Therapy options

This application helps to propose an appropriate fertility therapy method and to find the most suitable clinic worldwide based on the price, duration and legislative options of the treatment in various countries.

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How can Surgery of the urinary tract affect fertility

Operation which have impact on fertility varies depending of sex. 

One of the possible threat in males is surgery of prostate, urinary bladder and urethra. All of them can caused retrograde ejaculation or erectile dysfunction (the inability to get and maintain an erection). Any surgery of genitourinary tract of male can lead to inflammation. The most dangerous for fertility is orchitis (inflammation of testicles). Special case is restoration of fertility after vasectomy. The procedure, which can help is called vasectomy reversal. 

Surgeries of woman’s genitourinary tract are not strictly associated with infertility. One field of female urology is speciallized on genital prolapse (occurs when there is descent of one or more of the pelvic organs including the uterus, bladder, rectum, small or large bowel, or vaginal vault) which must be removed if woman wants to became pregnant in the future.

Retrograde ejaculation

Retrograde ejaculation occurs when semen, which would, in most cases, be ejaculated via the urethra, is redirected to the urinary bladder. Normally, the sphincter of the bladder contracts before ejaculation forcing the semen to exit via the urethra, the path of least resistance. 

Males with retrograde ejaculation are not irreversibly infertile because sperms are presented in urine and it is possible to isolate them with the help of assisted reproduction techniques. 

The procedure includes adjustment of the osmolarity (the measure of solute concentration per unit volume of solvent) of the patient's urine by drinking water. The small amount of antegrade-produced ejaculate is collected in a plastic beaker, while the retrograde fraction of the ejaculate needs to be urinated immediately into a jar with culture medium containing human serum albumin to dilute the urine. 

Finally, the urine/medium mixture has to be centrifuged, resuspended and filtrated on the glass wool column where sperms are separated. When the sperm is isolate than it could be injected directly into the egg (which is maintained from woman by transvaginal oocyte retrieval). The following procedure is in vitro fertilization (IVF).

Erectile dysfunction

It is characterized by the regular or repeated inability to obtain or maintain an erection during sexual intercourse. Even with an erection problem, a man may still have sexual desire and be able to have an orgasm and to ejaculate. But without erection, the semen cannot be inserted to the vagina naturally so the conception is not possible. 

Only option is to use methodes of assisted reproduction such as insemination or IVF.


Orchitis could cause azoospermia (no sperm in semen), most likely due to testicular tissue necrosis (a kind of cell death).

Substantial necrotic changes seen in Sertoli cells (a nurse cell of the testicles that helps in the process of sperm development) contribute to impaired spermatogenesis (development of sperms) by loss of function in supporting the dependent germ cells.

Vasectomy reversal

During vasectomy, the male vas deferens are severed and then tied/sealed in a manner so as to prevent sperm from entering into the seminal stream (ejaculate) and thereby prevent fertilization.

Vasectomy reversal is a term used for surgical procedures that reconnect the male reproductive tract after interruption by a vasectomy. Two procedures are possible at the time of vasectomy reversal: vasovasostomy (vas deferens to vas deferens connection) and vasoepididymostomy (epididymis to vas deferens connection). Although vasectomy is considered a permanent form of contraception, advances in microsurgery have improved the success of vasectomy reversal procedures. The procedures remain technically demanding and expensive, and may not restore the pre-vasectomy condition.

Pic. 1: Urinary system
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