Male reproductive health expertise
Fertility specialists focused on male fertility and reproductive health.
What Causes Infertility in Men?
What causes infertility in men and how can infertility be treated? Can azoospermia be treated? These are the types of questions we often receive from our patients. Infertility in men can be caused by a number of factors. The main problem that is common to all these factors is the sperm’s ability to fertilize the egg. This can be due to total absence of sperm cells in the ejaculate, genetic problems associated with the sperm cells or other problems that may contribute to a fertilization failure. Unlike female fertility, male fertility does not have the rapid rate of decline associated with age so it is possible for men to father a child through natural conception in much older age brackets. Therefore, male infertility is more involved with genetic and physiological problems rather than aging.
One common mistake when it comes to male infertility is the confusion between aspermia and azoospermia. Aspermia refers to a condition where there is no ejaculate during intercourse or via masturbation. This means there is no fluid coming out of the penis during intercourse. This is not to be confused with azoospermia, which is a condition where there is fluid coming out of the penis during ejaculation but there are no viable sperm cells that can initiate pregnancy.
In some cases, there might be live and viable sperm cells in the ejaculate, but they may not possess the necessary characteristics to allow for natural conception to occur, requiring additional treatments. In this section, we will discuss all forms of male infertility and mention available management options currently in use and on the horizon.
Stem Cell Therapy
Azoospermia can be divided into two categories: Obstructive azoospermia and Non-obstructive azoospermia. When there is an obstruction (as in the case of obstructive azoospermia), sperm cells are not able to come out into the ejaculate even though there is active sperm production. In such cases, surgical sperm retrieval methods are employed and sperm cells are extracted surgically. However, when azoospermia is non-obstructive, there is a sperm production/maturation problem. In non-obstructive azoospermia, surgical sperm extraction methods are not likely to yield desired outcomes. The other two alternatives are: Stem cell therapy or IVF treatment using a sperm donor.
If the patient is not yet ready to consider IVF treatment using donor sperm, an assessment cane be made whether he qualifies for our stem cell therapy. In our stem cell study, we use mesenchymal stem cells (from the patient’s own fat tissue). Fat tissue is extracted in a surgical procedure very much like liposuction. Once the fat tissue is extracted, further processing and laboratory work is in order to isoleate the mesenchymal stem cells. When stem cells are isolated, they are mixed with platelet rich plasma (prp), which is also obtained from the patient’s own blood sample. A mixture of mesenchymal stem cells and platelet rich plasma are directly injected into the testicles at four different locations, which are important for initiation and maturation of spermatogenesis.
You will be expected to stay in Cyprus for approximately 3-4 days for the stem cell therapy. This will give us enough time to run the necessary tests, obtain your blood sample, perform liposuction for the fat tissue and process all of them together for the injection. After injection with stem cells, there is a three month waiting period to observe the effect. Spermatogenesis (production and maturation of sperm cells) takes about 65 to 70 days. Therefore, anything that is likely to affect sperm cells will have an effect on the sperm sample after this period. If the semen analysis performed three months after the stem cell injection, an IVF treatment can be planned accordingly.
Success Rate of Stem Cell Therapy in Male Infertility
Within a short period of time since introducing this treatment, we have achieved success with a large number of patients who previously had zero sperm count in their ejaculate and who had undergone surgical sperm extraction without success. However, we have also had patients who did not responded to therapy. Therefore, while, in theory, this treatment provides all the necessary elements for re-initiating spermatogenesis, more work is required to specifically research the which subgroups of patients are likely to benefit more than the others before this treatment becomes a bullet proof technique, at least for specific male populations.
While the number of patients treated, the amount of time elapsed after treatment and how long spermatogenesis can be sustained after the stem cell therapy are all important considerations for assessing how successful the treatment is, so far, the results are indicating about 56% success rate in generating new sperm cell production in patients with non-obstructive azoospermia. These are still preliminary results and actual statistics are to be published after we have offered this treatment to at least 500 patients and have observed their semen parameters for a follow-up period of at least 2 years. It is only then when we can properly assess the initial and ongoing success of this procedure.
Success with any type of fertility treatment will depend on several conditions and generalized success rates may not always apply equally to everyone. For a customised assessment, please contact us and request more information.
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