Infertility, in general, is a reproductive disease in a man or a woman, referred to as the inability to achieve pregnancy after continuous tries for a period of 12 months, or more. This can be either primary, meaning the couple has never been able to get pregnant, or secondary, where they have achieved at least one pregnancy before but are now unable to do so. In the past, infertility was widely associated with only the woman’s inability to conceive but male infertility is now identified as a common cause of failure in pregnancy. It is reported that (30-40%) 1 in 3 cases of infertility in a couple is due to male infertility. The reasons associated with female or male infertility correspond to their unique anatomies of the reproductive system. There are multiple causes behind male infertility, some of which include ineffective sperm delivery such as in retrograde ejaculation, altered levels of testosterone (male sex hormone), and low or no sperm count also known as oligospermia and azoospermia, respectively, usually due to varicocele. While in a few cases, male infertility treatment is of no help, in other cases the answer to the question whether male infertility could be reversed is a big YES!
Pampiniform plexus is a bundle or network of veins in the spermatic cord which connects the vessels in the testicles to the abdominal cavity. Veins comprise valves that avoid the backflow of blood but sometimes, valvular dysfunction may cause blood to accumulate in some veins of the pampiniform plexus. Veins of the pampiniform plexus play an important role in thermoregulation as they cool down the artery around the testes. When the flow is disturbed, the elevation in temperature brings about several downstream effects. A varicocele is damage or lesion in the veins of the pampiniform plexus which causes them to dilate and inflame. Varicoceles are mostly observed on the left side of the scrotum where the left testicular vein combines with the left renal vein. The left side of the scrotum already receives greater blood flow, but this angular anatomy causes blood to flow against gravity. In some cases, bilateral varicoceles have also been reported, but an isolated right varicocele is rather rare. In general, about 15% of males suffer through varicoceles with greater incidence found in males who have just reached puberty. Varicoceles affect spermatogenesis not just by an elevation in temperature, but also due to oxidative stress from oxygen-free radicals. In the latter case, DNA modifications in the sperm become inevitable and greatly affect fertility.
The burning question in every individual’s mind who is suffering from varicocele is about the varicocele treatment and whether it is treatable without involving surgery. Varicocele male infertility treatment is advised to patients with varicocele that is associated with symptoms. Asymptomatic varicocele does not require any treatment since they are considered harmless. It is widely observed that the conventional methods of surgery used to treat varicocele are now being rendered unsafe and treatment for varicocele without surgery is the way to go forward. All surgical procedures including open microsurgical scrotal varicocelectomy, open inguinal varicocelectomy and sublingual varicocelectomy are all highly invasive and have a very high recurrence rate. Today, non-surgical alternatives are being considered by both doctors and patients. The treatment being employed without surgery is known as the embolization method.
3-D Precision Guided Varicocele Treatment by Dr. Imtiaz Ahmad:
Treatment for varicocele without surgery
3-D Precision Guided Varicocele Treatment by Dr Imtiaz Ahmad is one of the most advanced and precision-guided ways of treating varicocele, in this treatment one of the component is varicocele embolization, which is a catheter-directed procedure that involves radiological intervention in which the catheter is passed through the femoral vein or jugular vein in the neck and guided towards the testicular/gonadal vein. A contrast dye is then introduced to visualize the damage in the veins, which enables an easy correction procedure using selective catheters/microcatheters and exactly the same equipment and devices that are used in Neurosurgical procedures. The blood flow to the damaged vein is then blocked by a well-titrated mixture of FDA approved medications(only authorized to be used by certified and US-licensed physicians)to block the flow through an abnormal vein during real-time fluoroscopy (under x-rays guidance), which immediately stops blood flow and reduce the pressure being formed at the varicocele and around the testis. The blood flows through a different normal vein along the normal route, only this time, the varicocele is completely cured and the complications are thus solved. The entire procedure takes about 45-60 minutes under local anaesthesia and moderate conscious sedation which has gained a lot of patient compliance as opposed to the surgical techniques, where the recovery time alone is of 2 to 3 weeks. Reports have suggested sperm count improvement in about 83% of patients post embolization method, versus 63% via surgical ligation.
The old technology (30-40 year’s old) of placing coils and sclerosant chemical foam has been abandoned for this treatment.
In a nutshell: Can male infertility be reversed?
Yes, it can. However, time is a big factor here. The damage caused by varicocele may become irreversible if the symptoms are ignored and treatment delayed. This only leads to lifelong regret if the person plans on becoming a father. A healthy lifestyle including conscious management of weight and detachment from smoking, drinking and drugs can prevent varicocele and male infertility.
Dr. Ahmad has been practicing in the health care industry for more than 20 years.
In 1995 he completed his fellowship at Northwestern University Chicago Illinois USA.