Fertility Treatments
Fertility
The most modern techniques of assisted reproduction and male fertility treatments have greatly improved the way children and families are planned. All these techniques are of the highest technology and are very safe. At the Andromedi Clinics in Madrid, Seville and the Canary Islands we understand the level of commitment, responsibility and bioethics to carry them out with the best specialists and teams.
Fertility
Table of content
Vasovasostomy
Vasectomy reversal - Vasovasostomy
Now, vasectomies (surgeries to stop having children in men) are not completely irreversible. With vasovasostomies it is possible to regain reproductive function with minimal implications.
What is a Vasovasostomy?
A vasovasotomy is a surgery to re-canalize the vas deferens (through which sperm passes in ejaculation) that were cut or tied in a previous vasectomy.
The objective of this is clear: to recover the ability to have children in a natural way, because it is also possible to store sperm by laboratory techniques.

Simplified view of the vasovasostomy
When it’s made?
Vasovasostomies or vasectomy reversal surgeries can be performed any time the patient wants and is completely safe. For this, preoperative evaluations and an interview with the doctor are important.
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En cumplimiento del Reglamento General de Protección de Datos le informamos que los datos por Vd. proporcionados serán objeto de tratamiento por parte de Andromedi con la finalidad de prestarle el servicio solicitado y/o contratado. Los datos no se cederán a terceros salvo en los casos en que exista una obligación legal. Para más información puede consultarla pinchando aquí.

A simplified view of vasectomy
Vasectomy
Vasectomy
Vasectomy is the only definitive male contraceptive method. In it, men can feel confident that they cannot impregnate without using barrier methods such as condoms (which are not always comfortable or safe).
Why is it so ideal?
Vasectomy surgery can last less than 20 minutes and is done on an outpatient basis. This means that the patient undergoes treatment in a special office, not an operating room, and under local anesthesia.

A simplified view of vasectomy
What does it consist of?
Vasectomy consists of blocking (by an incision and a ligature) both vas deferens that communicate the testicles with the superior seminal tracts. For this reason, sperm remain where they are produced and are naturally reabsorbed.
Only a small cut (about a centimeter) is made in the midline of the scrotum, below the penis, and there are no visible scars.
Azoospermia
Azoospermia
Azoospermia is the relative absence of sperm in the semen that has been ejaculated, thus making it difficult to have children.
What makes the testicles make less sperm?
To determine that there is a real problem of azoospermia, it is necessary to perform a seminogram every four weeks for a reasonable time (the decreased production of sperm could be temporary).

Types of azoospermia (normal)
Now, the testicles can have difficulties maturing sperm for different reasons such as:
- Low levels of testosterone and FSH (follicle stimulating hormone).
- Morphological alterations in the sperm that prevent their training.
- Anatomical alterations in the seminiferous tubules.
- In severe cases, obstruction of the seminal tract.
How is it solved?
Treatment of azoospermia will depend on general medical evaluation and FSH levels, among other indicators. Hormone levels can be restored by exogenous administration and in severe cases, a testicular biopsy can be used to isolate sperm for use in in vitro fertilization techniques.

"In our centres in Madrid, Seville or the Canary Islands (Tenerife), we carry out the techniques and treatments with the most modern facilities and the best specialists and equipment to guarantee an effective solution".
Sterility
Male sterility
Similar to the previous one, male sterility is a total condition of inability to procreate naturally for different reasons.
What produces it?
Although very rare, cases of male infertility can be due to hormonal, anatomical, neoplastic and congenital factors, among which are:
- Congenital absence of testicles.
- Little or no synthesis of follicle stimulating hormone (FSH) in the pituitary gland or testicular insensitivity to it (due to the absence of cellular receptors to FSH).
- Death of sperm progenitor cells by toxic chemicals or cancer chemotherapy.
- Testicular ischemia due to a history of varicocele, severe traumatic injuries, testicular torsions or testicular cancer.
What are the alternatives?
Each case has its own peculiarities and medical management can depend a lot. Patience, persistence and a lot of communication as a couple are always recommended to face these situations while maintaining a constant check of fertile function with a specialist in the subject, such as those at our Clinics in Madrid, Seville and the Canary Islands (Tenerife).
In Vitro Fertilisation
IVF – ICSI
In vitro fertilization is a state-of-the-art laboratory technique. With it, and together with ICSI (intracytoplasmic sperm injection), many pregnancies have ended up being possible around the world.
What is in vitro fertilization?
In vitro fertilization is the assisted reproduction technique par excellence and it is about joining, through laboratory procedures, a sperm with an egg to fertilize it and start the long path of the formation of a human being.
After fertilization, the result of this union is implanted in the mother’s uterus so that it begins to develop normally.

Artificial insemination
How is the proccess?
First, the eggs (or oocytes) are removed from the mother’s ovaries and placed in a special medium that keeps them alive. Then, the sperm are isolated and trained and one is selected, to be inserted very carefully into the oocyte so that they become one and the genetic materials of both are combined.
Upon completion and if successful, the fertilized product is inserted into the walls of the uterus to implant and receive proper nutrition until a fetus is formed and the time of delivery arrives. It is a gestation like any other.
IVF – ICSI Success Odds
Taking into account all the implications of the treatment and the difficulty in producing a viable zygote (that is, suitable for implantation in the endometrium) the success rate is very favorable, around 50%.

DNA Fragmentation
DNA FRAGMENTATION
DNA fragmentation
DNA fragmentation is one of the main causes of male sterility and its measurement is considered a reliable indicator of seminal quality and its fertilizing capacity.
What is DNA fragmentation?
It is a complex molecular laboratory technique that is used to examine the genetic material of sperm in search of possible causes of failure in the attempts to have a child.

DNA Fragmentation
What can it be used for?
It can serve to determine the origin of the basic problem: not conceive, in order to take the necessary measures to achieve it effectively and successfully.
Varicocele
Varicocele
Varicocele represents a great risk to male reproductive function and is therefore a real urological emergency.
What is Varicocele?
Variocele occurs when the veins surrounding the spermatic cord dilate to the point that they become insufficient and the testicles begin to overload with warm, deoxygenated blood. The latter can be dangerous for sperm production, as well as being very painful.

Testicle anatomy
How is it treated?
The treatment of choice for varicocele is surgery.
This is an outpatient surgical procedure. The surgeon repairs the anatomical defect and restores normal circulation.
Author
Dr. Natalio Cruz
Natalio Cruz MD, with 25 years of medical experience, has been until 2016 Head of the Andrology Unit in the Urology Service of the Virgen del Rocío Hospital in Seville, National Coordinator of Andrology in the Spanish Association of Urology (AEU) and General Secretary in the ESSM, positions that he has narrowed to focus squarely on this exciting project of offering a high-level private medical consultation in Marbella, Seville, Madrid and Tenerife.
Andromedi pertenece a las organizciones médicas más destacadas en el sector de la Uro-Andrología