What is male infertility?
Male infertility is the inability to develop or deliver enough viable sperm to fertilize a woman’s egg. Along with fertility testing of the woman partner, male infertility testing should also be performed in the early stages of fertility treatment.
Causes of male infertility
The absence of sperm in the semen, low sperm counts and/or sperm that cannot reach the egg once ejaculated during intercourse are all causes of male infertility. Physical blockages can occur in the deferens tubes, either from a prior vasectomy or a failed vasectomy reversal.
Testosterone imbalance and other hormone conditions, as well as genetic or chromosomal issues that affect sperm production, viability, or motility can cause male infertility.
Impotence from spinal cord injuries or psychological/emotional traumas can also cause male infertility.
Symptoms of male infertility
Unfortunately, problems with sperm production, delivery, or genetic and chromosomal disorders don't necessarily have external symptoms and therefore can only be diagnosed by semen analysis and other specialized tests.
Treatment for male infertility
Semen can be collected by masturbation, electrical stimulation or by urological procedures that extract sperm directly from the testes, after which the sperm can be analyzed.
Sperm retrieval procedures, done under local or light sedation anesthesia, include Microepididymal Sperm Aspiration (MESA), Percutaneous Epididymal Aspiration (PESA), Testicular Excisional Sperm Aspiration (TESA), and Testicular Excisional Sperm Extraction (TESE). These procedures can also be used to extract sperm for later use for fertility treatment like in vitro fertilization (IVF), if necessary.
Genetic or chromosomal abnormalities can be determined by a blood test.
If sufficient healthy sperm can be retrieved, Intrauterine Insemination (IUI) can be performed where sperm are injected directly into the woman vagina.
Another treatment option is in vitro fertilization (IVF), where healthy sperm are used to fertilize a woman’s egg outside the womb and the resulting embryo is then implanted into the woman’s uterus.
Vasectomies can sometimes be reversed through microsurgery. However, if the man has a low sperm counts or sperm with low motility (sperm movement), IVF with ICSI (intracytoplasmic sperm injection), where one healthy sperm is directly injected into the egg, may be the best treatment.
In the case of genetic or chromosomal abnormalities, we have the technology to screen out abnormal sperm and keep only the healthy.