 

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Cytoplasmic Transfer

Cytoplasmic transfer is one of the latest innovations in IVF treatment. Even though cytoplasmic transfer in itself is not a treatment method, it is a procedure than can be used alongside with IVF. The main purpose of cytoplasmic transfer is to aid women who suffer from infertility due to deficient or damaged mitochondria, contained within an eggs cytoplasm.  Deficient mitochondria can lead to recurrent implantation failures and high levels of embryo fragmentation, which are causes of poor embryo development, and therefore,  a failed IVF cycle.  

Damage to mitochondria is often observed at higher ages, therefore, women in late 30s or early 40s are more prone to IVF failures due to compromised mitochondria. Cytoplasmic transfer uses the patient's own eggs but also requires a younger patient so that a healthy cytoplasm can be obtained for cytoplasmic transfer to take place. The younger patient's cytoplasm helps rejuvenate the patient's eggs and can increase the chances of success accordingly.

At North Cyprus IVF, we offer cytoplasmic transfer in order to give you a few more percentages of success. Make sure to ask us about our cytoplasmic transfer option to find out if you are suitable for this program.

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Male Infertility Problems

 Infertility in men is most often caused by:

1- Problems making sperm, which means producing too few sperm or none at all

2- Problems with the sperm's ability to reach the egg and fertilize it, which could be the case where abnormal sperm shape or structure prevent it from moving correctly

Sometimes a man is born with the problems that affect his sperm. Other times problems start later in life due to illness or injury. For example, cystic fibrosis often causes infertility in men. The number and quality of a man's sperm can also be affected by his overall health and lifestyle. Some things that may reduce sperm number and/or quality include:

- alcohol

- drugs

- environmental toxins, including pesticides and lead

- smoking cigarettes

- health problems

- medicines

-radiation treatment and chemotherapy for cancer

-age

In some cases, even if sperm production is not sufficient enough to produce sperm through ejaculation, minor surgical procedures like TESA and MESA can be used to retrieve the sperm. In the cases where the sperm is unable to reach and fertilize the egg, ICSI is used for assisted fertilization. In other cases where no sperm can be found or the quality is exceptionally low, using donor sperm becomes the only alternative.

Semen Analysis

With the aid of a semen analysis, sperm can  be categorized in the following groups:

Azoospermia: Nearly or no live sperm cells in semen

Oligospermia: Low count of live sperm cells

Asthenospermia: Low motility

Terathospermia: Low morphology

Fertile: No problems with count, motility or morphology

Sub-Fertile: Slight male factor infertility.

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2011's Last Bundles of Joy!