This procedure involves embryos that are frozen in a previous cycle and can be thawed and transferred in another cycle. Success rates for FET are better than fresh embryo transfers.
In IUI the semen is collected from the partner and is prepared in the lab and then inserted into the uterine cavity at the time of ovulation to facilitate fertilisation.
In IVF the egg and the sperm are extracted and allowed to fertilise under lab conditions in a petri dish, post which the embryos are transferred to the uterus.
In ICSI, fertilisation is achieved by injecting a sperm into the egg with the help of a micromanipulator. The resultant embryo is later transferred to the uterus for implantation.
Embryos are cultured in a lab until they reach the blastocyst stage (day-5) , post which, best quality blastocysts are transferred into the uterus for implantation. This process ensures only the best quality embryos are transferred to get better success rates.
Male infertility problems such as erectile dysfunction, ejaculatory problems, varicocele, low sperm count, azoospermia, oligospermia are treated using surgical techniques such as Percutaneous Epididymal Sperm Aspiration (PESA), Testicular Sperm Aspiration (TESA).
● Occurs when a man can’t get or keep an erection firm enough for sexual intercourse.
● You may be advised to change your lifestyle, referred to a counselling session, diagnosis and treatment to help cure the situation.
● Doctor may advise you to indulge in exercise, quit smoking and drinking or suggest some therapies to be performed at home along with oral medicines.
● Physical examination: This might include careful examination of your penis and testicles and checking your nerves for sensation.
● Blood test: A sample of your blood might be sent to the lab to check for signs of heart diseases, diabetes, low testosterone levels and other health conditions.
● Urine tests (urinalysis): Urine tests are used to look for signs of diabetes and other underlying conditions.
● Ultrasound: This test is performed by a specialist. He uses a device (transducer) held over the blood vessels that supply blood to the penis. This creates a video image to let your doctor see if you have blood flow problems.
● Psychological exam: Your doctor might ask you some questions to screen for depression and other possible psychological problems of erectile dysfunction.
● Oral medications: Oral medications are a successful treatment for erectile dysfunction. Doctor will advise you on this.
● Alprostadil urethral suppository: Alprostadil intraurethral therapy involves placing a tiny alprostadil suppository inside the penis in the penile urethra. This method helps in getting erection.
● Testosterone replacement: Some men have low levels of the hormone testosterone which results in erectile dysfunction. In this case, testosterone replacement therapy might be recommended.
● Penis pumps: Battery powered penis pumps may be given for erectile dysfunction. This creates vacuum and pulls blood into your penis.
● Penile implants: This treatment involves surgically placing devices into both sides of the penis. These implants consist of bendable rods thus help to keep the penis firm and bend.
Penile cancer is a disease in which cancer cells form in the tissues of the penis. Human papillomavirus (HPV) infection may increase the risk of penile cancer. Condom use and the HPV vaccine can help prevent infection with HPV.
● Fewer than 100 thousand cases per year in India.
● Treatable by a medical professional.
● Requires a medical diagnosis.
● Lab tests and imaging always required.
Various Treatment Options are listed below:
● Most penile cancer patients have some life-changing side effects.
● Urination: If the surgery removes part of the penis or entire penis, how a man urinates might change.
● In some cases a partial penectomy leaves enough of the penis to allow relatively normal urination.
● Sexuality: The surgery may affect the way a man thinks about sex because of the way the penis looks like after surgery.
● Mohs surgery may have little effect on sex and sexual pleasures once the person has recovered.
● After total penectomy, some people give up sex, but in some cases surgical reconstruction of the penis is possible.
● In some cases when men feel stressed and depressed, counseling could come of help.
Ectopic testis are found in the superficial inguinal scrotum, base of penis, perineum, or medial thigh. In case the testis crosses the midline, the cord structures may cross intra-abdominally or after exiting the inguinal canal.
Learn about the investigations and the diagnosis
● Hormonal treatment is an option to treat undescended testicles. The hormone used is hCG (human chorionic gonadotropin.
● If your child is 6 months old, the doctor will recommend surgery.
● Orchiopexy: This is a surgery if your child’s undescended testicle is low in the belly or in the groin. In this case the testicle can be moved to the scrotum.
● FS Orchiopexy: This is a surgery done if your child's undescended testicle is high in the belly, the blood vessels attached to the testicle may not be long enough to reach down into the scrotum. This surgery is a bit different and hence the name “Fowler-Stephens” orchiopexy.
● Open Surgery or Laparoscopic Surgery: The above mentioned methods of surgery can be done either as an open surgery or a laparoscopic surgery.
● Open surgery: The surgeon makes a cut in your child’s belly or groin and scrotum to do the surgery.
● Laparoscopic surgery: The surgeon uses a tool called a laparoscope for the surgery. It has a tiny camera that helps the surgeon during the surgery. There are no big cuts in this surgery.
● Have your child avoid doing straddling activities , such as cycling (tricycle), sitting on a toy, for at least 3 to 4 weeks.
● Do not let your child do intense exercise, such as sports or physical education at school for nearly 4 to 6 weeks.
● Your child may have a shower or a sponge bath after surgery.
● The doctors use stitches that dissolve on their own in 2 to 3 weeks.
● The incision will ooze fluid for 2 to 3 days.
● Your child may have mild to moderate pain for several days after surgery.
Peyronie’s disease is caused by repeated penile injury, typically during sex or physical activity. A fibrous scar tissue inside the penis that causes painful, curved erections.
Learn about the investigations and the diagnosis
● Medication or surgery may be recommended if symptoms persist or worsen.
● Medications-- Dietary supplement and collagenase clostridium histolyticum.
● Medical procedure -- Penile traction
● Surgery -- Your doctor might suggest surgery if deformity of your penis is severe.
● Suturing the unaffected area -- suturing the longer side of the penis results in straightening of the penis.
● Incision and Excision and grafting -- In this surgery, the surgeon makes one or more cuts in the scar tissue, allowing the sheath to stretch out and the penis to straighten. The surgeon might remove some of the scar tissue. A piece of tissue (graft) is often sewn into place to cover the holes in the tunica albuginea.
● Penile implants -- Surgically inserted penile implants replace the spongy tissue that fills with blood during the erection.
● Depending upon the type of surgery you have, you might be able to go home the same day or you may need to stay overnight.
Cancer in the male organs that make male hormones and sperm (testicles).
The testicles are located inside a loose bag of skin(scrotum) underneath the penis.
Learn about the investigations and the diagnosis
● Surgery: Surgery for cancer involves the removal of the tumor and sometimes some surrounding healthy tissue during an operation.
● Radical orchiectomy or inguinal orchiectomy is the first treatment for testicular cancer. Here the testicle with cancer is removed. This operation is done through an incision done in the groin along the beltline. This surgery involves the removal of entire testicle and most of the spermatic cord.
● Chemotherapy: This is a non-surgical procedure which uses drugs to destroy cancer cells, usually by keeping the cancer cells from growing, dividing, and making more cells. Chemotherapy is given by a medical oncologist.
● Radiation therapy: Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A radiation therapy regimen , or schedule, usually consists of a specific number of treatment sessions given over a set period of time. For testicular cancer, the radiation is generally directed at lymph nodes in the abdomen for men.
● In orchiectomy, the removal of 1 testicletypically does not affect a man's testosterone level if he still has the other testicle and it is normal in size. If a man’s testosterone levels are decreased , symptoms may include depression, fatigue, decreased sex drive, inability to achieve erection, hot flashes, as well as loss of muscle and bone mass in the long term. In this case, the man can still become a father.
● In case the surgery involves the removal of both the testicles, the man will no longer produce sperm or testosterone and will not be able to biologically produce children.
● Common side effects of chemotherapy are fatigue, nausea and vomiting,numbness and tingling in the hands and feet, high pitch hearing loss and ringing in the ears. There is also a risk of severe infections. Some drugs are linked to dangerous swelling in the lungs,shortness of breath, difficulty in breathing, or a persistent cough. Some men have a higher risk of blood clots, chest pain, or swelling in 1 or both arms or legs.
● Some long lasting effects from chemotherapy are fatigue, heart problems, and secondary cancers.
● Side effects from radiation therapy may include fatigue, mild skin reactions, upset stomach, loose bowel movements and peptic ulcers.
● Radiation therapy may cause problems with sperm production but newer techniques can help men to preserve fertility.
● Radiation therapy increases the risk of secondary cancers many years after treatment and may increase the risk of heart problems and gastrointestinal disease.
Orchiectomy is a surgical procedure in which one or both testicles are removed. The surgery is typically performed as treatment for testicular cancer, in some cases of testicular torsion, and is sometimes used in management of prostate cancer. There are 2 types of orchiectomy done:
a) Simple orchiectomy -- One or both testicles removed through a small cut in your scrotum. This may be done to treat prostate cancer if your doctor wants to limit the amount of testosterone that your body makes.
b) Radical inguinal orchiectomy -- One or both testicles is removed through a small cut in the lower part of your abdominal area instead of your scrotum. This may be done if you’ve found a lump in your testicle and your doctor wants to test your testicular tissue for cancer. Doctors may prefer to test for cancer using this surgery because a regular tissue sample or biopsy, can make cancer cells more likely to spread.
c) Subcapsular orchiectomy -- The tissues around the testicles are removed from the scrotum. This allows you to keep your scrotum intact so that there is no outward sign that anything has been removed.
The surgery usually takes about an hour.
● It can take up to two months for complete recovery.
● You will be going home just a few hour after the procedure, but you will return the next day for a follow-up appointment.
● Expect to take a few days off work to recuperate.
● You also need to limit physical activity such as exercise, sex, sports and running for a month.
● Wearing a scrotum support garment for the first two days after surgery.
● Avoid lifting upto 10 pounds for the first two weeks after surgery.
● Avoiding straining during bowel movement by eating fiber.
● Redness, pus or bleeding from the incision site.
● Severe pain or loss of feeling around the scrotum.
● Fever over 100 degree F.
● If you notice hematoma (a large purple area on the scrotum which indicates there is blood in that area).
● Inability to urinate.
● Contact doctor if you notice any of the above complications.
● Loss of muscle strength.
● Osteoporosis (a condition in which the bone tissue becomes fragile as a result of hormonal changes).
● Low level of fertility (or perhaps loss of fertility).
● Loss of sex drive and inability to get or maintain an erection.
● Hot flashes.
● Weight gain.
● Depression or low mood.
● Erectile dysfunction.
● Increased risk of cardiovascular disease.