Infertility due to unexpected causes

On June 27, Dr. Vu Duc Cong, Men's Health Center, said that he had just received a patient from Binh Duong, in good health. Although they still had sex regularly 2-4 times a week, after 2 years of marriage, the couple still had no "sweet fruit".

That prompted him to go to a urologist. When he received the results of the semen analysis, he could not believe that there was not a single sperm in the semen sample. Not stopping there, the patient was stunned when the doctor informed him that his two testicles had shrunk, the size of which was only equivalent to that of a child.

According to statistics in Vietnam, the normal volume of the testicles is from 12-25 ml. Cases where the testicles have a volume of less than 12 ml are considered small testicles. Because the testicles are oval in shape, they will be measured with a special ruler called Prader. The rulers are egg-shaped plastic bars with different sizes corresponding to 1 - 2 - 3 - 5 - 6 - 8 - 10 - 12 - 15 - 20 - 25 - 30 ml. With this ruler, doctors can measure the volume of the testicles with the most specific and accurate numbers.

According to the patient, his testicles used to be quite large. But after experiencing a 2-week orchitis, he noticed that his testicles were getting smaller. Apart from the change in size, testicular atrophy does not cause discomfort to the patient, so over time the patient forgot about this symptom.

A case of testicular atrophy treatment at the Andrology Center, Viet Duc Hospital (Hanoi). Photo: NLDO

Doctor Cong said that orchitis causes the internal structures of the testicles to be destroyed. Therefore, usually after the inflammatory stage, the testicles will atrophy. In addition, there are many other causes of testicular atrophy such as genetic diseases; orchitis due to mumps; varicocele ; reproductive endocrine system.

According to Dr. Cong, testicular atrophy has many causes, and each cause has a different treatment. For patients with testicular atrophy but stable sperm quality, the doctor will prescribe oral medication. Conversely, in cases of testicular atrophy where there is no sperm in the semen sample, the extent of testicular damage must be assessed before deciding on surgical intervention.

In this patient's case, the results of screening tests showed that his testicles were quite severely damaged, so the possibility of finding sperm through natural ejaculation was very low. The patient was indicated for microsurgical sperm retrieval (MicroTESE) to extract sperm from intact seminiferous tubules.

Before the surgery, the patient was treated with medication by Dr. Cong to increase the chance of finding sperm for 6 months before the surgery. Finally, thanks to perseverance and luck, the couple smiled after 2 hours of surgery. The number of sperm was enough for in vitro fertilization.

"Although not many people are as lucky as patient H. to be successfully treated, this is also a hope that opens up the opportunity to become fathers for those who are unfortunate enough to suffer from testicular atrophy," said Dr. Cong.

Healthy testicles help men maintain their health. Therefore, Dr. Cong recommends that men should spend more time taking care of this important organ carefully and quickly go to the doctor when there are unusual signs, especially when they see the testicles gradually shrinking over time.

Source: https://nld.com.vn/suc-khoe/vo-sinh-vi-nguyen-nhan-khong-ngo-20230627105943833.htm