Microsurgery for Male Infertility: The AIIMS Experience
The diseases responsible for male infertility and for cases undergoing exploration for microsurgical reconstruction at the All India Institute of Medical Sciences possibly differ from those reported in most Western literature. The largest number of cases surgically explored is for primary infertility with obstruction of unknown etiology. This has resulted in lower percentage of patients with a successful outcome. However, the socioeconomic factors around infertility management in our country dictate an attempt at reconstruction even when the expected outcomes are poor. Infertility is a major social issue in the Indian culture with immense pressure on married couples to have children. The stigma surrounding infertility is such that couples prefer seeking treatment through discreet unqualified practitioners who offer quick cures rather than visit a public hospital, thus delaying meaningful intervention. Coupled with the low per capita income and lack of adequate health insurance, social issues have a major impact on the management of male infertility at AIIMS. Fortunately, in patients with favorable prognostic factors, the outcomes are generally good.
KeywordsMicrosurgery for male infertility Congenital bilateral absence of the vas deferens Genital tuberculosis Filariasis Vaso-epididymal anastomosis Microsurgical varicocelectomy Vasovasal anastomosis Azoospermia
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