怎样治疗男性不孕不育

如何治疗男性不孕不育配图，仅供参考

1.1.3. Treatments
The therapeutical approach to male infertility depends on the underlying causes and includes medical and surgical treatments . Medical treatment of male infertility mainly involves hormonal treatment,which is based on the use of gonadotropin-releasing hormone (GnRH),gonadotropins,testosterone,dopamine agonists,aromatase inhibitors (AI),and selective estrogen receptor modulators (SERMs) .
Men affected by hypogonadotropic hypogonadism related to a reduced secretion of GnRH from the hypothalamus can be treated with GnRH therapy . The pulsatile administration of GnRH stimulates the anterior pituitary to release gonadotropins,with the re-establishment of the hypothalamus–pituitary–gonadal (HPG) axis leading to high levels of testosterone and stimulation of Sertoli cells by the FSH . In about 85% of patients treated with pulsatile GnRH,spermatogenesis is induced .
The administration of gonadotropins can be useful in men with hypogonadotropic hypogonadism related to pituitary dysfunction. It has been shown that gonadotropin therapy induces spermatogenesis in about 80% of patients . Dopamine agonists are used for the treatment of male infertility associated with prolactin-secreting pituitary adenoma . SERMs are indicated for the treatment of idiopathic infertility . Their action is based on the inhibition of central estrogen feedback upregulating the production of pituitary gonadotropins . Surgical therapy for male infertility is indicated mainly in men with obstructive azoospermia (OA) .
When treatment has failed or no specific treatment is available for the condition underlying male infertility,assisted reproductive technologies (ARTs) are indicated . Among them,the most used and successful are intrauterine insemination (IUI),in vitro fertilization (IVF),and intracytoplasmic sperm injection (ICSI) .
IUI is a technique that involves the introduction of spermatozoa through the cervix using a catheter . This technique is indicated in case of mild male infertility or unexplained infertility . However,IUI needs a good semen quality and thus it is not fully indicated for “idiopathic oligozoospermia and asthenozoospermia or in men affected by retrograde ejaculation and anejaculation .
IVF facilitates fertilization by bringing the spermatozoa close to the oocyte occurring outside the female body. IVF techniques usually include (i) a transvaginal ovum retrieval whereby a small needle is inserted through the back of the vagina and guided via ultrasound into the ovarian follicles to collect the fluid that contains the eggs and (ii) an embryo transfer whereby one or several embryos are placed into the uterus of the female with the intent to establish a pregnancy.
ICSI is the treatment of choice in case of IVF failure and it consists of the injection of a single spermatozoon directly into the oocyte’s cytoplasm . It can be used with ejaculated sperm,epididymal sperm,or testicular sperm. Retrieved epididymal or testicular spermatozoa are often cryopreserved to avoid repeated aspirations or biopsy in case of ART failure .","department":"