Male Infertility, Varicocele, and Diagnostic Methods
Male Infertility, Varicocele, and Diagnostic Procedures
In approximately half of the cases involving difficulties in conceiving (infertility), the problem stems from the male reproductive system. If a couple is unable to achieve pregnancy despite having regular, unprotected sexual intercourse for one year, the male partner must be evaluated by an andrologist.
Diagnostic Methods in Andrology
For proper infertility treatment, it is essential to accurately identify the root cause of the problem (is it a reproductive dysfunction, a blockage in the fallopian tubes, or a hormonal issue?). The diagnostic steps followed at our clinic are as follows:
- Andrological Physical Examination: This involves assessing the size and consistency of the testicles, manually checking for the presence of varicocele, and examining the general genital anatomy.
- Sperm Analysis (Spermiogram): This is the most fundamental diagnostic tool in the evaluation of male infertility. Through microscopic examination, sperm count, motility, structural characteristics (morphology), and viability are assessed. The sample is collected under sterile conditions in accordance with medical protocols.
- Hormonal and Genetic Blood Tests: The brain-testis axis, which regulates sperm production, is assessed by measuring testosterone, FSH, LH, prolactin, and thyroid hormones in the blood. In cases of severe sperm deficiency (azoospermia), genetic testing is performed.
- Radiological Imaging (Scrotal Color Doppler Ultrasound): The testicles, epididymal tissue, and vascular structures are examined using ultrasound waves. This procedure helps detect varicoceles, hydroceles (fluid accumulation), or undescended testicular tumors.
Varicocele: The Most Common Preventable Cause of Infertility
Varicocele is the abnormal enlargement and twisting of the veins in the scrotum (it is the testicular equivalent of varicose veins in the legs). It is diagnosed in approximately 40% of male infertility cases.
The dilated veins cause an increase in temperature and a buildup of toxic blood around the testicles, impairing sperm production and quality. It can also cause dull pain and swelling in the testicles. Once diagnosed, the veins are ligated using a safe surgical method called Microsurgical Varicocelectomy, performed with a surgical microscope. Following the procedure, improvements in sperm parameters and pregnancy rates are observed in a significant proportion of patients.