Erkek İnfertilitesinin Cerrahi Dışı Tedavisi: Spesifik Tedavi

Evli çiftlerin yaklaşık %15’i fertilite incelemesine maruz kalmaktadır. İnfertilite vakalarının yaklaşık olarak yarısında erkek faktörü bulunmaktadır. Son yıllarda üreme tıbbında çok sayıda ilerleme kaydedilmiştir. Daha önce tedavi edilemez olduğu düşünülen infertil çiftlerin artık genetik olarak babalık şansı olmaktadır. Her ne kadar şiddetli erkek faktörü bulunan vakalarda yardımcı üreme teknikleri ile sorunu çözmek mümkün ise de, bütün infertil eşlere bu tedavi yöntemlerini uygulamak fazladan tedavi olur, maliyet yükselir ve kadın partnerde ovaryen hiperstimülasyon gibi nadir ancak ciddi riskler meydana gelebilir. Herhangi bir androlojik tedaviden önce ciddi bir tanısal çalışma yapılmalı ve seçilmiş vakalarda yeterli tedavi opsiyonları sunularak, tedavi kişiselleştirilmelidir. Öncelikle infertilitenin etiyolojik nedenine yönelik spesifik terapötik tedavi denenmelidir. İnfertilitenin spesifik medikal tedavisi, geriye dönüşlü infertilite nedenlerinin ortaya çıkarılması ve uygun ilaçlar ile tedavi edilmesi esasına dayanmaktadır. Konjenital hipogonadotropik hipogonadizm gibi hormonal bozukluklar, hiperprolaktinemi, genital sistem enfeksiyonları ve cinsel fonksiyon bozuklukları gibi infertilite nedenlerinin tanısı kolaylıkla konulabilmekte ve cerrahi gerektirmeyen medikal yöntemlerle başarılı bir şekilde tedavi edilebilmektedir. Bu derlemede, erkek infertilitesinin geriye dönüşlü nedenleri ve cerrahi dışı spesifik medikal tedavi yöntemleri mevcut literatür ışığında tartışılmıştır.

Anahtar Kelimeler:

Erkek infertilitesi, cerrahi dışı, spesifik tedavi

Nonsurgical Treatment of Male Infertility: Specific Therapy

Approximately 15% of married couples undergo a fertility examination. Approximately half of the infertility cases have a male factor. Numerous advances have been made in reproductive medicine in the last few years. Infertile couples who previously were considered untreatable now have a chance at genetic paternity. Although it is possible to solve the problem with assisted reproductive techniques in cases with severe male factor, applying these treatment methods to all infertile partners is extra treatment, the cost increases, and rare but serious risks such as ovarian hyperstimulation may occur in the female partner. Prior to any andrological treatment, a serious diagnostic work-up should be performed and treatment should be individualized, providing adequate treatment options in selected cases. Primarily, specific therapeutic therapy directed against the etiological cause of infertility should be attempted. Specific medical treatment of infertility is based on identifying the causes of reversible infertility and treating it with appropriate drugs. Infertility causes such as hormonal disorders, i.e. congenital hypogonadotropic hypogonadism, hyperprolactinemia, genital tract infections, and sexual dysfunctions can be easily diagnosed and successfully treated with medical methods that do not require surgery. In this review, reversible causes of male infertility and nonsurgical specific medical treatment methods are discussed in the light of the current literature.

Keywords:

Male infertility, nonsurgical, specific therapy,

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