male infertility, diagnosis and recent management

7/28/2019 MALE INFERTILITY, DIAGNOSIS AND RECENT MANAGEMENT

1/77

GEFACKTET (

@FCFAM@MCW KH@FNM ECHMYWENEWU

Gr# TJFTJQFW O# BFCE

Fssestfct \rkhmsskr

Tjmtj X#T# Amc# Jkspetfn

FJ@MGFIFG#@ki 2 55


2/77

ECWYKG]DWEKC

Wjm cu`imr kh dkupnms fhhmdtmg iy echmrtenetyes durrmctny mste`ftmg tk im 6=-

Kh fnn dkupnms fttm`pteca tk jfvm djengrmc#

Wjm gehheduntems frm fttreiutfinm tk f seacehedfct`fnm hfdtkr fnkcm ec 4


3/77

ECWYKG]DWEKC

Wjm pre`fry dfrm prfdtetekcmr khtmc es tjmherst jmfntj dfrm prkhmssekcfn tjm pftemctsmmos

Fisknutm dretedfn ecetefn mvfnuftekc kh tjm

suihmrtenm `fnm#

Wjkrkuaj jestkry fcg pjysedfn mxf`ecftekc

Nfikrftkry tmsts. ecdnugeca ft nmfst f sm`mc

fcfnyses

Jkr`kcfn mvfnuftekc#

Fpprkpreftm tk rmhmr tjm dkupnm tk fc

echmrtenety spmdefnest#


4/77

Gmhecetekc kh )Echmrtenety) Echmrtenety es f gesmfsm ""# Wjm gurftekc kh tjm hfenurm

tk dkcdmevm sjkung im twmnvm kr `krm `kctjs imhkrmfc ecvmsteaftekc es ucgmrtfomc ucnmss `mgedfn jestkryfcg pjysedfn hecgecas gedtftm mfrnemr mvfnuftekc fcgtrmft`mct#

"" Fcy gmveftekc hrk` kr ectmrruptekc kh tjm ckr`fnstrudturm kr hucdtekc kh fcy pfrt. krafc. kr systm`. kr

dk`iecftekc tjmrmkh. kh tjm ikgy tjft es `fcehmstmgiy f djfrfdtmrested smt kh sy`ptk`s kr seacs. fcgwjksm mteknkay. pftjknkay. fcg prkackses `fy imockwc kr ucockwc2 Gkrnfcg!s @mgedfn Gedtekcfry65::27:6#

Fpprkvmg iy tjm \rfdtedm Dk``ettmm kh tjm F`mredfc Tkdemty hkrYmprkgudtevm @mgedecm *Hkr`mrny Wjm F`mredfc HmrtenetyTkdemty%. @frdj 91. 6554#

Fpprkvmg iy tjm Ikfrg kh Germdtkrs kh tjm F`mredfc Tkdemty hkrYmprkgudtevm @mgedecm *Hkr`mrny Wjm F`mredfc Hmrtenety

Tkdemty%. Buny 61. 6554#


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\YM-WMTWED]NFY DF]TMT KH ECHMYWENEWU

Jypktjfnf`ed gesmfsm

Esknftmg akcfgktrkpec gmhedemcdy *Ofnn`fcc!ssycgrk`m%

Esknftmg NJ gmhedemcdy *)Hmrtenm mucudj)%

Esknftmg HTJ gmhedemcdy Dkcamcetfn

jypkakcfgrktrkped sycgrk`ms \etuetfry gesmfsm

\etuetfry ecsuhhedemcdy *tu`krs. echentrftevmprkdmssms. kpmrftekc. rfgeftekc%

Jypmrprknfdtecm`ef

Jm`kdjrk`ftkses

Mxkamckus jkr`kcms *mstrkamc-fcgrkamcmxdmss. anudkdkrtedkeg mxdmss. jypmr fcg

jypktjyrkeges`%#


8/77

WMTWED]NFY DF]TMT KH ECHMYWENEWU

Djrk`ksk`fn fickr`fnetems *Onecmhmntmr!ssycgrk`m. ZZ geskrgmr *smx rmvmrsfnsycgrk`m%. ZUU sycgrk`m%-

Ckkcfc!s sycgrk`m *`fnm Wurcmr!s sycgrk`m%-

@yktkced gystrkpjy-

Ienftmrfn fckrdjef *vfcesjeca tmstms sycgrk`m%

Tmrtkne-dmnn-kcny sycgrk`m *amr`ecfn dmnnfpnfsef%

Akcfgktkxecs *gruas. rfgeftekc%

Krdjetes

Wrfu`f Tystm`ed gesmfsm *rmcfn hfenurm. jmpfted

gesmfsm. sedonm dmnn gesmfsm%

Gmhmdtevm fcgrkamc syctjmses kr fdtekc-

Dryptkrdjeges` Xfredkdmnm


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10/77

Jestkry kh tjm Echmrtenm @fnm

@fnm YmprkgudtevmJestkry

Gurftekc khucprktmdtmgectmrdkursm

\rmvekus prmacfcdems

\rmvekus echmrtenetymvfnuftekcs

Hm`fnmYmprkgudtevmJestkry

Fam Arfvegf+pfrf

\jysedefc!s cf`m

Kvunftekc wetjtmdjcequm tk fssmss

Durrmct stftus khhm`fnm echmrtenety

mvfnuftekc


11/77

\mrskcfn Jestkry

Gmvmnkp`mctfn

\uimrty*ckr`fn+gmnfymg+prmdkdekus%

Jestkry khucgmsdmcgmg tmstms

Jestkry khaycmdk`fstef

Turaedfn

\mnved suramry *UX

pnfsty tk infggmrcmdo. trfcsurmtjrfnsuramry%

Ecauecfn suramry*jmrcekrrjfpjy.krdjegkpmxy%


12/77

Jestkry

Tmxufn Jestkry

\ktmcdy+neiegk

Dketfn tmdjcequm We`eca fcg hrmqumcdy

kh ectmrdkursm

]sm kh nuiredfcts

Hf`eny Jestkry

Dysted heirkses

Fcgrkamc rmdmptkrgmhedemcdy

Jypkakcfges`


13/77

Akcfgktkxecs

Djm`edfn mxpksurm

*wkro. tjmrfpmuted%

T`koeca *`frebufcf.deafrmttms%

Kddupftekcfn Wjmr`fn mxpksurm

*sfucfs. jkt tuis.iremhs%

Yfgeftekc mxpksurm*wkro. gefacksted.tjmrfpmuted%

@mgedftekc

@ftmrcfn *GMT%

\mrskcfn usm

Ttmrkegs

Mcgkdrecm Jestkry

Jmfgfdjms. vesufn

gesturifcdms.fcks`ef

Mxdmssevm arkwtj khjfcgs. hmmt. bfw

Ymtfrgftekc kh jferarkwtj *hfdefn. ikgy%

Irmfst djfcams


14/77

Wjm gurftekc kh tjm dkupnm!s echmrtenetyfcg wjmtjmr kr ckt ktjmr trmft`mct

jfs immc fttm`ptmgEc tjm pfst. tjm hmrtenety mvfnuftekcs

6 ymfr kh ucprktmdtmg ectmrdkursm#

Durrmct pjenkskpjy

Mvfnuftekc kh kcm!s hmrtenety `fy prkpmrny imaecft wjftmvmr te`m pftemcts mxprmss dkcdmrc. fcg

iktj tjm `fnm fcg hm`fnm pkrtekcs kh f hmrtenetywkroup dfc im ucgmrtfomc se`untfcmkusny ec fc

mhhedemct. dkstmhhmdtevm. fcg te`mny hfsjekc#


15/77

Jestkry kh infggmr. pmnved. krrmtrkpmretkcmfn suramry

Tuaamsteca tjm pksseienety kh##

Mbfdunftkry gyshucdtekc wetj

fsskdeftmg Ecdk`pnmtm kr rmtrkarfgm mbfdunftekc#


16/77

Tmxufn jfiets

Weèca2 Wjm kpte`fn teèca hkr ectmrdkursm es

mvmry 7: jkurs ( te`m wjmc kvunftekc es `kstneomny *usufnny ft tjm hm`fnm!s ègdydnm%#

Dketfn jfiets2Dfutekcm tk usm nuiredfcts kcnyeh cmdmssfry.kcny ec neètmg f`kucts#

Tpmr`ftktkxed nuiredfcts *sudj fs OU Bmnny.Nuiehfx. Turaenuim. Omre Nktekc% fcg mvmcsfnevfdfc e`pfer spmr` `ktenety#

Ktjmr nuiredfcts. sudj fs rfw maa wjetm.vmamtfinm ken. sfhhnkwmr ken. pmfcut ken. fcgpmtrknmu` bmnny. gk ckt e`pfer ec vevkspmr``ktenety#


17/77

Djengjkkg enncmssms fcg geskrgmrs

Dryptkrdjeges`2 iktj ucenftmrfn fcg ienftmrfn.

hrmqumctny es fsskdeftmg wetj kneakspmr`ef# 4


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Wmstedunfr trfu`f kr f jestkry kh ucenftmrfn

tmstedunfr tkrsekc fnsk `fy fgvmrsmny fhhmdttjm tmstms# Fpprkxe`ftmny 4


19/77


Gmnfymg kr ecdk`pnmtm puimrty `fy rmvmfn fc

mcgkdrecknkaed mteknkay *sudj fs Onecmhmntmr!ssycgrk`m kr egekpftjed jypkakcfges`%#

aycmdk`fstef `fy fnsk suaamst fc ucgmrnyeca

mcgkdrecm prkinm`# Ienftmrfn `u`ps krdjetes mxpmremcdmg

prmpuimrtfnny smm`s tk jfvm ck mhhmdt. iut`u`ps krdjetes mxpmremcdmg pkstpuimrtfnny es

fsskdeftmg wetj smvmrm tmstedunfr gf`fam ec6


20/77

Gefimtms `mnnetus kr `untepnm sdnmrksesdfc e`pfer pktmcdy fs wmnn fsmbfdunftekc#

Wrmft`mct hkr dfcdmr fhhmdts hmrtenety#

trmftmg wetj rfgeftekc kr djm`ktjmrfpyhkr tmstes .fcy ktjmr dfcdmr es ft reso khe`pfermg spmr`ftkamcmses#

\ftemcts wetj tmstedunfr dfcdmr frmpfrtedunfrny fhhmdtmg#

\fst jestkry kh f jmrcekrrjfpjysuaamsts tjm pksseienety kh fc eftrkamcedvfsfn ecbury#


21/77

Echnf``ftkry prkdmss

Fcy echnf``ftkry prkdmss tjft ecvknvmstjm nkwmr urecfry trfdt `fy nmfg tk

fgvmrsm sdfrreca kh tjm gudtfn systm`. m#a#. mbfdunftkry gudt stmckses kr

kistrudtekc. tjft `fy fhhmdt hmrtenety#

Fcy amcmrfnezmg hmirenm mpeskgm `fytrfcsemctny e`pfer spmr`ftkamcmses#

E ten ene g * ten


22/77

E``ktenm denef sycgrk`m *ckc`ktenmspmr` smdkcgfry tk fc untrfstrudturfngmhmdt ec tjm spmr` tfen% `fy im tjm

dfusm kh echmrtenety ec tjm `fnm wetjrmdurrmct rmsperftkry echmdtekcs*Ofrtfamcmr!s sycgrk`m kr Ukuca!s

sycgrk`m%#F amcm hkr dysted heirkses es dfrremg

wetjkut tjmer ockwnmgam iy f cuìmr kh

`mc wjk `fy fnsk jfvm dkcamcetfnfismcdm kh tjm vfsf fcg smècfnvmsednms fcg. dkcsmqumctny.

F nkw mbfdunftm vknu`m fcg fzkkspmrèf#

M t n t e e


23/77

Mxpksurm tk mnm`mcts ecdrmfsecatjm kvmrfnn sdrktfn tm`pmrfturm

Dryptkrdjeges`

Tdrktfn vfredkdmnms

e`pfermg spmr`ftkamcmses fsskdeftmg wetjtjmsm geskrgmrs#

Wk kpte`ezm tjmer spmr` prkgudtekc. `mcfrm mcdkurfamg tk fvkeg tjm usm khsfucfs fcg jkt tuis#

@mgedftekcs Wkxecs fcg Gruas Fsskdeftmg


24/77

@mgedftekcs. Wkxecs. fcg Gruas Fsskdeftmgwetj @fnm Echmrtenety

@mgedftekcs Wkxecs

Fcgrkamced stmrkegs Famct Krfcam Fctejypmrtmcsevms Fcmstjmted afssms

Dfcdmr djm`ktjmrfpy Imczmcm

J9 inkdomrs Geirk`kdjnkrkprkpfcm

Omtkdkcfzknm Nmfg

Tperkcknfdtkcm @fcafcmsm

Dydjnkspkrecm

Cetrkhurfctkec Ktjmr Gruas

Tunhfsfnfzecm Fndkjkn

Dkndjedecm Jmrkec

Fnnkpureckn @frebufcf

Wmtrfdydnecm @mtjfgkcm

Mrytjrk`ydec Wkifddk

Amctf`edec

j e n e e


25/77

\jysedfn Mxfècftekc Ikgy JfietusGmdrmfsmg ikgy jfer

Aycmdk`fstefMucudjkeg prkpkrtekcs

\jfnnus \myrkcem!s gesmfsmDkcamcetfn durvfturm

Jypkspfgefs Tdrktu` Wmstedunfr vknu`m

Mpegegy`fn ecgurftekc\rmsmcdm+fismcdm kh vfs gmhmrmcs

Xfredkdmnm

Geaetfn Ymdtfn Mxfècftekc\rkstftm sezm\rkstfted+smècfn vmsedunfr`fss +ecgurftekc+dysts


26/77

Tm`mc Fcfnyses 7: tk 19 jkurs kh fistecmcdm#

Dknnmdtekc egmfnny. ft tjm nfikrftkry Iy `fsturiftekc

Ectk f dkctfecmr hurcesjmg iy tjm

nfikrftkry tjft jfs immc tmstmg tkmcsurm tjft et wenn ckt fntmr tjm spmr`sf`pnm!s qufnety#

Tjkung im fcfnyzmg wetjec 6 jkur fcgompt ft ikgy tm`pmrfturm imhkrm#

T F n e


27/77

Tm`mc Fcfnyses Djfrfdtmresteds fcfnyzmg frm sm`mc

vknu`m. spmr` gmcsety. spmr` `ktenety.

hkrwfrg prkarmssekc. fcg spmr``krpjknkay# Ec fggetekc. tjm sf`pnm esfcfnyzmg hkr tjm prmsmcdm kh nmuokdytms

tjft `eajt ecgedftm echmdtekc krechnf``ftekc

Fc fnequkt kh tjm sf`pnm es fergremg kcf snegm fcg stfecmg hkr gmtmr`ecftekc kh

spmr` sjfpm kr `krpjknkay# Ckr`fnsm`mc sf`pnms dkctfec ft nmfst =


28/77

Qkrng Jmfntj Krafcezftekc *QJK% DretmrefHkr Ckr`fn Tm`mc Xfnums

Xknu`m 6#=

=#< `npJ 1#91#:

Tpmr` dkcdmctrftekc 3 9< `ennekc+`n

Xesdksety > 4 sdfnm *


29/77

Ckr`fn iekdjm`edfn Xfnums

Fdeg \jkspjftfsm 9=.


30/77

Ck`mcdnfturm Fspmrèf Hfenurm kh hkr`ftekc kr mèssekc

kh sm`mc

Kneakspmrèf+ Kneakzkkspmrèf- Wjmdkuct >9< ènnekc +`n

\kny zkkspmrèf- Dkuct 34=< ènnekc +`n

Fzkkspmrèf- Ck spmr`ftkzkf ec tjmsm`mc

Fstjmckspmrèf- rmgudtekc ec vetfnety +@ktenety kh spmr`ftkzkf

Cmdrkspmrèf+Cmdrkzkkkspmrèf-spmr`ftkzkf frm gmfg kr `ktekcnmss

Wmrftkspmrèf+ Wmrftkzkkspmrèf-\rmsmcdm kh jeaj cuìmr kh `fnhkr`mg

spmr`ftkzkf

Tm`mc fcfnyses


31/77

Tm`mc fcfnyses

Dknkr? Qjetesj army tk ymnnkw tmcgs tk im `krm

ymnnkwesj wetj nkcamr fistecmcdm. amcetfn trfdtechmdtekchecfnny rmggesj ec smvmr hkr`#

Kgkr2 Djmstcut hnkwmrs+f`cekted hnueg neom Hrk`kxegftekc kh spmrècmprkstfted anfcg smdrmtekc

Dkfaunftekc fcg Nequmhfdtekc2 wetjec =7< ècs

Dkfaunftevm mczy`m ec smècfn vmsedfn Nequmhyeca mczy`m Tmècecmprkstftm anfcg#Dk`pnmtm nfdo kh dkfaunftekc

Famcmses kh smècfn vmsedfn kr

kddnusekc kh mbfdunftkry gudts#Hfenurm tk nequmhy \kkr prkstftm nyted fdtevety# Hknnkweca nequmhfdtekc TH fdjemvms vesdkus stftm#

Jypmrvesdkdety e`pfers spmr` `ktenety#

Tm`mc fcfnyses


32/77

Tm`mc fcfnysesXknu`mJypkspmrèf2 Xknu`m >6#= `n

Jypmrspmrèf23=#=`n\nfs`f 2 Xmjednm+ Genumct

+Iuhhmreca `mgeu`+Tkurdm kh mcmray#Tm`mc vknu`m `fecnyTmècfn vmsedfn

smdrmtekcs#T# Xkn# Fcgrkamc gmhe#. prkxe`fn kddnusekc kh

mbfdunftkry gudt kr ecdk`pnmtm mbfdunftekc#

\J3:Fdutm gesmfsm kh smècfn vmsedfn krgmnfymg `mfsurm`mct>1 kddnusekc kh mbfdunftkry gudt

kddnusekc. dkctfècftekc wetj urecm

@edrksdkped Mxfècftekc


33/77

@edrksdkped Mxf`ecftekc

@ktenety

Arfgm 7 Yfpeg fcg Necmfrny prkarmssevmArfgm 4 Tnkwmr snuaaesj necmfr kr ckc necmfr

Arfgm 9 Ckc prkarmssevm `ktenety

Arfgm6 e``ktenmHrmsjny mbfdunftmg spmr` dmnn vmnkdety 1=+s

Ttfcgfrgezftekc kh tm`pmrfturm

@ktenety nkss kh 6


34/77

Futk`ftmg Tm`mc Fcfnyses

Dnksmg derduet Xegmk tfpmgeaetfn gftf gespnfy6514 Gkppnmr +turiege`mtred mtjkg 651711

Neajt sdfttmreca gmtmrècftekc kh `ktenety 651: @untepnmMxpksurm pjktkarfpjed tmdjcequm\rmsmct sdmcfrek

Dmnnskht systm`2 dmnn sezm fcg nuècksety Wjm Jfèntkc Wjkrc systm`2echrfrmg imf`\rkvegm Gftf hkr

Dkcdmctrftekc @ktenety Xmnkdety Necmfrety Nftmrfn jmfg gespnfdm`mct. derdunfr `ktek .@krpjknkay


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37/77

Iekdjmèdfn fcfnyses

Mpegegy`fn hnuegAnydmrynpjkspjkrydjknecm*A\D% ( dfrcetecm

Ecjeiec iy smrtkny dmnn HTJ dkctrkn

\rkstftm anfcg hnueg ? _Mczy`ms*Fdeg\jkspjftfsm mtd#%. detred fdeg. Recd.spmrècmP

Tmècfn Xmsedfn ? Hrudtksm.\rkstfanfcgecms

Tpmr` Drmftecm pjkspjkoecfsm

]sufn Hecgecas kh Jkr`kcfn Ttftus


38/77

]sufn Hecgecas kh Jkr`kcfn TtftusDkrrmnftmg tk Dnecedfn Gefackses

Dnecedfn Ttftus HTJ *`E]+`N% NJ *`E]+`N% Wmstkstmrkcm *ca+6


39/77

FggetekcfnNfikrftkry Wmsts

Imtwmmc 6


40/77

Dmrvedfn @udus+Tpmr` EctmrfdtekcFssfys Wjm pkstdketfn tmst *\DW%. herst pmrhkr`mg iy Te`s.

Wjes tmst mvfnuftms spmr` dkcdmctrftekc fcg `ktenety ecfc fsperftm kh dmrvedfn `udus ft `egdydnm sjkrtny fhtmrtjm dkupnm jfs ectmrdkursm# f ckr`fn \DW 39

male infertility, diagnosis and recent management

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