+ Infertility?

Infertility and subfertility are two different concepts. Infertility refers to a state in which reproductive function has certain deficiencies and needs medical assistance. Subfertility refers to a condition in which a couple who has no problem with reproductive function is unable to become pregnant even if they continue normal marital relationship for one year. The term "normal marital relationship" as used here refers to a marital relationship that regulates a male's ejaculation cycle and calculates a woman's ovulation date.

Statistics show that if a married couple has a normal marital relationship without contraception, the probability of becoming pregnant within one year is about 80-90%. Couples who want to get pregnant will get a lot of stress if they are not able to achieve it. This stress again makes the pregnancy difficult by breaking down the balance of life.

Especially stress is a major cause of infertility and subfertility and it can cause ovulation disorder, fallopian tube disorder and uterine spasm. Therefore, it is important for women to relax their minds. Not only women but also stress affects men. Erectile dysfunction caused by stress makes it difficult to have intercourse, and it also has a negative impact on the production of healthy sperm. In other words, all married couples should be patient to have a child.

+ The Male Factor

Statistics shows that subfertility causes are more in men than women. There are a variety of reasons caused by males, which can be largely divided into inherited factors and acquired factors.

[Inherited factors]

  • If you have a paternal family history
    It is difficult to get pregnant by heredity.
  • Taking maternal medication during pregnancy
    A male has lost reproductive function or has become defective due to abnormal growth by drug taken by mother during her pregnancy.
  • When the testicles were not transferred to the scrotum at birth
    The testicle is not functioning because it’s not located in right position

[Acquired Factors]

  • Varicose veins
    If the vein, which is the passage of blood, is blocked by pressure or obstruction, the part of the vein inside is abnormally enlarged. This is because the blood supply to the living area is not smooth and the normal activity of the germ cell is not done.
  • Thyroid disease
    Thyroid disease that occurs in the thyroid gland that secretes human hormones can cause abnormalities in hormone secretion, which can also affect fertility control.
  • Multiple radiotherapy experience
    Frequent exposure to radiation can cause various cell abnormalities.
  • Long-term smoking and drinking
    Smoking and drinking for many years impairs the function of the human body and lowers fertility.
  • Exposure to long-term environmental hormones (environmental toxins)
    When abnormal hormones (environmental hormones) enter the body, they interfere with the normal hormone action and physiological function.
  • Reduction of sperm ejaculation due to frequent intercourse
    Many times a day, the amount of sperm required for pregnancy decreases, and pregnancy does not work well.
  • Testicle damage
    Damage to the testicles that produce sperm will result in loss of reproductive capacity.

+ Infertility Treatment

There are two ways to treat male males: [medical treatment / surgical treatment].

[Medical treatment]

The pharmacological treatment of male infertility revealed specific causes of male sterility and drug therapy in which specific drugs were given for each of the causative diseases such as endocrine disease, congestive heart failure, If you do not have antioxidants, anti-estrogen, etc. There are medications. The treatment period for medication usually requires a minimum of 3 months in total of 74 days required for spermatogenesis in the testes and 10-14 days for mature and sperm transport in the epididymis. During the treatment period, we perform periodic semen tests and, if necessary, hormone tests.

  1. Endocrine disorders
    Among the causes of male infertility, hypogonadotropic hypogonadism is well known as endocrine disorder disease. Causes are inherited cases such as Kalman syndrome, acquired cases as radiation therapy, and pituitary adenoma. Treatment usually takes more than one year of gonadotropin injection
  2. Pyospermia
    Pyospermia is observed in 10-20% of male infertility, and increased leukocyte levels in the semen indicate infection or inflammation in the male reproductive tract. Leukocytes promote the production of reactive oxygen which can have a detrimental effect on sperm motility and fertility. Treatment is to find the causative organism through culture tests and administration of antibiotics for 2 to 12 weeks.
  3. Anti-Sperm antibody
    Anti-sperm antibodies do not inhibit reproductive performance in all males, but high levels in infertile males are a direct cause of sperm motility or fertility problems. Therapy is to administer an immunosuppressant (steroids) to lower the activity of the antibody. If persistent antibodies are observed at high levels, they may interfere with pregnancy through intercourse or artificial insemination. In addition, micro injection (intracytoplasmic sperm injection) may be necessary because of the failure of fertilization in vitro.
  4. Retrograde ejaculation
    The retrograde ejaculation refers to a condition in which semen backflows from the posterior urethra to the bladder due to the blockage of the bladder neck during ejaculation. Causes include bladder neck surgery, diabetes, and spinal cord injury. Treatments include input of sympathetic stimulants and if you are not responding to medication, you can take sperm from the urine and try pregnancy through artificial insemination or in vitro fertilization.

Assuming no abnormalities in the function of the reproductive system that produces the sperm, it is most influenced by the healthy state of the spermatozoa in the malnutrition and metabolic status of males. In other words, it is essential to supplement the nutrients needed to produce healthy sperm to maintain normal health.

[Surgical Treatment]

  1. Anastomosis
    Vasectomies are the most common cause which is performed to correct for obstruction in the passage of sperm.
  2. Epididymostomy
    An epididymectomy involves surgical removal of the epididymis, a long coiled tube that lies in the upper portion of each testicle. It is in this structure where the sperm is matured and stored. This operation is rarely indicated and is used only as a last option in the treatment of pain. It may be advised if a chronic infection does not respond to antibiotic therapy, and for post-operative complications of vasectomy.
  3. Venous Varices resection
    It is the most common cause of male infertility due to the increase of testicular temperature and the retrograde flow of testicular toxicants. The varicose vein correction method is to divide or lengthen the increased veins, and it is divided into luminal embolization, laparoscopic surgery and incision using a microscope.
  4. Sperm extraction
    In congenital amenorrhea, congenital bilateral hypoplasia, or amniocentesis due to obstructive neurodegenerative disorders that cannot be corrected surgically, microgranulation (intracytoplasmic sperm injection) is performed in the epididymis or testis to obtain high fertilization rate and pregnancy success rate. In addition, in the treatment of nonobstructive azoospermia, which is difficult to treat to date, it is possible to find a small part of normal testicular spermatogenesis in some part of the testis, and it is possible to become pregnant through modification. In recent years, microsurgery through the surgical microscope during sperm retrieval has reduced complications such as vascular damage and has reported a higher success rate of sperm retrieval.

+ Road to Healthy Life

1. Importance of pre-pregnancy management

It is reported that 95% of women of childbearing age have one or more factors that can have a negative impact on future pregnancies. It is reported that the intrauterine fetal environment during pregnancy not only affects neonate but also affects the health and growth after birth. It is very important that couple are managed and maintained at the optimum condition before the pregnancy for the future health of the second generation. Therefore, Pre-pregnancy management is necessary to prevent genetic diseases such as neural tube defects and phenylcauteropathies, as well as helping planned pregnancy, reducing complications of women's chronic diseases such as diabetes, epilepsy and cardiovascular disease.

2. General Pre-pregnancy Preparation

In the case of an unplanned pregnancy, you will miss the time to eliminate, control, or prevent anomalies that can affect your pregnancy. Therefore, it is very important to plan ahead for pregnancy. For pregnancy, the couple should prepare together at least three months in advance. Pregnant mothers should check their ovulation cycle, control their weight, and avoid smoking and over drinking. From this time on, you would need to start taking folic acid or nutritional supplements to help you get pregnant and continue taking it even after your pregnancy. In the case of a husband, it takes about 100 days for sperm to mature and be used for pregnancy. You should try to avoid smoking and make yourself in the best condition.

3. Counseling with obstetrics before pregnancy

Young couples think they are very healthy. However, pre-pregnancy counseling mothers are often found with factors that can affect pregnancy, such as anemia, chronic illness, and gynecological disease. Therefore, even if you think you are healthy, it is recommended to counsel with doctor before pregnancy. In the case of first pregnancy, unexpected diseases are diagnosed sometimes. If you see irregular ovulation, the probability of pregnancy decreases. So it’s better to check the ovulation cycle, and if the cycle is severely irregular, you will receive treatment such as ovulation promotion.

4. Treatment of chronic diseases before pregnancy

Pre-pregnant mothers who have to take medicines or need regular injections such as insulin are in worry. Especially in older pregnancies over 35 years old, it is reported that the frequency is high. In such cases, planned pregnancy is important. First, you need to know if your condition can cover your pregnancy. If you are able to conceive, try to stop the administration of medicine or injection about one month before the time of pregnancy. If you are unable to stop treatment even during pregnancy, you should take medicines or injections that have less effect on the fetus. When pregnant, it is important to observe the progress carefully from the beginning under the cooperation of obstetrics and gynecology department.

5. Role of husband before pregnancy

Pregnancy is not just for the mother. Husbands are also encouraged to participate in the planning of pregnancy. You should check your health condition to see if there is a disease or condition that may affect sperm production. The proportion of males among the causes of infertility cannot be ignored. Therefore, the husband's health is also very important. From the pre-pregnancy period, you should try to quit smoking, quit drinking, and exercising properly to help your pregnancy.