Treatment is based on the cause
1. Sexual problems
Sexual problems include erectile dysfunction (impotence) or
premature ejaculation. These can be treated with variety of options
like use of medications, behavioral therapy etc.
2. Too few sperm/Sperm movement
The treatment options depend on the cause. It may be due to
infection, injury or a block in a man’s system which makes the semen
not to have any sperms. The options may include the following:
-Use of antibiotics to clear up infection: If the underlying cause of the
problems, especially related to too few sperm is infection, then an
appropriate antibiotic would be prescribed to clear up the infection.
-Correction of epididymal blockage: The epididymis is a coil-like
structure in the testicles that helps to store and transport sperm.
Sometimes the epididymis becomes blocked, preventing sperm from
being ejaculated normally. If this is causing infertility, surgery to
correct the blockage can be performed.
-Repair of Varicoceles: Varicoceles (like varicose veins of the testes)
that occur in young men (aged less than 25 years) may be repaired
surgically.
3. Surgical extraction of sperm: Surgical extraction of sperm may be
an option for men with:
-An obstruction which prevents the release of sperm, such as an injury
or infection
Congenital absence of the vas deferens (men born without the tube
that drains the sperm from the testicle)
- Vasectomy
Surgery may be considered if an older man has an abnormal sperm
count and his partner has no obvious problems.
- Testicles which produce very low numbers of sperm (non-obstructiv
e azoospermia)
The procedure can be carried out in two ways:
- Percutaneous epididymal sperm aspiration (PESA): In this
procedure, sperm cells are collected through a fine needle directly
from the epididymis (where sperm is stored)
- Testicular sperm extraction (TESE): This technique involves
collecting sperm cells from a biopsy from the testicular tissue after
making a small incision in the scrotal skin
Any material with sperm will be frozen and placed in storage for use at
a later stage. If surgical retrieval of sperm is successful, usually
enough sperm is obtained for several cycles of treatment.