Both spouses with non-conception should be investigated extensively. At least 0-50 of couples without children have problems in males.

Sperm test is done by taking the sample obtained by masturbation. For this test, it is ideal for the man not to ejaculate for 2-5 days. If done shortly after the number may be low, too long for men who have not ejaculated dead sperm is likely to increase. After the sample arrives at the laboratory, many parameters are examined, including fluid volume, sperm count, motility, and sperm structure (morphology). 

Sperm tests are mostly done by microscopy instead of machines and directly examined by laboratory or embryologists. This means that there may be personal differences between the tests and even different results can be obtained in the same center in the same person. This result is not surprising, and if we encounter a problematic test, we should repeat it after 3-4 weeks.

Normal sperm parameters

Varicocele

Varicocele is the most common abnormality detected by urologists. It is recommended by urologists to evaluate each patient with sperm disorder for varicocele. Varicocele dilates the vessels around the testicle, causing the temperature of the testicle to rise and this increase in temperature may impair sperm function. Therefore, urologists can connect or remove these vessels with a small surgical intervention. However, one need to be very careful about it. Varicocele surgery should be performed only if it is severe, visible findings or can be detected by examination and if there are enough clinical symptoms to cause severe pain in men. Such conditions may also increase the chances of IVF treatment. However, it is a damaging method to consider as varicocele, which has no complaints, is unclear on examination or is not visible to the eye, and is only detected by ultrasound. Both unnecessary surgery is performed, and a vein that should be removed is also removed and sometimes it may have more negative consequences on sperm. We recommend that you seek advice from a IVF Specialist before surgery.

Surgical Sperm Obtaining Methods

If there are no sperm cells in the sperm test (azospermia) or extremely low (cryospermia), it is possible to find sperm cells from the testes or sperm channels called epididymis to find healthy sperm. Sperms obtained in this way can be frozen for later use or used for fertilization of the ovos by microinjection during in vitro fertilization.

The methods applied for this purpose; 

1. PESA is a injection procedure for withdrawal of sperm from the epididymis. It is performed under local anesthesia by our experienced andrologists.
2. TESA is the name given to the application of sperm withdrawal from the testicles by injection. It is performed under local anesthesia by our experienced andrologists.
3. Micro TESE:  It is the process of obtaining sperm by magnification under a microscope. It is performed under general anesthesia by our experienced andrologists.

Hysteroscopy

Hysteroscopy is another minimally invasive surgical procedure that does not require any incision in the patient's body. In utero is evaluated through the cervix through a thin camera system. After this procedure, the patient can continue the normal life on the same day. It is frequently used in the diagnosis and treatment of problems that may prevent pregnancy in the uterus. It makes a huge contribution to the IVF treatment success.

With Hysteroscopy

• Fibroids
• Endometrial polyps
• Intrauterine adhesions (Asherman's Syndrome)
• Abnormal bleeding
• Congenital deformities in the uterus (curtain, T-shaped uterus, dysmorphic uterus, etc.)

Problems can be treated.

Laparoscopy

Laparoscopy is a modern surgical method which is very effective, comfortable and minimally damaging to both the diagnosis and treatment of infertility problems due to anatomic disorders.

Laparoscopic surgery is a closed operation performed by placing cameras and instruments to the abdomen through only a few small incisions without opening the abdomen as wide as the open surgeries. As it is understood, the reproductive organs are directly visualized with the camera system placed in the abdomen, the diagnosis is made by direct observation and if there is any problem, the problem can be solved in a closed manner.

Laparoscopy can be used to precisely control the openness of the tubes. In addition, the definitive diagnosis of endometriosis can only be made by laparoscopy.

It is used in diagnosis as well as in the treatment of the following diseases

• Endometriosis
• Ovarian Cysts
• Fibroids
• Ectopic pregnancy
• Opening or blocking the fallopian tubes; in cases where hydrosalpenx tubes are filled with inflamed fluid, this tube should be removed or closed, otherwise it may not be possible to obtain results with IVF treatments.