Male Fertility

Male Factor Fertility

Micro-TESE
In the case of men who do not have sperm in their ejaculate fluid ( azoospermia), one of the major options for them is to go directly to the testicles and look for any small areas of sperm production. This is called microdissection testicular sperm extraction, or “micro-TESE”. At CRAFT, we’ve helped over 3800 azoospermia men who had absolutely zero-sperm count to have their own child.
The testicles are s exposed, and systematically inspected under the operative microscope to locate any small areas where sperm are being produced within the testicle. At CRAFT, we use very high magnification to find the innermost sperms, multiple areas are sampled and immediately examined to see if any sperm are present. Once we find a sperm , the same are used for Intracytoplasmic Sperm Injection (ICSI) .
The microTESE success rate is quite favorable for men. In fact, doctors are able to find sperm approximately 60 percent of the time during microTESE procedures.
Micro-TESE
Male fertility
3800 live childbirths from men with absolutely zero sperm count
Diagnosis and Medical Management of Male Factor Infertility:
Dr. C. Mohamed Ashraf MD DGO DPS (Germany)
Chief Infertility Specialist
Dr. Antony Thomas MS MCH(Urology)
Uro Andrologist & Sexologist
  • Micro-TESE
  • Micro varicocelectomy
  • Treatment of erectile dysfunction
  • Penile implant surgeries

Andrology & Sexology

Addressing Male Infertility Treatment
To address the increased male infertility complications, CRAFT has a fully-fledged Andrology and Sexology department, headed by Dr. Sandeep Prabhakaran MS (PGI) MCh-Urology (SGPGI) Consultant Uro Andrologist & Sexologist. CRAFT is the only centre in India to do Micro TESE-ICSI, which is very effectively used in case of Non-obstructive Azoospermia, where the conventional TESE-ICSI or PESA–ICSI are not effective. We had several successful pregnancies for women with partners who were strongly advised for donor or with failed donor IVF cycles.
Reproductive Urology
  • Clinical Evaluation of Male Infertility
  • Laboratory Evaluation of Male Infertility
  • Basic Semen Analysis & Culture
  • Sperm Function Test
Andrology & Sexology
I. Advanced Semen Testing
  • Estimation of Seminal ROS (Reactive Oxygen Specimen)
  • Estimation of DNA Fragmentation in Sperms (DFI)
  • Genetic Testing
  • Karyotyping
  • Microdeletion in ‘Y’ chromosome (PCR)
II. Imaging Studies Ultrasound Scan 2D
  • Scrotal Ultrasound Color Doppler
  • Trans sectal Ultrasonography
  • Abdominal Ultrasonography
  • Vasography-asses Patency of Male Genital Ductal System
Male infertility
Male infertility
Male factor infertility is responsible for about 50-55% of all infertility cases. Despite its high prevalence, not much effort has been made at tackling this problem. We at CRAFT, offer a holistic and comprehensive treatment plan for male infertility – which could be low or zero sperm count , motility issues, surgical problems like varicocele, infections or sexual problems.
We have an expert team comprising of Reproductive endocrinologists, Andrologists, ,Radiologists, who will offer you quality care and support.
What causes male infertility?
There may be any number of conditions affecting the sperm count, or the condition of the sperm, and how sperm gets to where it needs to be. Hormonal and chromosomal issues could be impacting your ability to conceive, and something as seemingly innocuous as our lifestyle can impair fertility. Here are some of the more common causes of infertility
  • Life style factors – Smoking, Tobacco use, Dietary practices like increased consumption of junk and high calorie food, excess caffeine consumption, Excessive alcohol, Occupational hazards like exposure to pesticides, excessive use of mobile phones and laptops. Obesity and stress. All these can bring down your fertility potential.
  • Surgical problems Varicocele, Inguinal hernias, hydrocele, undescented testes
  • Infections
  • Hormonal imbalances- Hypogonadism, Thyroid problems, Hyperprolactinemia
  • Sexual problems like Errectile dysfunction, Loss of libido ,Premature ejaculation, Anejaculation
Evaluation of Male
We believe in individualized treatment protocols and for which evaluation of male partner is absolutely essential. Our team makes sure that this is not just limited to a routine semen analysis, but includes
A comprehensive analysis of your history,
Clinical examination,
Advanced sperm tests like SPERM DNA FRAGMENTATION
INDEX,VITALITY TESTS Hormonal tests Radiological investigations like Scrotal Doppler, Penile Doppler, Trans Rectal Ultrasound .
Genetic tests – Karyotyping, Tests for Y chromosome Micro deletions Correction of even subtle sperm quality abnormalities is essential before you embark on ICSI treatment..
Advanced Semen Testing
SPECIAL INTERVENTIONS IN ICSI LAB TO TACKLE MALE INFERTILITY
What we offer?
We bring under one roof, the complete evaluation and treatment for male infertility.
SURGICAL RETRIEVAL OF SPERMS IN AZOOSPERMIA
MICRO SURGICAL PROCEDURES –MTESE, MICROSCOPIC VARICOCELE SURGERY
MEDICAL MANAGEMENT
TREATMENT FOR SEXUAL PROBLEMS
SPECIAL INTERVENTIONS IN ICSI LAB TO TACKLE MALE INFERTILITY
Selecting the right sperm for ICSI is of paramount importance to give you good embryos and a healthy baby. We find that many a times sperm abnormalities are be the reason for poor quality embryos in your previous failed cycle
Our embryologists with their precise skill and expertise use advanced methods of sperm selection for the ICSI procedure. This includes
  • Double Density Gradient Centrifugation
  • MACS( Magnetic Assisted Cell sorting )
  • ZYMOT
Our lab also make use of advanced techniques like Oocyte Activation using Calcium ionophore to improve fertilization rate in males with severe sperm abnormalities like Absolute Teratozoospermia .
SPERM FREEZING
Men are able to freeze their sperm for use in their own future treatment. The process of sperm banking, otherwise known as sperm freezing or cryopreservation, is a great way for couples (or single folks) to preserve their chances of conceiving a biological baby in the future — especially if the partner with testes is in a high-risk profession or about to undergo certain medical procedures or treatments.
FERTILITY PRESERVATION
SPERM FREEZING
Medical Management of Male infertility
• Endocrine Management of Hypogonadism
• Hyperproclactinoma
• Excess Androges/Oestrogen
• Idiopathic Infertility with Pharmacologic Therapy
Surgical Management of Male Infertility
• Testis Biopsy – Microsurgical Technique
Obstructive Azoospermia
• Vasal Reversal by
  • Vaso Vasostomy
  • Vaso Epididymostomy
• Trans Urethral Resection of Ejaculatory Duct in ED Obstruction (Obstructive Azoospermia)
• Microsurgical Epididymal Sperm Aspiration (MESA)
• Percutaneous Epididymal SPERM Aspiration (PESA)
• Testicular Sperm Aspiration (TESA)
• Testicular Sperm Extraction (TESE)
Non Obstructive Azoospermia
• Conventional TESE
• icro TESE (Microscopic Testicular Sperm Extraction)
Peculiarity of Micro TESE
• To obtain Sperms in Non Obstructive Azoospermia (NOA)
• Failed Conventional TESE also benefited
• Use of Karl Zeiss Operating Microscope X 25 magnification, High end designed for Urogenital Surgeries
Male with
• Kline Felters Syndrome
• Idiopathic Azoospermia
• ‘Y’ Chromosome Microdeletion
• Impaired Testicular Pathology
  • Hypo Spermatogenesis
  • Maturation Arrest
  • Sertoli only cell histology
Varicocele Surgery
Optional: Laparoscopic Varicocelectomy/Conventional/Microsurgical
Suggested: Microscopic High Magnification Karl Zeius Sub Inguinal – X 25 Magnification
Varicocelectomy
Peculiarity: Lymphatic sparing Testiculary Artey sparing very least chance of recurrence and highest success rate
Andro & IVF LAB
• Sperm Banking Cryopreservation / Vitrification
  • For Cancer Patient
  • Before submitting to Radio/ Chemo Therapy
  • Hypogonadal Male
  • For Transplant Patient on Immune Suppressant etc.,
• Oocyte Vitrification
• Embryo Vitrification
• Prenatal Genetic Diagnosis (PGD)
SEXOLOGY
Erectile Dysfunction
• Clinical Evaluation
• Laboratory Evaluation
Specialized Evaluation and Testicular Assessment
• Penile Triplex Doppler
• Combined Intracavernosal Injection and Stimulation
• Dynamic Infusion Cavernosometry and Cavernosography
Periscope
• Overall Estimation of Vascularage
• Penile Brachial Pressure Index
• Dynamic Infusion Cavernosometry and Cavernosography
Psycho Physiologic Evaluation
• Electro Penogram/Rigiscan for Nocturnal Penile Tumuscene and Rigidity Monitoring (NPTR)
• Audio Visual and Vibratory Stimulation
• Psychologic Evaluation
Psychologic Evaluation
• Functional Ejaculatory Dysfunction
• Neurogenic An Ejaculation
• Retrograde Ejaculation
• Retrograde Ejaculation
  1. Treatment Modalities
  1. Medical
  2. Vibro Ejaculation
  3. Electro Ejaculation
Medical Management
• Penile Pharmaco Therapy
• Medical Devices – Vacuum Erection Device
• Venocele- Penile Occlusion
• Extra Corporeal Short & Shock Ware Lithotripsy (Non Responders to Medical Management)
Penile Prosthetic Surgery
• Indian Prosthesis
• Inflatable Two Pieces
• Three Pieces Prosthesis
Others
• Conventional Circumcision
• Cosmetic Circumcision
• Frenulo Plasty
• Glanuloplasty
• Venous Leak Surgery in selected cases
• Penile Reconstruction
• Dorsal Neurectomy in selected cases for Pre Mature Ejaculation
• Priapism
• Peyronies Disease
Orichiopexy for Undescended Testis
• Conventional
• Laparoscopic
• Hernia (Open & Laparoscopic) and Hydrocele Surgeries
Men’s Health
• Hypogonadism in Young
• Gynaecomastia (Male Breast Enlargement)
• Androgen Deficiency in aging Men
• Prostate Health in Urological and Andrological Perspective
Sexual Medicine
• Hypoactive Sexual Disorder
• Sexual Arousal Disorder
• Orgasmic Disorder
• Sexual Pain Disorder
• Sexual Orientation Issue