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If a change in diet and lifestyle is not sufficient to enhance fertility, there are certain medications that may help. There are two main types of male fertility drug, which are human menopausal gonadotropin (hMG) and human chorionic gonadotropin (hCG).
This condition means that the testicles are not receiving the signals to make sperm, as the brain is not producing enough of the correct hormones.
The treatment may last for as long as six months, with two or three injections required each week.Men with fertility problems can also be treated with pulsatile gonadotropin-releasing hormones (GnRH) or the follicle stimulating hormone (FSH). Metformin hydrochloride is used to treat diabetes, but it can also be used to treat ovulation problems in women with polycystic ovary syndrome (PCOS).
The success rates achieved by these drugs can vary, depending on factors such as the age of the woman and the quality of the sperm. Some methods produce conception rates of approximately 40 per cent, and gonadotropins have a conception rate of 20 per cent to 60 per cent. Fertility problems are not uncommon, with one in seven couples in the UK experiencing issues. Serious ComplicationsUrinary retention (inability to void) is a serious complication of severe BPH that requires immediate medical attention. If you are having difficulties becoming pregnant, you may have decided to try certain fertility treatments in order to increase your chances of conceiving.
Intrauterine insemination (IUI) is often the first type of fertility treatment attempted by couples. Sperm washing may sound strange, but it actually works to ensure that only the healthiest sperm are used during the procedure. Sperm washing is a procedure used to prepare sperm for use in IUI It allows your partner’s sperm a better chance for survival and fertilization.
The simple sperm wash technique is the most basic way of washing and preparing sperm for IUI. As the sperm mixture is spun, sperm cells fall to the bottom of the test tube, producing a mass of dense, highly active sperm.
In the early 1980s, researchers reported that it might also cause separation of X and Y-sperm. This was based on the theory that a) a small fraction of X-sperm are the fastest of all, b) next fastest are the Y-sperm, and c) slowest are the majority of X-sperm. Later investigation proved that this was not the case, but the method has been promoted in some clinics for gender selection. Treatment with gonadotropins causes the testicles to produce sperm and male sexual hormones directly, bypassing the brain.
There is a condition called retrograde ejaculation, which causes sperm to be released into the bladder instead of the penis.
Imipramine can be used to close the neck of the bladder.Although fertility treatment cannot guarantee a pregnancy, the drugs used can help to increase the sperm count to 20 million or more. There are several drugs available, but which is the most suitable will depend on the reason for the ovulation problem.
This drug can lower the insulin levels in the body, which can lower male sexual hormones and help the body to ovulate. This can correct a hormonal imbalance that could prevent ovulation from occurring each month. In patients who are taking bromocriptine, figures show that between 65 per cent and 85 per cent of women become pregnant. About half of men with BPH go on to develop an actual overall increase in the size of the prostate. The prostate is a walnut-shaped gland located below the bladder and in front of the rectum. The prostate gland provides the following functions:The glandular cells produce a milky fluid.
Prostatitis is an inflammation of the prostate gland that can be caused by bacterial or nonbacterial factors. Many medications can cause lower urinary tract symptoms or urinary retention, and can worsen symptoms of BPH. Sperm washing can increase your chances of conception and may help you to welcome a new addition to your family. Sperm washing separates sperm cells from a man’s semen, helping to get rid of dead or slow-moving sperm as well as additional chemicals that may impair fertilization.
Semen is diluted in a test tube, with a special solution of antibiotics and protein supplements. The medium is a hospitable environment for the sperm, and healthy sperm will swim up into it.


This is because it also works to separate dead sperm cells, white blood cells, and other waste products from the sperm. They are used when men are not producing sperm due to a condition called primary hypogonadotropic hypogonadism. One study has shown that 40 per cent of couples achieved at least one pregnancy after the treatment. There may be certain side effects caused by fertility drugs. This treatment may benefit women who have too much of the prolactin hormone, as this can reduce the levels of oestrogen. Some men with minimally enlarged prostate glands may experience symptoms while other men with much larger glands may have few symptoms. Bladder obstruction can cause kidney damage, bladder stones, urinary tract infections, blood in the urine, and incontinence as urine dribbles out in small amounts.DiagnosisA doctor makes a diagnosis of BPH based on description of symptoms, medical history, physical examination, and various blood and urine tests. Once sperm has been washed in the laboratory, it can be used during IUI to help achieve pregnancy.
After it is spun, active, healthy sperm will make their way, to the very bottom layer of the liquid in the test tube, while debris and dead sperm will get caught in the top two layers. The medication is usually in the form of pills or capsules that need to be inserted into the vagina.
Studies have found that 30 per cent of pregnancies achieved with gonadotropins result in multiple births, compared to 1 to 2 per cent with natural conception.
BPH is very common among older men, affecting about 60% of men over age 60 and 80% of men over age 80.BPH SymptomsThe symptoms associated with BPH are collectively called lower urinary tract symptoms (LUTS).
These urinary difficulties are part of a group of symptoms called collectively lower urinary tract symptoms (LUTS).About a third of men with BPH have LUTS symptoms that interfere with their quality of life. If necessary, your doctor may refer you to a urologist for more complex test procedures.Some diagnostic tests are used to rule out cancers of the prostate or bladder as the cause of symptoms. Watchful waiting (also known as active surveillance) involves lifestyle changes and an annual examination.
They can be used by women with PCOS who have not responded to other treatment, or by women who are undergoing In Vitro Fertilisation (IVF).
The FSH and LH is injected over the course of approximately twelve days, followed by an injection of hCG. It rarely causes serious complications, and men usually have a choice whether to treat it immediately or delay treatment. Tests may also be performed to see if BPH has caused any kidney damage.Medical HistoryThe doctor will ask about your personal and family medical history, including past and present medical conditions.
Your doctor needs to monitor your condition to determine when it may be time to start treatment.Treatment. The doctor will also ask about any medications you are taking that could cause urinary problemsPhysical ExaminationDigital Rectal Exam. Five-alpha-reductase inhibitors (5-ARIs) and alpha-blockers are the main types of drugs used for BPH treatment.Drug WarningIn 2011, the Food and Drug Administration (FDA) announced it had revised the prescription labels of 5-ARI drugs to include new information on increased risk of high-grade prostate cancer. It reaches normal adult size and shape, about that of a walnut, when a man is in his early 20s. Finasteride (Proscar, generic) and dutasteride (Avodart, Jalyn) are the 5-ARIs used for treating BPH. The doctor inserts a gloved and lubricated finger into the patient's rectum and feels the prostate to estimate its size and to detect nodules or tenderness. They include drug therapies to help shrink or relax the prostate, minimally invasive procedures that use lasers to reduce excess prostate tissue, and surgery to remove part of the prostate.Deciding Between Treatment and Watchful WaitingThe choice between watchful waiting and treatment usually depends on symptom severity. The FDA recommends that doctors rule out other urologic conditions, including prostate cancer, that may mimic BPH before prescribing 5-ARIs for BPH treatment.In 2012, the FDA revised the finasteride label to include the warning that sexual side effects (lowered libido, ejaculation disorders, orgasm disorders, and erectile dysfunction) may persist even after the drug is stopped. The American Urological Association’s BPH Symptom Score uses seven questions to evaluate a patient’s urinary symptoms during the past month. Drug ApprovalIn 2011, the FDA approved the widely used erectile dysfunction drug, tadalafil (Cialis) for treatment of BPH.
The test helps rule out prostate cancer or problems with the muscles in the rectum that might be causing symptoms, but it can underestimate the prostate's size. Tadalafil may be used to treat BPH and erectile dysfunction in men who have both conditions.
The changes that occur with male sex hormone as part of the aging process appear to play a role in the enlargement of the prostate gland.Male Hormones. It is never the sole diagnostic tool for either BPH or prostate cancer.Other Physical Examinations. The symptom score can fall anywhere between 0 and 35.Patients with mild symptoms will have low scores and may decide to delay treatment. The doctor will press and manipulate (palpate) the abdomen and sides to detect signs of kidney or bladder abnormalities.


IntroductionHyperplasia is a general medical term referring to an abnormal increase in cells. The most important androgen is testosterone, which is produced in the testes throughout a man's lifetime.
The doctor may test reflexes, sensations, and motor response in the lower body to rule out possible nerve-related (neurologic) causes of bladder dysfunction.Prostate Specific Antigen (PSA) TestA PSA test measures the level of prostate-specific antigen (PSA) in the patient's blood.
The prostate converts testosterone to another powerful androgen, dihydrotestosterone (DHT). It is the most common noncancerous form of cell growth in men and usually begins with microscopic nodules in younger men.
DHT stimulates cell growth in the tissue that lines the prostate gland (the glandular epithelium) and is the major cause of the rapid prostate enlargement that occurs between puberty and young adulthood. And, some drugs used to treat BPH can decrease PSA levels. UrinalysisA urinalysis can detect signs of bleeding or infection.
In general, there is no reason to treat BPH with medications unless symptoms become very bothersome. The size of the prostate, determined by exam or ultrasound, cannot indicate the need for medications. A urinalysis also helps rule out bladder cancer.UroflowmetryTo determine whether the bladder is obstructed, an electronic test called uroflowmetry measures the speed of urine flow.
Evidence suggests that:Medications are the best choice for men with mild-to-moderate symptoms who want treatment.
To perform this test, the patient urinates into a special toilet equipped with a measuring device. Specific factors indicate the best choice, although most men take an alpha-blocker.Men with moderate-to-severe symptoms often respond to the same medications as men with mild symptoms. These risk factors include obesity, high blood pressure, low levels of HDL (“good”) cholesterol, diabetes, and peripheral artery disease (PAD). However, bladder obstruction can also be caused by other conditions including weak bladder muscles and problems in the urethra.CystoscopyCystoscopy, also called urethrocystoscopy, is a test performed by a urologist to check for problems in the lower urinary tract, including the urethra and bladder. Lifestyle factors that are unhealthy for the heart (such as lack of physical activity, cigarette smoking, and poor diet) may also possibly increase BPH risk or worsen its symptoms.SymptomsLower urinary tract symptoms (LUTS) are categorized either as voiding (formerly called obstructive) or storage (formerly called irritative) symptoms. The doctor can determine the presence of structural problems including enlargement of the prostate, obstruction of the urethra or neck of the bladder, anatomical abnormalities, or bladder stones. A quarter of men with moderate symptoms, and even more men with severe symptoms, eventually need surgery. The test may also identify bladder cancer, and causes of blood in the urine and infection.In this procedure, a thin tube with a light at the end (cytoscope) is inserted into the bladder through the urethra.
Other medical conditions, such as bladder problems, can also cause these symptoms.Some men with BPH may have few or no symptoms. The doctor may insert tiny instruments through the cytoscope to take small tissue samples (biopsies). Transurethral resection of the prostate (TURP) is the standard procedure, but less invasive procedures, particularly those using heat or lasers to destroy prostate tissue, are becoming more common. An enlarged prostate may be accompanied by few symptoms, while severe LUTS may be present with normal or even small prostates.Voiding (Obstructive) SymptomsVoiding symptoms can be caused by an obstruction in the urinary tract, which may be due to BPH. The patient may be given local, spinal, or general anesthesia.UltrasoundUltrasound is a painless procedure that can give an accurate picture of the size and shape of the prostate gland. As the bladder becomes distended with urine, nerve impulses from the bladder signal the brain that it is full, giving the individual the urge to void. Ultrasound tests of the prostate generally use one of two methods:Transrectal ultrasonography (TRUS) uses a rectal probe for assessing the prostate. By voluntarily relaxing the sphincter muscle around the urethra, the bladder can be emptied of urine. TRUS is significantly more accurate for determining prostate volume.Transabdominal ultrasonography uses a device placed over the abdomen.
It can give an accurate measure of postvoid residual urine and can be used to check for kidney damage caused by severe BPH.Postvoid Residual UrineThe postvoid residual urine volume (PVR) test measures the amount of urine left after urination. Normally, about 50 mL or less of urine is left; more than 200 mL is a sign of abnormalities. These abnormalities include narrowing of the urethra, weakened bladder, and prostate muscle contractions. Such conditions can produce obstruction, impair or weaken the detrusor muscle surrounding the bladder, or cause other damage that impacts the urinary tract.




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