Andrology, which means the science of men in Ancient Greek (Andros, “man”; and -logia, “science”), is the name given to the medical specialty that deals with men’s health today.
Differences Between Andrology and Urology?
Andrology, which is considered as the upper branch of urology specialization, mainly deals with male reproductive and sexual health problems, and with this feature, it can be counted as the equivalent of gynecology in men.
Which Diseases Does Andrology Department Look For?
All diseases of the male reproductive system are diagnosed and treated by Andrology.
Major Diseases Considered by Andrology Department:
- Male Infertility (Infertility
- Varicocele (Swelling in Testicular Veins)
- Erectile Dysfunction (Erectile Dysfunction)
- Premature Ejaculation (Premature Ejaculation)
- Low Testosterone (Hypogonadism)
- Decreased Sexual Desire in Male
- Penile Curvature (Peyronie’s Disease)
- Sexually transmitted diseases
- Prostate Diseases
Andrology Department Treatment Areas
Infertility is defined by the World Health Organization as “the inability of couples to have children who have had regular sexual intercourse for at least 1 year and who do not use any contraceptive method”. Approximately 15% of married couples experience infertility problems and seek treatment. In 5% of these couples, no results can be obtained despite all treatment attempts. About half of these couples are male and half female, and various factors play a role.
For a healthy pregnancy, sperm production, sperm transport into the semen (semen) from the testicles, and thus sufficient number and quality of sperm must be found in the semen. Failure in any of these stages can lead to infertility in men.
Varicocele is the leading cause of infertility in men. Varicocele can be defined as dilation in testicular veins that disrupts testicular temperature regulation and nutrition.
Some infectious diseases (such as gonorrhea) that affect sperm production (testicular inflammation due to mumps), transport (prostate inflammation) or both also cause male infertility. Ejaculation problems, the presence of antibodies that destroy sperm in the body, some pituitary tumors that disrupt hormone production, radiotherapy, chemotherapy, failure of one or two testicles to descend into the ovarian sac in childhood or delay in stroke are other disorders encountered in men who cannot have children. Finally, hormonal irregularities, obstruction in the ducts carrying sperm, genetic diseases and some drugs used can result in male infertility. In addition to these diseases, smoking and alcohol use, obesity, previous genital infections, environmental pollution and work stress are among the conditions that increase the risk of infertility.
What Should Couples who cannot Have Children do?
Most couples have more than one cause of infertility, so both couples need medical control. The male partner of these couples, following a detailed examination, is the first to be done with semen analysis. If deemed necessary after the first evaluation by the doctor, ultrasound evaluation of the testicles, hormone and genetic tests can be performed.
If there is any cause of infertility detected after these examinations and tests, surgical treatment, treatment of infections and hormone therapy can be applied for this cause. If these methods do not help, an assisted reproductive technician is recommended to the patient.
Assisted Reproductive Techniques
A sperm concentration below 15 million per milliliter in a man is called oligozoospermia. Following the treatment of diseases that impair sperm count and quality in these individuals, if the number of motile sperms reaches 5 million, vaccination (Intrauterine Insemination – IUI) treatment is applied. After the sperm taken from the male undergo various procedures in the Andrology laboratory, it is introduced into the uterus of the female partner through a channel. Thus, the probability of pregnancy is improved by increasing the number of sperms that will encounter the egg
If the vaccination process fails or the number of motile sperms is below 5 million, in vitro fertilization (intracytoplasmic sperm injection) treatment is applied. In this treatment, the eggs collected from the female partner and the sperm collected from the male partner are combined in the laboratory using the microinjection method.
What to Do to a Man Without Sperm?
Approximately half of the couples who have infertility problems have a malfunction in the sperm parameters of men. In approximately 15% of these men, no sperm cells are found in the semen ejaculated during ejaculation.
This condition, called azoospermia, can now be treated thanks to advances in in vitro fertilization treatments. Sperm can be obtained with simple surgical interventions in men with azoospermia problem and these sperms can be used during microinjection in IVF treatment. Thus, most of the patients with azoospermia who could never have a child in the past can have healthy children thanks to the sperm obtained from the testis.
In cases where there is a disorder in sperm production in the testicle, there are several techniques developed by andrologists to obtain sperm from the testicular sperm. The easiest and quickest of these is the testicular sperm aspiration (TESA) procedure. There is no bleeding during the TESA procedure performed by inserting a needle into several points of the testicle and the patient can be discharged within a few hours
extraction (TESE) process is applied and sperm is collected by making a small incision in the testicle. If this procedure fails, the testicle is opened completely and the areas with sperm production in the testis are investigated using surgical microscopes. TESE and microscopic TESE (micro TESE) procedures are extremely safe surgical interventions when performed by competent persons, and patients are usually discharged on the same day.
Apart from these techniques, techniques called Microscopic Epididymal Sperm Aspiration (MESA) or Percutaneous Epididymal Sperm Aspiration (PESA) have been described. In these techniques, sperm is obtained from the canal system called epididymis where the sperm produced in the testicle is stored. Although some experts claim that these sperms are of higher quality than the sperm obtained from testicles, studies conducted in recent years reveal that the DNA structure of fresh sperm obtained from testis is more suitable for in vitro fertilization treatments.