Currently, in the treatment of male infertility, the most acceptable are the following statements:
🔸 all diagnostic and treatment actions for both of married couple should be coordinated, taking into account the woman’s reproductive reserve
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🔸 attempts of the treatment should be limited in time
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🔸 eliminate all adverse factors, recommend an adequate rhythm of sexual life, improve working conditions, recommend proper nutrition. Cancel medications that are not essential and can be harmful to sperm
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🔸 if the basic disease (causative factor) is identified, the treatment should be pathogenic. In cases of idiopathic teratozoospermia it is recommended to use vitamins, antioxidants, agents that improve microcirculation
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🔸 in case of urethra or additional gonads inflammation the treatment should be carried out
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🔸 correction of cryptorchidism should be done at the age of 3 years
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🔸 detected varicocele, regardless of its severity, is a subject of surgical treatment
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🔸 during hormone therapy, the length of an uninterrupted course should correspond to 2.5 months, considering the duration of the cycle of spermatogenesis 72-76 day
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🔸 the purpose of androgen therapy of primary (hypergonadotropic) hypogonadism is to maintain a normal male phenotype and enhance sexual function. The chances of infertility correction in this situation are minimal
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🔸 antiestrogens and gonadotropins of chorionic gonadotropin, recombinant luteinizing hormone (LH) and follicle-stimulating hormone (FSH) have been used relatively successfully for the treatment of infertility due to secondary (hypogonadotropic) hypogonadism. Excessive exposure of prolactin can be blocked by bromocriptinum or dostinex
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🔸 detection of autoimmune infertility requires special treatment
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🔸 in obstructive azoospermia, attempts of immediate surgical restore of the vas deferens should be limited to uncomplicated situations that allow you to expect a relatively stable result. In other cases, considering the current capabilities of assisted reproductive technologies, attempts should be directed to extract sperm from the epididymis (PESA) or testis (TESE) followed by IVF-ICSI (in vitro fertilization) by injecting a single sperm into the egg’s cytoplasm
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🔸in case of secretory infertility, a high-tech operation can be performed using the microscope (microTESE) followed by IVF-ICSI as well.
