{"id":716,"date":"2019-10-27T11:29:27","date_gmt":"2019-10-27T11:29:27","guid":{"rendered":"https:\/\/www.lowcostivf.net\/male-infertility\/"},"modified":"2023-11-19T13:53:58","modified_gmt":"2023-11-19T13:53:58","slug":"male-infertility","status":"publish","type":"page","link":"https:\/\/www.lowcostivf.net\/tr\/male-infertility\/","title":{"rendered":"Erkek K\u0131s\u0131rl\u0131\u011f\u0131"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"716\" class=\"elementor elementor-716\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3377c9c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3377c9c\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2cc2b2e\" data-id=\"2cc2b2e\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d6e62cc elementor-widget elementor-widget-jnews_element_header_elementor\" data-id=\"d6e62cc\" data-element_type=\"widget\" data-widget_type=\"jnews_element_header_elementor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div  class=\"jeg_block_heading jeg_block_heading_5 jeg_aligncenter jnews_module__0_69fc89f95e595\">\n                <h3 class=\"jeg_block_title\"><span>Te\u015fhis ve Y\u00f6netim<\/span><\/h3>\n                <style>.jnews_module__0_69fc89f95e595.jeg_block_heading_5 .jeg_block_title span, .jnews_module__0_69fc89f95e595.jeg_block_heading_5 .jeg_block_title i { color: #7a7a7a; }<\/style>\n            <\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-15268d0 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"15268d0\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-816195f\" data-id=\"816195f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6bd76e8 elementor-widget elementor-widget-video\" data-id=\"6bd76e8\" data-element_type=\"widget\" data-settings=\"{&quot;youtube_url&quot;:&quot;https:\\\/\\\/www.youtube.com\\\/watch?v=GUMpOAQNdzM&quot;,&quot;video_type&quot;:&quot;youtube&quot;,&quot;controls&quot;:&quot;yes&quot;}\" data-widget_type=\"video.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-wrapper elementor-open-inline\">\n\t\t\t<div class=\"elementor-video\"><\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-7811448\" data-id=\"7811448\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-de847cb related_topics elementor-widget elementor-widget-text-editor\" data-id=\"de847cb\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p style=\"color: white !important;\">\u0130lgili konular<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-22f9925 elementor-align-justify elementor-button-info elementor-widget elementor-widget-button\" data-id=\"22f9925\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/tr\/infertility\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon elementor-align-icon-right\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-angle-double-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"elementor-button-text\">K\u0131s\u0131rl\u0131\u011f\u0131n Tan\u0131m\u0131 ve \u00c7e\u015fitleri<\/span>\n\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9f9fde7 elementor-align-justify elementor-button-info elementor-widget elementor-widget-button\" data-id=\"9f9fde7\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/tr\/female-infertility\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon elementor-align-icon-right\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-angle-double-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"elementor-button-text\">Kad\u0131n K\u0131s\u0131rl\u0131\u011f\u0131n\u0131n Nedenleri ve Tedavisi<\/span>\n\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-00c04d9 elementor-align-justify elementor-button-info elementor-widget elementor-widget-button\" data-id=\"00c04d9\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/tr\/testing\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon elementor-align-icon-right\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-angle-double-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"elementor-button-text\">K\u0131s\u0131rl\u0131k Testi ve Te\u015fhisi<\/span>\n\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a349762 elementor-align-justify elementor-button-info elementor-widget elementor-widget-button\" data-id=\"a349762\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/tr\/treatment-decision\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon elementor-align-icon-right\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-angle-double-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"elementor-button-text\">Do\u011fru Tedaviyi Se\u00e7mek<\/span>\n\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-17ebc65 elementor-align-justify elementor-button-info elementor-widget elementor-widget-button\" data-id=\"17ebc65\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/tr\/surgical-sperm-retrieval\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon elementor-align-icon-right\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-angle-double-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"elementor-button-text\">Cerrahi Sperm Elde Etme Y\u00f6ntemleri<\/span>\n\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0378330 elementor-align-justify elementor-button-info elementor-widget elementor-widget-button\" data-id=\"0378330\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/tr\/stem-cell-therapy-for-azoospermia\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon elementor-align-icon-right\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-angle-double-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"elementor-button-text\">Obstr\u00fcktif Olmayan Azospermi \u0130\u00e7in K\u00f6k H\u00fccre Tedavisi<\/span>\n\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-beeea1c elementor-align-justify elementor-button-info elementor-widget elementor-widget-button\" data-id=\"beeea1c\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"\/tr\/fertility-treatment-options\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon elementor-align-icon-right\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-angle-double-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"elementor-button-text\">Do\u011furganl\u0131k Tedavisi Se\u00e7enekleri<\/span>\n\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-47d0440 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"47d0440\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-43e53eaf\" data-id=\"43e53eaf\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1ab4602c elementor-widget elementor-widget-text-editor\" data-id=\"1ab4602c\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div>W<b>Erkeklerde K\u0131s\u0131rl\u0131\u011fa Ne Sebep Olur?<\/b><\/div><div><b>\u00a0<\/b><\/div><p>Erkek k\u0131s\u0131rl\u0131\u011f\u0131 s\u00f6z konusu oldu\u011funda yayg\u0131n bir hata, aspermi ve azospermi aras\u0131ndaki kar\u0131\u015f\u0131kl\u0131kt\u0131r. Aspermi, cinsel ili\u015fki s\u0131ras\u0131nda veya mast\u00fcrbasyon yoluyla ejak\u00fclat\u0131n olmad\u0131\u011f\u0131 bir durumu ifade eder. Bu, ili\u015fki s\u0131ras\u0131nda penisten s\u0131v\u0131 gelmedi\u011fi anlam\u0131na gelir. Bu, ejak\u00fclasyon s\u0131ras\u0131nda penisten s\u0131v\u0131n\u0131n \u00e7\u0131kt\u0131\u011f\u0131 ancak hamileli\u011fi ba\u015flatabilecek canl\u0131 sperm h\u00fccrelerinin olmad\u0131\u011f\u0131 bir durum olan azospermi ile kar\u0131\u015ft\u0131r\u0131lmamal\u0131d\u0131r.<\/p><p>Baz\u0131 durumlarda ejak\u00fclatta canl\u0131 ve ya\u015fayabilir sperm h\u00fccreleri olabilir, ancak bunlar do\u011fal gebeli\u011fin olu\u015fmas\u0131 i\u00e7in gerekli \u00f6zelliklere sahip olmayabilir ve ek tedaviler gerektirebilir. Bu b\u00f6l\u00fcmde, t\u00fcm erkek k\u0131s\u0131rl\u0131\u011f\u0131 bi\u00e7imlerini tart\u0131\u015faca\u011f\u0131z ve \u015fu anda kullan\u0131mda olan ve ufukta g\u00f6r\u00fcnen mevcut tedavi se\u00e7eneklerinden bahsedece\u011fiz.<\/p><p><strong>Erkek fakt\u00f6r\u00fc k\u0131s\u0131rl\u0131\u011f\u0131 genel olarak iki ana grupta kategorize edilebilir:<\/strong><\/p><p><strong><em>1- Sperm yapma sorunlar\u0131<\/em><\/strong>Bu, \u00e7ok az sperm h\u00fccresi \u00fcretmek veya hi\u00e7 \u00fcretmek anlam\u0131na gelir. Bu kategori ayr\u0131ca obstr\u00fcktif azospermi ve obstr\u00fcktif olmayan azospermi kategorilerine ayr\u0131lm\u0131\u015ft\u0131r.<\/p><p><strong>obstr\u00fcktif azospermi<\/strong> sperm \u00fcretiminin oldu\u011fu ancak spermin d\u0131\u015far\u0131 ejak\u00fclata ta\u015f\u0131nd\u0131\u011f\u0131 kanallar\u0131n \u00e7e\u015fitli nedenlerle bloke\/hasarl\u0131 veya k\u0131s\u0131tlanm\u0131\u015f oldu\u011fu bir durumdur. Bu durumlarda, <a href=\"\/tr\/surgical-sperm-retrieval\/\">cerrahi sperm \u00e7\u0131karma y\u00f6ntemleri<\/a> genellikle ba\u015far\u0131l\u0131 olurlar ve obstr\u00fcktif azospermisi olan erkekler genellikle IVF\/ICSI tedavisi yoluyla kendi biyolojik \u00e7ocuklar\u0131na sahip olabilirler. Vazektomi ge\u00e7irmi\u015f erkekler de bu gruba aittir. Aktif bir sperm h\u00fccresi \u00fcretimine sahipken, sperm h\u00fccrelerinin ejak\u00fclata at\u0131lmas\u0131ndan sorumlu olan t\u00fcpler cerrahi olarak bloke edilmi\u015ftir.<\/p><p>\u00d6zetle, aktif sperm \u00fcretimi olmas\u0131na ra\u011fmen sperm h\u00fccrelerinin penil a\u00e7\u0131kl\u0131ktan \u00e7\u0131k\u0131\u015f\u0131n\u0131 engelleyen herhangi bir sorun obstr\u00fcktif azospermi olarak bilinir. Obstr\u00fcktif azospermi tedavisi vakadan vakaya de\u011fi\u015febilir ve cerrahi y\u00f6ntem t\u0131kan\u0131kl\u0131\u011f\u0131n nerede oldu\u011funa ba\u011fl\u0131 olarak de\u011fi\u015febilir.<\/p><p><strong>T\u0131kanmayan azospermi<\/strong> sperm h\u00fccrelerinin \u00fcretimi veya olgunla\u015fmas\u0131 ile ilgili sorunlar\u0131 ifade eder. Bu durumlarda daha \u00e7ok do\u011fu\u015ftan gelen bozukluklardan, genetik problemlerden veya sperm \u00fcretimi veya olgunla\u015fma sorunlar\u0131na neden olan \u00e7evresel fakt\u00f6rlerden bahsediyoruz. Ameliyatla sperm elde etme bazen sorun, aktif sperm \u00fcretiminin oldu\u011fu, ancak sperm h\u00fccrelerinin olgunla\u015fmas\u0131n\u0131n, h\u00fccreler erkek cinsel organ\u0131n\u0131n d\u0131\u015f\u0131na \u00e7\u0131kma kabiliyetini kazanmadan \u00f6nce bir noktada durdu\u011fu, sperm olgunla\u015fmas\u0131n\u0131n sonraki a\u015famalar\u0131nda oldu\u011funda ba\u015far\u0131 sa\u011flayabilir. Bununla birlikte, \u00e7o\u011fu non-obstr\u00fcktif azospermi vakas\u0131nda sorun, erken \u00fcretim veya olgunla\u015fma eksikli\u011fidir, bu nedenle, cerrahi sperm ekstraksiyonunun istenen sonucu vermesi muhtemel de\u011fildir. Kuzey K\u0131br\u0131s T\u00fcp Bebek Merkezinde \u201c<a href=\"\/tr\/stem-cell-therapy-for-azoospermia\/\">Terap\u00f6tik K\u00f6k H\u00fccre \u0130nf\u00fczyonu<\/a>\u201d 2016&#039;n\u0131n ba\u015f\u0131ndan beri. Bu, \u015fu ana kadar \u00e7ok umut verici sonu\u00e7lar sunan olduk\u00e7a deneysel ve klinik bir \u00e7al\u0131\u015fmad\u0131r. K\u00f6k h\u00fccre tedavisi, h\u00fccresel yenilenmeyi ve sperm h\u00fccrelerine farkl\u0131la\u015fmay\u0131 te\u015fvik etmek i\u00e7in hastan\u0131n kendi k\u00f6k h\u00fccrelerinin elde edilmesini ve testislerdeki olas\u0131 kusurlu b\u00f6lgelere enjekte edilmesini i\u00e7erir. Kendi biyolojik \u00e7ocu\u011funuza sahip olmak \u00f6nemliyse ve aray\u0131\u015fa ge\u00e7meden \u00f6nce olas\u0131 t\u0131bbi y\u00f6ntemleri denemek istiyorsan\u0131z \u201c<a href=\"\/tr\/ivf-with-sperm-donation\/\">Don\u00f6r Sperm ile T\u00fcp Bebek Tedavisi<\/a>\u201c, bu \u00e7al\u0131\u015fma uygun bir se\u00e7enek olabilir. Bu \u00e7al\u0131\u015fma i\u00e7in uygun olup olmad\u0131\u011f\u0131n\u0131z\u0131 g\u00f6rmek i\u00e7in l\u00fctfen bizimle ileti\u015fime ge\u00e7in.<\/p><p><em><strong>2- Spermin yumurtaya ula\u015fma ve d\u00f6lleme yetene\u011finde sorunlar<\/strong> BT<\/em>Bu, anormal sperm \u015feklinin veya yap\u0131s\u0131n\u0131n do\u011fru hareket etmesini engelleyebilece\u011fi bir durum olabilir. Bazen bir erkek, sperminin \u00fcreme yeteneklerini etkileyen problemlerle do\u011far. Di\u011fer zamanlarda sorunlar, hastal\u0131k veya yaralanma nedeniyle ya\u015fam\u0131n ilerleyen d\u00f6nemlerinde ba\u015flar. Bir erke\u011fin sperminin say\u0131s\u0131 ve kalitesi, genel sa\u011fl\u0131\u011f\u0131 ve ya\u015fam tarz\u0131ndan da etkilenebilir. Sperm say\u0131s\u0131n\u0131 ve\/veya kalitesini azaltabilecek baz\u0131 \u015feyler \u015funlard\u0131r:<\/p><p>- Alkol<br \/>\u2013 Kas e\u011fitiminde kullan\u0131lan anabolik steroidler dahil olmak \u00fczere ila\u00e7lar<br \/>\u2013 Pestisitler ve kur\u015fun dahil olmak \u00fczere \u00e7evresel toksinler<br \/>- Sigara i\u00e7iyor<br \/>\u2013 Son ate\u015fli hastal\u0131k veya do\u011fu\u015ftan\/genetik sorunlar gibi sa\u011fl\u0131k sorunlar\u0131<br \/>- \u0130la\u00e7lar<br \/>\u2013 Kanser i\u00e7in radyasyon tedavisi ve kemoterapi veya i\u015f yerinde radyasyona maruz kalma.<br \/>- Ya\u015f<\/p><p>Sorunun nedenini ve ciddiyetini anlamak i\u00e7in semen analizi \u00e7ok \u00f6nemlidir. Bir semen analizi, sperm hacmi ve sperm say\u0131s\u0131 gibi \u00e7ok \u00f6nemli parametreleri g\u00f6sterecek ve bu da bize ejak\u00fclatta yumurtalar\u0131 d\u00f6llemek i\u00e7in yeterli sperm h\u00fccresi olup olmad\u0131\u011f\u0131n\u0131 s\u00f6yleyecektir. Ancak yeterli say\u0131da sperm h\u00fccresine sahip olmak yeterli ko\u015ful de\u011fildir. Bu sperm h\u00fccrelerinin ayr\u0131ca, di\u015fi \u00fcreme sisteminde d\u00f6llenmenin ger\u00e7ekle\u015fmesi i\u00e7in spermin serbest\u00e7e hareket etme ve yumurtalara ula\u015fma yetene\u011fini g\u00f6steren belirli bir hareketlili\u011fe sahip olmas\u0131 gerekecektir. Benzer \u015fekilde sperm morfolojisi de sperm h\u00fccrelerinin y\u00fczde ka\u00e7\u0131n\u0131n normal bir yap\u0131ya sahip oldu\u011funu g\u00f6steren \u00e7ok \u00f6nemli bir di\u011fer fakt\u00f6rd\u00fcr. Sperm h\u00fccrelerinin b\u00fcy\u00fck bir k\u0131sm\u0131 anormallik g\u00f6steriyorsa, bu, DNA par\u00e7alanma sorunlar\u0131n\u0131 taramak i\u00e7in daha geli\u015fmi\u015f sperm testi gerektirebilecek, sperm h\u00fccrelerinde DNA ile ilgili daha temel genetik problemler oldu\u011funu d\u00fc\u015f\u00fcnd\u00fcrebilir. Di\u011fer bir parametre ise ejak\u00fclattaki beyaz kan h\u00fccreleridir. Sperm \u00f6rne\u011findeki beyaz kan h\u00fccrelerinin say\u0131s\u0131 genellikle, sperm h\u00fccrelerinin d\u00f6llenmeyi ger\u00e7ekle\u015ftirme yetene\u011fini bozabilecek bir idrar yolu enfeksiyonunu d\u00fc\u015f\u00fcnd\u00fcr\u00fcr. Bu gibi durumlarda do\u011fal veya suni yolla gebelik elde edilemeden enfeksiyonun temizlenmesi i\u00e7in antibiyotik tedavisine ba\u015flanabilir. \u00d6te yandan pH, sperm \u00f6rne\u011finin \u00fcreme i\u015flevini etkileyebilecek ba\u015fka bir parametresidir. Di\u015fi \u00fcreme sistemindeki d\u00fc\u015fmanca asidik ko\u015fullarda hayatta kalmak i\u00e7in sperm h\u00fccrelerinin nispeten alkali bir pH&#039;\u0131 s\u00fcrd\u00fcrmesi \u00f6nemlidir. Sperm \u00f6rne\u011fi olmas\u0131 gerekenden daha az alkali ise, yumurta ile bulu\u015fmas\u0131 gereken fallop t\u00fcplerine olan yolculu\u011funu ba\u015far\u0131yla tamamlayamayabilir.<\/p><p>G\u00f6rd\u00fc\u011f\u00fcn\u00fcz gibi, sperm h\u00fccrelerinin \u00fcreme nitelikleri s\u00f6z konusu oldu\u011funda bir\u00e7ok husus vard\u0131r. Bu nedenle, t\u00fcm bu hususlarla ilgili olarak dikkatli bir soru\u015fturma yap\u0131lmas\u0131 gerekmektedir. D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc&#039;n\u00fcn 2010 y\u0131l\u0131nda sperm canl\u0131l\u0131\u011f\u0131 i\u00e7in yay\u0131nlad\u0131\u011f\u0131 standartlar\u0131na g\u00f6re, normal sperm i\u00e7in a\u015fa\u011f\u0131daki parametreler olu\u015fturulmu\u015ftur:<\/p><p><strong>Hacim: &gt; 2,0 ml<br \/>Konsantrasyon: &gt;20 milyon\/ml<br \/>Motilite: &gt; 50%<br \/>Morfoloji: &gt;30%, normal morfoloji ile<br \/>Beyaz Kan H\u00fccreleri (Yuvarlak H\u00fccreler): &lt; 1 milyon\/ml<br \/>pH: 7.2-7.8<\/strong><\/p><p>Bu de\u011ferlerin do\u011fal anlay\u0131\u015f i\u00e7in olu\u015fturuldu\u011funu unutmamal\u0131s\u0131n\u0131z. A\u015f\u0131lama veya t\u00fcp bebek gibi k\u0131s\u0131rl\u0131k tedavilerinde kullan\u0131lan tedavinin t\u00fcr\u00fcne g\u00f6re fizyolojik s\u00fcre\u00e7lerin bir k\u0131sm\u0131n\u0131 veya \u00e7o\u011funu atlad\u0131\u011f\u0131m\u0131z i\u00e7in \u00e7ok daha d\u00fc\u015f\u00fck de\u011ferlerle \u00e7al\u0131\u015fabiliyoruz.<\/p><p>En do\u011fru sonu\u00e7lar i\u00e7in sperm \u00f6rne\u011finizi analize vermeden \u00f6nce l\u00fctfen 2-5 g\u00fcn perhiz yapt\u0131\u011f\u0131n\u0131zdan emin olun. Bu, do\u011furganl\u0131k tedavisinden \u00f6nce bir numune sa\u011flamadan \u00f6nce de \u00f6nemlidir. Her durumda, bir sperm \u00f6rne\u011fi vermeniz gerekiyorsa, aksi belirtilmedik\u00e7e 2 ila 5 g\u00fcnl\u00fck bir perhiz s\u00fcresi olmas\u0131 en iyisidir. Ayr\u0131ca, yukar\u0131daki say\u0131lar\u0131n do\u011fal anlay\u0131\u015f i\u00e7in referans de\u011ferler olarak olu\u015fturuldu\u011funu unutmay\u0131n. Bu nedenle sperm tahlilinizin WHO kriterlerinde belirtilen parametrelerden d\u00fc\u015f\u00fck \u00e7\u0131kmas\u0131 \u00e7ocuk sahibi olamayaca\u011f\u0131n\u0131z anlam\u0131na gelmez. Bu basit\u00e7e, do\u011fal olarak gebe kalman\u0131n \u00e7ok zor olabilece\u011fi anlam\u0131na gelir.<\/p><p>Semen analizindeki say\u0131lar\u0131n ne anlama geldi\u011fi ve bir sperm \u00f6rne\u011finin parametrelerine g\u00f6re nas\u0131l kategorize edilece\u011fi hakk\u0131nda daha fazla bilgi i\u00e7in l\u00fctfen \u201c b\u00f6l\u00fcm\u00fcm\u00fcze bak\u0131n.<a href=\"\/tr\/testing\/\">K\u0131s\u0131rl\u0131k Testi<\/a>&quot; b\u00f6l\u00fcm. Bu b\u00f6l\u00fcmde, \u00e7e\u015fitli semen parametrelerine dayal\u0131 sperm s\u0131n\u0131fland\u0131rmalar\u0131 hakk\u0131nda bilgi bulacaks\u0131n\u0131z. Baz\u0131 durumlarda, sperm \u00fcretimi bo\u015falma yoluyla sperm \u00fcretmek i\u00e7in yeterli olmasa bile (yukar\u0131da bahsedilen obstr\u00fcktif azospermi durumunda oldu\u011fu gibi), sperm elde etmek i\u00e7in TESA, PESA ve MESA gibi k\u00fc\u00e7\u00fck cerrahi prosed\u00fcrler kullan\u0131labilir. Bunlar nispeten kolay, h\u0131zl\u0131 ve nispeten a\u011fr\u0131s\u0131z i\u015flemlerdir. Bu i\u015flemler s\u0131ras\u0131nda canl\u0131 sperm h\u00fccreleri bulunursa d\u00f6llenme m\u00fcmk\u00fcn olabilir. Ancak cerrahi olarak elde edilen sperm h\u00fccreleri ejak\u00fclatta bulunanlara g\u00f6re daha az olgun olma e\u011filiminde oldu\u011fundan, cerrahi olarak elde edilen sperm h\u00fccreleri ile d\u00f6llenme oranlar\u0131n\u0131n ejak\u00fclatta bulunan sperm h\u00fccrelerine g\u00f6re daha d\u00fc\u015f\u00fck olaca\u011f\u0131 unutulmamal\u0131d\u0131r.<\/p><p>Bazen, azospermili hastalar hangi tip azospermiden muzdarip olduklar\u0131n\u0131 tam olarak bilmeyebilirler ve kapsaml\u0131 ve pahal\u0131 testlerden ziyade cerrahi sperm ekstraksiyonu giri\u015fiminde bulunmak daha maliyet ve zaman a\u00e7\u0131s\u0131ndan daha etkili olabilir. Normalde, cerrahi sperm ekstraksiyonunun kad\u0131n partnerin yumurta al\u0131m\u0131yla ayn\u0131 anda yap\u0131lmas\u0131n\u0131 tavsiye ediyoruz, b\u00f6ylece taze elde edilen sperm h\u00fccreleri, ba\u015far\u0131 \u015fans\u0131n\u0131 art\u0131rman\u0131n bir yolu olarak bir IVF d\u00f6ng\u00fcs\u00fcnde taze elde edilen yumurta h\u00fccreleriyle birlikte kullan\u0131labilir. Cerrahi sperm ekstraksiyonunun sonucu tahmin edilemedi\u011finde, hastalar IVF d\u00f6ng\u00fcs\u00fcn\u00fc ba\u015flatmakta kendilerini rahat hissetmezler. Ya t\u00fcp bebek d\u00f6ng\u00fcs\u00fc ba\u015flat\u0131l\u0131rsa, kad\u0131n hastaya yumurta al\u0131m\u0131 yap\u0131l\u0131rsa ancak yumurtalar\u0131 d\u00f6lleyecek sperm yoksa? Bir se\u00e7enek, t\u00fcp bebek d\u00f6ng\u00fcs\u00fcn\u00fc iptal etmek zorunda kalmamak i\u00e7in cerrahi ekstraksiyon yoluyla elde edilen sperm \u00f6rne\u011fini dondurmakt\u0131r. Bununla birlikte, cerrahi olarak elde edilen sperm h\u00fccrelerinin kalitesi ve olgunla\u015fma seviyeleri, standart sperm h\u00fccrelerine k\u0131yasla daha d\u00fc\u015f\u00fck olaca\u011f\u0131ndan, cerrahi olarak al\u0131nan\/\u00e7\u0131kar\u0131lan spermlerin dondurulmas\u0131 genellikle \u00f6nerilmez. Bu zor bir ikilem olu\u015fturur ve b\u00f6yle bir durumda do\u011fru karar yoktur. S\u0131kl\u0131kla tavsiye etti\u011fimiz \u015fey, t\u00fcp bebek d\u00f6ng\u00fcs\u00fcn\u00fc cerrahi sperm ekstraksiyonu ba\u015far\u0131l\u0131 olacakm\u0131\u015f gibi planlamakt\u0131r. Ba\u015far\u0131l\u0131 olursa, IVF d\u00f6ng\u00fcs\u00fc tamamlanabilir. De\u011filse, hastalara iki se\u00e7enek verilebilir:<\/p><p>1- Kad\u0131n hastadan elde edilen yumurtalar\u0131 gelecekte kullan\u0131lmak \u00fczere dondurun (don\u00f6r spermiyle veya muhtemelen erkek hasta k\u00f6k h\u00fccre tedavisini denemek isteyebilir ve kendi sperm h\u00fccreleriyle yeniden tedaviyi deneyebilir - a\u015fa\u011f\u0131daki b\u00f6l\u00fcme bak\u0131n) Kuzey K\u0131br\u0131s T\u00fcp Bebek Klini\u011finde k\u00f6k h\u00fccre tedavisi hakk\u0131nda daha fazla bilgi i\u00e7in)<\/p><p>2- T\u00fcp bebek d\u00f6ng\u00fcs\u00fcn\u00fc don\u00f6r sperm kullanarak tamamlay\u0131n. Hakk\u0131nda daha fazla bilgi i\u00e7in l\u00fctfen ilgili sayfay\u0131 ziyaret edin.\u00a0<a href=\"\/tr\/ivf-with-sperm-donation\/\">Don\u00f6r sperm kullan\u0131larak t\u00fcp bebek tedavisi<\/a>. <a> <img decoding=\"async\" style=\"width: auto; max-width: 100%;\" src=\"https:\/\/www.lowcostivf.net\/wp-content\/uploads\/2019\/10\/shutterstock-49747087_1.jpeg\" alt=\"Obstr\u00fcktif olmayan azospermi i\u00e7in k\u00f6k h\u00fccre tedavisi\" \/><\/a><\/p><div id=\"152130577755930961\"><div><div id=\"element-e2e90e10-ab65-4bb2-8181-69ee6d8a7603\" class=\"platform-element-contents\" data-platform-element-id=\"367329698330093151-1.0.5\"><h2>K\u00f6k H\u00fccre Tedavisi : Azoospermi Tedavi Edilebilir mi?<\/h2><\/div><div>\u00a0<\/div><\/div><\/div><div class=\"paragraph\"><p>Azospermi iki kategoriye ayr\u0131labilir: Obstr\u00fcktif azospermi ve Obstr\u00fcktif olmayan azospermi. Bir t\u0131kan\u0131kl\u0131k oldu\u011funda (obstr\u00fcktif azospermi durumunda oldu\u011fu gibi), aktif sperm \u00fcretimi olmas\u0131na ra\u011fmen sperm h\u00fccreleri ejak\u00fclata \u00e7\u0131kamaz. Bu gibi durumlarda cerrahi sperm elde etme y\u00f6ntemlerine ba\u015fvurulur ve cerrahi olarak sperm h\u00fccreleri \u00e7\u0131kar\u0131l\u0131r. Ancak azospermi engelleyici olmad\u0131\u011f\u0131nda sperm \u00fcretimi\/olgunla\u015fmas\u0131 sorunu vard\u0131r. Obstr\u00fcktif olmayan azospermide, cerrahi sperm \u00e7\u0131karma y\u00f6ntemlerinin istenen sonu\u00e7lar\u0131 verme olas\u0131l\u0131\u011f\u0131 yoktur. Di\u011fer iki alternatif ise k\u00f6k h\u00fccre tedavisi veya sperm don\u00f6r\u00fc kullan\u0131larak yap\u0131lan t\u00fcp bebek tedavisidir.<\/p><p>Hasta, don\u00f6r sperm kullan\u0131larak IVF tedavisini d\u00fc\u015f\u00fcnmeye hen\u00fcz haz\u0131r de\u011filse, k\u00f6k h\u00fccre tedavimize uygun olup olmad\u0131\u011f\u0131 konusunda bir de\u011ferlendirme yap\u0131l\u0131r. K\u00f6k h\u00fccre \u00e7al\u0131\u015fmam\u0131zda mezenkimal k\u00f6k h\u00fccre (hastan\u0131n kendi ya\u011f dokusundan) kullan\u0131yoruz. Ya\u011f dokusu, liposuction&#039;a \u00e7ok benzeyen cerrahi bir prosed\u00fcrle \u00e7\u0131kar\u0131l\u0131r. Ya\u011f dokusu \u00e7\u0131kar\u0131ld\u0131ktan sonra, mezenkimal k\u00f6k h\u00fccrelerin izole edilmesi i\u00e7in ileri i\u015flemler ve laboratuvar \u00e7al\u0131\u015fmalar\u0131 yap\u0131l\u0131r. K\u00f6k h\u00fccreler izole edildi\u011finde yine hastan\u0131n kendi kan \u00f6rne\u011finden elde edilen trombositten zengin plazma (prp) ile kar\u0131\u015ft\u0131r\u0131l\u0131r. Mezenkimal k\u00f6k h\u00fccreler ve trombosit a\u00e7\u0131s\u0131ndan zengin plazma kar\u0131\u015f\u0131m\u0131, spermatogenezin ba\u015flat\u0131lmas\u0131 ve olgunla\u015fmas\u0131 i\u00e7in \u00f6nemli olan d\u00f6rt farkl\u0131 konumda testislere do\u011frudan enjekte edilir.<\/p><p>K\u00f6k h\u00fccre tedavisi i\u00e7in yakla\u015f\u0131k 3-4 g\u00fcn K\u0131br\u0131s&#039;ta kalman\u0131z beklenecektir. Bu bize gerekli testleri yapmak, kan \u00f6rne\u011finizi almak, ya\u011f dokusu i\u00e7in liposuction yapmak ve enjeksiyon i\u00e7in hepsini bir arada i\u015flemek i\u00e7in yeterli zaman verecektir. K\u00f6k h\u00fccre enjeksiyonundan sonra etkinin g\u00f6r\u00fclmesi i\u00e7in \u00fc\u00e7 ayl\u0131k bir bekleme s\u00fcresi vard\u0131r. Spermatogenez (sperm h\u00fccrelerinin \u00fcretimi ve olgunla\u015fmas\u0131) yakla\u015f\u0131k 65 ila 70 g\u00fcn s\u00fcrer. Dolay\u0131s\u0131yla sperm h\u00fccrelerini etkilemesi muhtemel olan her \u015fey bu s\u00fcreden sonra sperm \u00f6rne\u011fine etki edecektir. K\u00f6k h\u00fccre enjeksiyonundan 3 ay sonra semen analizi yap\u0131l\u0131rsa buna g\u00f6re t\u00fcp bebek tedavisi planlanabilir.<\/p><p><span style=\"font-size: medium;\"><span style=\"color: #515151;\">Daha fazla bilgi i\u00e7in l\u00fctfen web sitemizdeki ilgili sayfay\u0131 ziyaret edin.<\/span> <\/span><a href=\"\/tr\/stem-cell-therapy-for-azoospermia\/\">obstr\u00fcktif olmayan azospermi i\u00e7in k\u00f6k h\u00fccre tedavisi.<\/a><\/p><\/div><div>\u00a0<\/div><div><div><div>\u00a0<\/div><hr class=\"styled-hr\" \/><div><span style=\"font-size: x-large;\">Bilimsel A\u00e7\u0131dan Erkek K\u0131s\u0131rl\u0131\u011f\u0131<\/span><\/div><\/div><div><hr class=\"styled-hr\" \/><div>\u00a0<\/div><\/div><div class=\"paragraph\"><p><strong>Erkek K\u0131s\u0131rl\u0131\u011f\u0131nda Androjenik Anabolik Steroid K\u00f6t\u00fcye Kullan\u0131m\u0131n\u0131n Rol\u00fc<\/strong><br \/>kaydeden Ahmet \u00d6zyi\u011fit<\/p><p><strong>Vaka Analizi<\/strong><br \/>28 ya\u015f\u0131nda kasl\u0131 bir adam, 27 ya\u015f\u0131ndaki partneriyle k\u0131s\u0131rl\u0131k ara\u015ft\u0131rmalar\u0131na gidiyor. 3 y\u0131ld\u0131r gebe kalmaya \u00e7al\u0131\u015f\u0131yorlar (ba\u015far\u0131s\u0131zl\u0131kla). Kad\u0131n partnerin t\u00fcm ara\u015ft\u0131rmalar\u0131, normal yumurtal\u0131k fonksiyonuna, a\u00e7\u0131k fallop t\u00fcplerine ve normal bir endokrin profiline sahip oldu\u011funu g\u00f6stermektedir. Erkek partnerin iki y\u0131l \u00f6nce klinikte ger\u00e7ekle\u015ftirilen ilk ara\u015ft\u0131rmalar\u0131, onun ciddi \u015fekilde oligozoospermik ve hatta &lt;10.000 sperm\/ml ile azospermik oldu\u011funu ve bunun &gt; 90 %&#039;nin WHO (1999) kriterlerine g\u00f6re anormal morfolojiye sahip oldu\u011funu g\u00f6sterdi. 2011&#039;de erkek partnerle ilgili yap\u0131lan en son takip ara\u015ft\u0131rmas\u0131, testis hacminin azald\u0131\u011f\u0131n\u0131 (1.5 ml) ve anormal derecede y\u00fcksek FSH seviyesine sahip oldu\u011funu g\u00f6steriyor. Testik\u00fcler sperm aspirasyonunu (TESA) i\u00e7erebilen bir tedavi plan\u0131 kullanan ICSI d\u00fc\u015f\u00fcn\u00fclmektedir. Kasl\u0131 yap\u0131s\u0131 g\u00f6z \u00f6n\u00fcne al\u0131nd\u0131\u011f\u0131nda, dan\u0131\u015fman adama son on iki ayd\u0131r steroid kullan\u0131p kullanmad\u0131\u011f\u0131n\u0131 sorar. Adam, spor salonunda bir arkada\u015f\u0131n\u0131n verdi\u011fi &quot;bir \u015feyi&quot; ald\u0131\u011f\u0131n\u0131, ancak alt\u0131 ay \u00f6nce &quot;bunu&quot; almay\u0131 b\u0131rakt\u0131\u011f\u0131n\u0131 ve yeniden ba\u015flamay\u0131 d\u00fc\u015f\u00fcnmedi\u011fini itiraf ediyor. Daha sonra ba\u015fka sorular\u0131 yan\u0131tlamay\u0131 reddediyor.<\/p><p><strong>girii\u015f<\/strong><br \/>Androjenik anabolik steroid k\u00f6t\u00fcye kullan\u0131m\u0131, kardiyovask\u00fcler, metabolik ve \u00fcreme sistemleri dahil olmak \u00fczere \u00e7e\u015fitli organ ve sistemlerde istenmeyen ve bazen geri d\u00f6n\u00fc\u015f\u00fc olmayan de\u011fi\u015fikliklere neden olabilir(1). Steroid k\u00f6t\u00fcye kullan\u0131m\u0131 ile k\u0131s\u0131rl\u0131k aras\u0131ndaki kesin ili\u015fki hakk\u0131nda s\u0131n\u0131rl\u0131 literat\u00fcr bulunmas\u0131na ra\u011fmen, mevcut literat\u00fcr, istismar kurbanlar\u0131n\u0131n steroid kaynakl\u0131 baz\u0131 temel ortak \u00f6zelliklerine i\u015faret ederek konuya biraz \u0131\u015f\u0131k tutmaktad\u0131r. Steroid k\u00f6t\u00fcye kullan\u0131m\u0131n\u0131n dozu ve zaman \u00e7er\u00e7evesi, muhtemelen \u00fcreme i\u015flevi \u00fczerindeki etkinin boyutunu belirleyecektir. Bir dizi \u00e7al\u0131\u015fma, steroid kullan\u0131m\u0131n\u0131n kesilmesinden sonra sperm \u00f6zelliklerinin asl\u0131nda normal seviyelere d\u00f6nebilece\u011fini(2,3,6), a\u011f\u0131r AAS kullananlarda ise serum testosteron seviyelerinin normal seviyelere geri d\u00f6nmeyebilece\u011fini(1) ortaya koymaktad\u0131r.<\/p><p>Androjenik anabolik steroid (AAS) k\u00f6t\u00fcye kullan\u0131m\u0131 olan hastalara yakla\u015f\u0131rken kar\u015f\u0131la\u015f\u0131lan ana sorunlardan biri, k\u00f6t\u00fcye kullan\u0131m ge\u00e7mi\u015flerinin ayr\u0131nt\u0131l\u0131 bir a\u00e7\u0131klamas\u0131n\u0131 sunma konusunda isteksiz olma e\u011filiminde olmalar\u0131d\u0131r, bu da \u00fcreme i\u015flevi \u00fczerindeki potansiyel etkinin etkili bir \u015fekilde de\u011ferlendirilmesini zorla\u015ft\u0131r\u0131r. . Bununla birlikte, daha invaziv tedavi se\u00e7eneklerini d\u00fc\u015f\u00fcnmeden \u00f6nce, daha fazla ara\u015ft\u0131rma yap\u0131lmal\u0131d\u0131r.<\/p><p><strong>Mevcut Vaka \u00c7al\u0131\u015fmas\u0131 Analiz Edildi<\/strong><br \/>Mevcut vaka bize erkek fakt\u00f6r\u00fc k\u0131s\u0131rl\u0131\u011f\u0131 olan bir \u00e7ift sunuyor. \u00c7iftin do\u011furganl\u0131k klini\u011findeki dan\u0131\u015fman\u0131, erkek partnerin kasl\u0131l\u0131\u011f\u0131n\u0131 fark eder ve onlara, erkek partnerin kulland\u0131\u011f\u0131n\u0131 kabul etti\u011fi olas\u0131 steroid kullan\u0131m\u0131n\u0131 sorar. Hastan\u0131n madde kullan\u0131m\u0131yla ilgili ba\u015fka sorular\u0131 yan\u0131tlamakta teredd\u00fct etmesi g\u00f6z \u00f6n\u00fcne al\u0131nd\u0131\u011f\u0131nda, k\u00f6t\u00fcye kullan\u0131m \u00f6yk\u00fcs\u00fcn\u00fcn do\u011fru olmayabilece\u011fi varsay\u0131labilir. Hasta, kons\u00fcltasyondan alt\u0131 ay \u00f6nce AAS kullanmay\u0131 b\u0131rakt\u0131\u011f\u0131n\u0131 iddia etse de, 1992&#039;de yap\u0131lan bir \u00e7al\u0131\u015fma, uzun s\u00fcreli AAS kullan\u0131m\u0131yla elde edilen kas kazan\u0131mlar\u0131n\u0131n yar\u0131s\u0131n\u0131n, kullan\u0131mdan sonraki iki ay i\u00e7inde kaybolaca\u011f\u0131na ve daha sonra da kaybedilece\u011fine dair kan\u0131t sa\u011flar. ay(4). Hastan\u0131n kasl\u0131l\u0131\u011f\u0131 \u00e7ok iyi fark ediliyorsa, hasta hala steroidleri k\u00f6t\u00fcye kullan\u0131yor olabilir veya yak\u0131n zamana kadar kullan\u0131yor olabilir. B\u00f6yle bir senaryoda, testis hacminin, hipofiz gonadotropinlerinin ve sperm say\u0131s\u0131n\u0131n normal seviyelerden sapmalar g\u00f6sterdi\u011fi bilinmektedir. Anabolik steroidlerin, negatif geribildirim yoluyla gonadotropin sekresyonunu bask\u0131lamas\u0131 beklenir, bu da serum gonadotropinlerinin azalmas\u0131na, serum testosteron d\u00fczeylerinin d\u00fc\u015fmesine, testik\u00fcler atrofiye ve AAS k\u00f6t\u00fcye kullan\u0131m\u0131 ile AAS aras\u0131ndaki ili\u015fkiyi ara\u015ft\u0131ran \u00e7o\u011fu vaka \u00e7al\u0131\u015fmas\u0131nda kan\u0131tland\u0131\u011f\u0131 \u00fczere bozulmu\u015f sperme neden olur. erkek k\u0131s\u0131rl\u0131\u011f\u0131(3)<\/p><p>Erkek hastan\u0131n madde kullan\u0131m\u0131yla ilgili do\u011fruyu s\u00f6ylemekte isteksiz olma olas\u0131l\u0131\u011f\u0131 g\u00f6z \u00f6n\u00fcne al\u0131nd\u0131\u011f\u0131nda, tedavinin ilk ad\u0131m\u0131, uzun s\u00fcreli AAS kullan\u0131m\u0131n\u0131n ge\u00e7ici ve kal\u0131c\u0131 etkilerinin erkek k\u0131s\u0131rl\u0131\u011f\u0131 \u00fczerindeki etkilerine g\u00f6re ayr\u0131nt\u0131l\u0131 olarak anlat\u0131laca\u011f\u0131 psikolojik dan\u0131\u015fma olacakt\u0131r. di\u011fer sistemler gibi. Dan\u0131\u015fmanl\u0131k, bir \u00e7ocu\u011fa ebeveynlik yapmay\u0131 ciddi olarak d\u00fc\u015f\u00fcn\u00fcyorsa, hastay\u0131 AAS istismar\u0131n\u0131 kal\u0131c\u0131 olarak durdurmaya potansiyel olarak ikna edebilir.<\/p><p>1997&#039;de yap\u0131lan bir \u00e7al\u0131\u015fma, d\u00f6rt AAS k\u00f6t\u00fcye kullan\u0131m\u0131 vakas\u0131n\u0131 ve bunlar\u0131n takip \u00e7al\u0131\u015fmalar\u0131n\u0131 analiz ediyor. D\u00f6rt vakan\u0131n t\u00fcm\u00fc, azospermi ve azalm\u0131\u015f testis hacmi bulgular\u0131 ile birlikte \u00e7al\u0131\u015fmaya ilk kabul edildi\u011finde d\u00fc\u015f\u00fck seviyelerde hipofiz gonadotropinleri g\u00f6stermektedir. D\u00f6rt vakada da hastalardan steroid kullanmay\u0131 b\u0131rakmalar\u0131 isteniyor ve 12 ve 18 ay sonra ayn\u0131 testler uygulan\u0131yor. D\u00f6rt vakan\u0131n hepsinde, hipofiz gonadotropin seviyelerinde ve toplam sperm say\u0131s\u0131nda iyile\u015fmeler bildirilmi\u015ftir. D\u00f6rt vakadan \u00fc\u00e7\u00fc sonraki y\u0131llarda do\u011fal gebelik bildirmektedir(5). 1995 y\u0131l\u0131nda yap\u0131lan bir \u00e7al\u0131\u015fma, semen analizi madde kullan\u0131m\u0131 s\u0131ras\u0131nda hi\u00e7 sperm bulunmad\u0131\u011f\u0131n\u0131 g\u00f6steren AAS k\u00f6t\u00fcye kullan\u0131m\u0131 olan 34 ya\u015f\u0131ndaki bir erkek hastay\u0131 kullan\u0131r. Hastaya 6 ay boyunca hCG ile birlikte r-hFSH verilerek 13 milyon\/ml sperm say\u0131s\u0131 ve hormon seviyeleri normal s\u0131n\u0131rlar i\u00e7inde(6). Her iki \u00e7al\u0131\u015fma da AAS hasar\u0131n\u0131n tersine \u00e7evrilebilir y\u00f6n\u00fc i\u00e7in kan\u0131t sa\u011flamaktad\u0131r.<\/p><p>Torres-Calleja ve arkada\u015flar\u0131 taraf\u0131ndan 2001 y\u0131l\u0131nda yap\u0131lan bir \u00e7al\u0131\u015fma, AAS k\u00f6t\u00fcye kullan\u0131m\u0131n\u0131n baz\u0131 taciz kurbanlar\u0131nda morfolojik olarak normal sperm y\u00fczdesini potansiyel olarak bozabilece\u011fini g\u00f6stermektedir(8). Ortaya \u00e7\u0131kan d\u00fc\u015f\u00fck sperm say\u0131s\u0131, ili\u015fkili azospermi veya oligozoospermi ile birlikte AAS&#039;nin neden oldu\u011fu hipogonadotropik hipogonadizm olarak tan\u0131mlanabilir(2,8,15). Bu, mevcut hastan\u0131n deneyimi ile uyumludur. Bununla birlikte, hastalar\u0131m\u0131z\u0131 bu vaka \u00e7al\u0131\u015fmalar\u0131ndan ve alandaki \u00e7e\u015fitli literat\u00fcr\u00fcn bulgular\u0131ndan ay\u0131ran bir\u00e7ok \u015fey vard\u0131r. Her \u015feyden \u00f6nce, erkek partnerin testis hacmi, incelenen di\u011fer vakalardan bile daha fazla, \u00f6nemli \u00f6l\u00e7\u00fcde azal\u0131r. Bu ama\u00e7la testis k\u00fc\u00e7\u00fclmesinin olas\u0131 bir a\u00e7\u0131klamas\u0131 i\u00e7in hastaya varikosel ve epididimit \u00e7al\u0131\u015fmas\u0131 yap\u0131lmas\u0131 gerekebilir(13). \u0130kinci olarak, literat\u00fcrde sunulan birka\u00e7 vakan\u0131n aksine, hastan\u0131n y\u00fcksek serum FSH seviyesi vard\u0131r ki bu, di\u011fer vakalar\u0131n belgeledi\u011finin tam tersidir. Ancak testis hacminin azalmas\u0131yla birlikte sperm say\u0131s\u0131n\u0131n azalma ve FSH&#039;nin artma e\u011filiminde oldu\u011fu bildirilmi\u015ftir(14). Erkeklerde y\u00fcksek FSH seviyeleri ayr\u0131ca, Klinefelters sendromu veya hasarl\u0131 germinal epitel gibi kromozomal anormallik olas\u0131l\u0131\u011f\u0131n\u0131 g\u00fc\u00e7lendiren geli\u015fimsel kusurlara veya testis yetmezli\u011fine i\u015faret edebilir. Sperm konsantrasyonu 5 milyon\/ml&#039;nin alt\u0131nda olan \u015fiddetli oligospermik erkeklerde, serum FSH konsantrasyonunun normal aral\u0131\u011f\u0131n \u00fczerinde olma e\u011filiminde oldu\u011fu da bildirilmi\u015ftir(8). Mevcut vaka \u00e7al\u0131\u015fmas\u0131yla olas\u0131 senaryolar\u0131 daha fazla ara\u015ft\u0131rmak i\u00e7in, serum testosteron ve estradiol seviyeleri \u00f6l\u00e7\u00fclmedi\u011fi i\u00e7in hastan\u0131n tam bir hormonal profilinin belirlenmesi gerekir. Klinefelters sendromu (KFS) \u015f\u00fcphesini ortadan kald\u0131rmak i\u00e7in bir karyotip analizi gerekli olacakt\u0131r. Bir \u00e7al\u0131\u015fma, KFS&#039;li t\u00fcm deneklerinin y\u00fcksek plazma FSH seviyelerine sahip oldu\u011funu, KFS hastalar\u0131n\u0131n yakla\u015f\u0131k d\u00f6rtte birinin Y kromozom mikrodelesyonlar\u0131na sahip oldu\u011funu bulmu\u015ftur(9). Son zamanlarda yap\u0131lan ba\u015fka bir \u00e7al\u0131\u015fma, mikrodelesyonlar\u0131n varl\u0131\u011f\u0131ndan ba\u011f\u0131ms\u0131z olarak, germ h\u00fccre fonksiyonu ciddi \u015fekilde bozulmu\u015f erkeklerde serum FSH seviyesinin y\u00fckseldi\u011fini bulmu\u015ftur(10). FSH d\u00fczeyi y\u00fcksek olan her erkekte Y kromozomu mikrodelesyonu olmas\u0131 gerekmese de, en uygun tedavi y\u00f6nteminin belirlenmesi i\u00e7in ciddi oligozoospermisi olan erkeklerde tan\u0131sal testlerin yap\u0131lmas\u0131 gerekti\u011fi s\u00f6ylenebilir(11).<\/p><p><strong>\u00c7\u00f6z\u00fcm<\/strong><br \/>Hastalar\u0131n gen\u00e7 ya\u015flar\u0131 g\u00f6z \u00f6n\u00fcne al\u0131nd\u0131\u011f\u0131nda ve kad\u0131n partnerin endokrin profili ve yumurtal\u0131k fonksiyonunun normal parametreler i\u00e7inde oldu\u011fu g\u00f6z \u00f6n\u00fcne al\u0131nd\u0131\u011f\u0131nda, kan\u0131tlar\u0131n g\u00f6sterdi\u011fi gibi hipofiz gonadotropin d\u00fczeylerini ve sperm say\u0131s\u0131n\u0131 g\u00f6zlemlemek i\u00e7in sonraki aylarda erkek partner \u00fczerinde daha fazla test yap\u0131lmas\u0131ndan yanay\u0131z. AAS hasar\u0131, hasta a\u011f\u0131r bir \u015fekilde k\u00f6t\u00fcye kullanmad\u0131\u011f\u0131 s\u00fcrece tersine \u00e7evrilebilir. Dene\u011fin AAS kullan\u0131m\u0131n\u0131 b\u0131rakmas\u0131 ve alt\u0131 ay i\u00e7inde tekrar test etmesi, daha \u00f6nce bahsedilen di\u011fer testleri ba\u015fka bir sorun g\u00f6stermedi\u011fi s\u00fcrece en uygun eylem olacakt\u0131r. ICSI ve TESA prosed\u00fcrleri, bu noktada gereksiz ila\u00e7 kullan\u0131m\u0131 ve invaziv tedavi protokollerinin yan\u0131 s\u0131ra gereksiz duygusal ve mali y\u00fck getirecektir.<\/p><p><strong>REFERANSLAR<\/strong><br \/>1. Karila, T (2003) Anabolik androjenik steroidlerin, anabolik madde ba\u011f\u0131ml\u0131lar\u0131n\u0131n kardiyovask\u00fcler, metabolik ve \u00fcreme sistemleri \u00fczerindeki olumsuz etkileri. Tez T\u0131p Fak\u00fcltesi, Helsinki \u00dcniversitesi.<br \/>2. Schurmeyer, T., Knuth, UA, Belkien, E. <em>et al<\/em>. (1984) Anabolik steroid 19-nortestosteron taraf\u0131ndan ind\u00fcklenen geri d\u00f6n\u00fc\u015f\u00fcml\u00fc azospermi. <em>Lancet<\/em>, <strong>BEN<\/strong>: 417\u2013420.<br \/>3. Holma, PK (1977) Bir anabolik steroidin (metandienon) spermatogenez \u00fczerindeki etkileri. <em>do\u011fum kontrol\u00fc<\/em>, <strong>15<\/strong>, 151.<br \/>4. Forbes, GB ve ark. (1992). Testosteronun neden oldu\u011fu v\u00fccut kompozisyonundaki de\u011fi\u015fikliklerin s\u0131ras\u0131 ve ila\u00e7 durdurulduktan sonra de\u011fi\u015fikliklerin tersine d\u00f6nmesi.<em> JAMA<\/em>. 267:397-399.<br \/>5. Gazvani MR, Buckett W, Luckas MJ, Aird IA, Hipkin LJ, Lewis-Jones DI. (1997). Steroid k\u00f6t\u00fcye kullan\u0131m\u0131ndan sonra azosperminin konservatif tedavisi. <em>U\u011fultu<\/em>, <strong>12<\/strong>: 1706\u20138<br \/>6. Moretti, E. ve ark. (2007) Androjenik Anabolik Steroidlerin Kullan\u0131lmas\u0131ndan Sonra Spermatogenez \u0130yile\u015fmesi Olgusunda Yap\u0131sal Sperm ve An\u00f6ploidiler \u00c7al\u0131\u015fmalar\u0131\u201d <em>J Yard\u0131mc\u0131 Reprod<\/em> <em>genet<\/em>, 24:195-198.<br \/>7. Simoni M, Weinbauer GF, Gromoll J, Nieschlag E. (1999). Erkek gonadal fonksiyonunda FSH&#039;nin rol\u00fc. <em>Ann Endokrinol<\/em>. 60: 102-6.<br \/>8. Martin-du-Pan, RC ve Bischof, P. (1995) K\u0131s\u0131r erkeklerde artan folik\u00fcl uyar\u0131c\u0131 hormon: artan plazma FSH&#039;si her zaman epitel hasar\u0131na ba\u011fl\u0131 m\u0131d\u0131r? <em>H\u0131mm. \u00e7o\u011faltmak<\/em>., 10, 1940\u20131945. 9. Mitra A, Dada R, Kumar R, Gupta NP, Kucheria K, Gupta SK. (2006). Klinefelter sendromlu azospermik hastalarda Y kromozom mikrodelesyonlar\u0131. <em>Asyal\u0131 J Androl<\/em>. 8(1):81-88.<br \/>10. Kumar R, Dada R, Gupta NP, Kucheria K. (2006) Obstr\u00fcktif olmayan azospermi ve Y kromozomu mikrodelesyonlar\u0131 olan infertil erkeklerde serum FSH seviyeleri ve testis histolojisi. <em>Ind J Urol<\/em>. <em>22 <\/em>: 332-6.<br \/>11. Foresta C, Moro E, Ferlin A (2001). <strong>Y kromozomu mikrodelesyonlar\u0131 ve spermatogenezdeki de\u011fi\u015fiklikler. <\/strong><em>Endokrin Rev<\/em>, <strong>22:<\/strong>226-239<br \/>12. J Pundir, DK Chui, DW Lipscomb. (2008) Anabolik steroidler ve erkek k\u0131s\u0131rl\u0131\u011f\u0131. <em>Journal of obstetrics and jinekology : Institute of Obstetrics and Gynecology dergisi.<\/em> 28(8):810-811.<br \/>13. \u015eah P (1998). &quot;Oligospermili erkeklerde d\u00fc\u015f\u00fck doz \u00f6strojen-testosteron kombinasyon tedavisinin rol\u00fc&quot;. <em>Do\u011furganl\u0131k ve K\u0131s\u0131rl\u0131k<\/em> <strong>70<\/strong> (4): 780\u2013781<br \/>14. Bujan L, Mieusset R, Mansat A, Moatti JP, Mondinat C, Pontonnier F (1989) K\u0131s\u0131r erkeklerde testis boyutu: semen \u00f6zellikleri ve hormonal kan seviyeleri ile ili\u015fki. <em>Br J Urol<\/em> 64(6), 632-63.<br \/>15. Penna, S., &amp; Hern\u00e1ndez, G. (2010) 75 Androjenik Anabolik Steroidlerin (AAS) Venezuelal\u0131 v\u00fccut geli\u015ftiricilerde \u00fcreme i\u015flevi ve lipid metabolizmas\u0131 \u00fczerindeki etkileri. <em>\u00dcreme Biyot\u0131p \u00c7evrimi\u00e7i <\/em>20:3; 30-31<\/p><\/div><\/div>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-d20be5d elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"d20be5d\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3ffeb49\" data-id=\"3ffeb49\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-878e309 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"878e309\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-inner-column elementor-element elementor-element-fc7610d\" data-id=\"fc7610d\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4237a89 elementor-cta--skin-classic elementor-animated-content elementor-bg-transform elementor-bg-transform-zoom-in elementor-widget elementor-widget-call-to-action\" data-id=\"4237a89\" data-element_type=\"widget\" data-widget_type=\"call-to-action.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<a class=\"elementor-cta\" href=\"\/tr\/female-infertility\/\">\n\t\t\t\t\t<div class=\"elementor-cta__bg-wrapper\">\n\t\t\t\t<div class=\"elementor-cta__bg elementor-bg\" style=\"background-image: url(https:\/\/www.lowcostivf.net\/wp-content\/uploads\/2019\/11\/female-infertility-350x250.jpg);\" role=\"img\" aria-label=\"kad\u0131n k\u0131s\u0131rl\u0131\u011f\u0131\"><\/div>\n\t\t\t\t<div class=\"elementor-cta__bg-overlay\"><\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-cta__content\">\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<h2 class=\"elementor-cta__title elementor-cta__content-item elementor-content-item\">\n\t\t\t\t\t\tKad\u0131n K\u0131s\u0131rl\u0131\u011f\u0131\t\t\t\t\t<\/h2>\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-cta__description elementor-cta__content-item elementor-content-item\">\n\t\t\t\t\t\t<p style=\"text-align: center; !important;\">Kad\u0131n K\u0131s\u0131rl\u0131\u011f\u0131n\u0131n Nedenleri ve Tedavisi<\/p>\t\t\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-ribbon elementor-ribbon-left\">\n\t\t\t\t<div class=\"elementor-ribbon-inner\">Kad\u0131n K\u0131s\u0131rl\u0131\u011f\u0131<\/div>\n\t\t\t<\/div>\n\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-inner-column elementor-element elementor-element-e48d3ad\" data-id=\"e48d3ad\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-93daac0 elementor-cta--skin-classic elementor-animated-content elementor-bg-transform elementor-bg-transform-zoom-in elementor-widget elementor-widget-call-to-action\" data-id=\"93daac0\" data-element_type=\"widget\" data-widget_type=\"call-to-action.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<a class=\"elementor-cta\" href=\"\/tr\/testing\/\">\n\t\t\t\t\t<div class=\"elementor-cta__bg-wrapper\">\n\t\t\t\t<div class=\"elementor-cta__bg elementor-bg\" style=\"background-image: url(https:\/\/www.lowcostivf.net\/wp-content\/uploads\/2019\/11\/Testing-350x250.jpg);\" role=\"img\" aria-label=\"Test yapmak\"><\/div>\n\t\t\t\t<div class=\"elementor-cta__bg-overlay\"><\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-cta__content\">\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<h2 class=\"elementor-cta__title elementor-cta__content-item elementor-content-item\">\n\t\t\t\t\t\tTest yapmak\t\t\t\t\t<\/h2>\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-cta__description elementor-cta__content-item elementor-content-item\">\n\t\t\t\t\t\t<p style=\"text-align: center; !important;\">K\u0131s\u0131rl\u0131k Testi ve Te\u015fhisi<\/p>\t\t\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-ribbon elementor-ribbon-left\">\n\t\t\t\t<div class=\"elementor-ribbon-inner\">Test yapmak<\/div>\n\t\t\t<\/div>\n\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-inner-column elementor-element elementor-element-6317380\" data-id=\"6317380\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c4cb266 elementor-cta--skin-classic elementor-animated-content elementor-bg-transform elementor-bg-transform-zoom-in elementor-widget elementor-widget-call-to-action\" data-id=\"c4cb266\" data-element_type=\"widget\" data-widget_type=\"call-to-action.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<a class=\"elementor-cta\" href=\"\/tr\/treatment-decision\/\">\n\t\t\t\t\t<div class=\"elementor-cta__bg-wrapper\">\n\t\t\t\t<div class=\"elementor-cta__bg elementor-bg\" style=\"background-image: url(https:\/\/www.lowcostivf.net\/wp-content\/uploads\/2019\/11\/Treatment-Decision-350x250.jpg);\" role=\"img\" aria-label=\"Tedavi-Karar\"><\/div>\n\t\t\t\t<div class=\"elementor-cta__bg-overlay\"><\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-cta__content\">\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<h2 class=\"elementor-cta__title elementor-cta__content-item elementor-content-item\">\n\t\t\t\t\t\tTedavi Karar\u0131\t\t\t\t\t<\/h2>\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-cta__description elementor-cta__content-item elementor-content-item\">\n\t\t\t\t\t\t<p style=\"text-align: center; !important;\">Do\u011fru Tedaviyi Se\u00e7mek<\/p>\t\t\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-ribbon elementor-ribbon-left\">\n\t\t\t\t<div class=\"elementor-ribbon-inner\">Tedavi Karar\u0131<\/div>\n\t\t\t<\/div>\n\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-326f1e7 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"326f1e7\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-inner-column elementor-element elementor-element-60a52c9\" data-id=\"60a52c9\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e60a9ca elementor-cta--skin-classic elementor-animated-content elementor-bg-transform elementor-bg-transform-zoom-in elementor-widget elementor-widget-call-to-action\" data-id=\"e60a9ca\" data-element_type=\"widget\" data-widget_type=\"call-to-action.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<a class=\"elementor-cta\" href=\"\/tr\/miscarriages\/\">\n\t\t\t\t\t<div class=\"elementor-cta__bg-wrapper\">\n\t\t\t\t<div class=\"elementor-cta__bg elementor-bg\" style=\"background-image: url(https:\/\/www.lowcostivf.net\/wp-content\/uploads\/2019\/11\/Miscarriages-350x250.jpg);\" role=\"img\" aria-label=\"D\u00fc\u015f\u00fckler\"><\/div>\n\t\t\t\t<div class=\"elementor-cta__bg-overlay\"><\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-cta__content\">\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<h2 class=\"elementor-cta__title elementor-cta__content-item elementor-content-item\">\n\t\t\t\t\t\tD\u00fc\u015f\u00fckler\t\t\t\t\t<\/h2>\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-cta__description elementor-cta__content-item elementor-content-item\">\n\t\t\t\t\t\t<p style=\"text-align: center; !important;\">Tekrarlayan D\u00fc\u015f\u00fckler ve Tedavi Se\u00e7enekleri<\/p>\t\t\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-ribbon elementor-ribbon-left\">\n\t\t\t\t<div class=\"elementor-ribbon-inner\">D\u00fc\u015f\u00fckler<\/div>\n\t\t\t<\/div>\n\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-inner-column elementor-element elementor-element-cb8b0ac\" data-id=\"cb8b0ac\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2c88270 elementor-cta--skin-classic elementor-animated-content elementor-bg-transform elementor-bg-transform-zoom-in elementor-widget elementor-widget-call-to-action\" data-id=\"2c88270\" data-element_type=\"widget\" data-widget_type=\"call-to-action.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<a class=\"elementor-cta\" href=\"\/tr\/improving-fertility\/\">\n\t\t\t\t\t<div class=\"elementor-cta__bg-wrapper\">\n\t\t\t\t<div class=\"elementor-cta__bg elementor-bg\" style=\"background-image: url(https:\/\/www.lowcostivf.net\/wp-content\/uploads\/2019\/11\/improving-fertility-350x250.jpg);\" role=\"img\" aria-label=\"do\u011furganl\u0131\u011f\u0131n iyile\u015ftirilmesi\"><\/div>\n\t\t\t\t<div class=\"elementor-cta__bg-overlay\"><\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-cta__content\">\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<h2 class=\"elementor-cta__title elementor-cta__content-item elementor-content-item\">\n\t\t\t\t\t\tDo\u011furganl\u0131\u011f\u0131 Art\u0131rmak\t\t\t\t\t<\/h2>\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-cta__description elementor-cta__content-item elementor-content-item\">\n\t\t\t\t\t\t<p style=\"text-align: center; !important;\">Do\u011furganl\u0131k seviyenizi nas\u0131l iyile\u015ftirirsiniz (Y\u00fckseltirsiniz)?<\/p>\t\t\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-ribbon elementor-ribbon-left\">\n\t\t\t\t<div class=\"elementor-ribbon-inner\">Do\u011furganl\u0131k<\/div>\n\t\t\t<\/div>\n\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-inner-column elementor-element elementor-element-b7eaf5f\" data-id=\"b7eaf5f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-0a1fa1e elementor-cta--skin-classic elementor-animated-content elementor-bg-transform elementor-bg-transform-zoom-in elementor-widget elementor-widget-call-to-action\" data-id=\"0a1fa1e\" data-element_type=\"widget\" data-widget_type=\"call-to-action.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<a class=\"elementor-cta\" href=\"\/tr\/ivf-failures\/\">\n\t\t\t\t\t<div class=\"elementor-cta__bg-wrapper\">\n\t\t\t\t<div class=\"elementor-cta__bg elementor-bg\" style=\"background-image: url(https:\/\/www.lowcostivf.net\/wp-content\/uploads\/2019\/11\/ivf-failures-350x250.jpg);\" role=\"img\" aria-label=\"IVF ba\u015far\u0131s\u0131zl\u0131klar\u0131\"><\/div>\n\t\t\t\t<div class=\"elementor-cta__bg-overlay\"><\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-cta__content\">\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<h2 class=\"elementor-cta__title elementor-cta__content-item elementor-content-item\">\n\t\t\t\t\t\tT\u00fcp Bebek Ba\u015far\u0131s\u0131zl\u0131klar\u0131\t\t\t\t\t<\/h2>\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-cta__description elementor-cta__content-item elementor-content-item\">\n\t\t\t\t\t\t<p style=\"text-align: center; !important;\">Tekrarlanan T\u00fcp Bebek Ba\u015far\u0131s\u0131zl\u0131klar\u0131<\/p><br>\t\t\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-ribbon elementor-ribbon-left\">\n\t\t\t\t<div class=\"elementor-ribbon-inner\">T\u00fcp Bebek Ba\u015far\u0131s\u0131zl\u0131klar\u0131<\/div>\n\t\t\t<\/div>\n\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Te\u015fhis ve Y\u00f6netim https:\/\/www.youtube.com\/watch?v=GUMpOAQNdzM \u0130lgili Konular K\u0131s\u0131rl\u0131\u011f\u0131n Tan\u0131m\u0131 ve T\u00fcrleri Kad\u0131n K\u0131s\u0131rl\u0131\u011f\u0131n\u0131n Nedenleri ve Y\u00f6netimi K\u0131s\u0131rl\u0131k Testi ve Te\u015fhisi Do\u011fru Tedaviyi Se\u00e7mek Cerrahi Sperm Ekstraksiyon Y\u00f6ntemleri Obstr\u00fcktif Olmayan Azospermide K\u00f6k H\u00fccre Tedavisi Do\u011furganl\u0131k Tedavisi Se\u00e7enekleri Erkeklerde K\u0131s\u0131rl\u0131\u011f\u0131n Nedenleri Nelerdir? Erkek k\u0131s\u0131rl\u0131\u011f\u0131 s\u00f6z konusu oldu\u011funda yayg\u0131n bir hata, kafa kar\u0131\u015f\u0131kl\u0131\u011f\u0131d\u0131r [\u2026]<\/p>","protected":false},"author":1,"featured_media":1446,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-716","page","type-page","status-publish","has-post-thumbnail","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.3 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Male Infertility - North Cyprus IVF<\/title>\n<meta name=\"description\" content=\"What causes infertility in men and how can infertility be treated? Can azoospermia be treated? 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