What is Male Infertility?
As many as 40 percent of couples experience infertility associated with the male partner. Usually, a man must produce healthy, actively moving sperm cells. These specialized cells must pass freely from the testes, through the penis, and be capable of traveling through the uterus into the fallopian tubes. Male infertility may be associated with several conditions such as low sperm count or low motility of the sperm cells.
Causes of Male Infertility
The etiology of male infertility can be classified into structural, infectious, congenital, anatomic and hormonal and more rarely, genetic causes. Listed below are among the most common problems.
Vas deferens obstruction - The vas deferens that carries sperm from the testicles to the penis can be blocked for a variety of reasons including prior vasectomy, injury, infection or physical anomaly.
Infections - There are many types of infections that might cause sterility or low sperm counts in men. These can be recent infections or from childhood. Common infections can be mumps or certain types of sexually transmitted infections (STI).
Chronic Disease - Diseases that can affect hormonal controls and sperm production, particularly when not controlled are also causes of infertility. Diabetes, hypertension and other problems can all affect the fertility of men.
Erectile Dysfunction (ED) - Problems maintaining an erection or ejaculatory difficulties will result in sperm transport problems. This may be caused by chronic illnesses like diabetes, hypertension or heart problems. Some medications used to treat chronic illnesses can contribute to these types of male factor. Spinal cord injuries may damage the nerves which assist in normal sexual function.
Failure to Produce Sperm - If the body isn't producing sperm there can be many reasons. Some may be from hormonal dysfunction or testicular failure. Genetic illnesses and certain medications may also impact sperm production.
Exposure to Harmful Substances - Environmental or work hazards such as solvents, radiation and high temperatures can affect sperm production.
Injury - Traumatic injury to the testicles may lead to destruction of sperm producing cells.
Varicocele - This is a varicose vein located in the testes and can interrupt normal blood flow or increase the temperature surrounding the testes.
Each male factor patient will receive individual recommendations for treatment options in conjunction with our staff Urologist.
Testing for Male Infertility
Testing for infertility in the male begins with a complete medical history and physical examination. A complete semen analysis is scheduled for the male following three days of abstinence. Unlike sperm testing performed at a commercial lab, the semen analysis at WCFC is interpreted by a reproductive biologist with advanced expertise in the subtle forms of male infertility.
A semen sample is collected and analyzed in our special Andrology laboratories. The sample is checked for sperm count, motility, sperm shape and other factors. A single semen analysis is only a screening test and does not provide a diagnosis, and thus, more advanced testing may be required.
Our nursing staff assists our patients in scheduling the above tests. Level one is completed within about one month to avoid any delay in your care. After reviewing the results, Dr. Diaz will meet with you to explain the results and make recommendations for treatment.
It is important to recall that infertility is a couple's condition and at times, both male and female factors may be present. For example, the female partner may develop anti-sperm antibodies or suboptimal cervical mucus against her partner's sperm cells. This underscores the need for both male and female partners to be tested simultaneously when searching for the causes of infertility.
Male Fertility Treatment
For a long time male infertility was a mystery. Today, however, an accurate diagnosis can be made in about 80 percent of cases, and treatment is successful in more than half of these. Only when the cause of the man's infertility is isolated can effective treatment begin. A low sperm count or low motility may be caused by a hormonal imbalance or by damaged sperm-producing cells due to infection, trauma or a varicocele. Abnormalities associated with varicocele occasionally respond to surgical correction.
The ability to deliver the sperm into the woman's vagina may also be a problem. This may be due to obstruction of the man's sperm passages resulting from trauma, surgery or genetic malformation. Micro-surgery may correct these problems. PESA at West Coast Fertility is a highly successful technique used to collect sperm in cases of obstruction of the ejaculatory duct or after a prior vasectomy. It is performed in our Surgi-suite under anesthesia and involves using a fine aspirating needle to collect sperm directly from the testes. The sperm is frozen and later it is injected directly into the female egg cell using ICSI, thus achieving fertilization.
Medical problems like diabetes or high blood pressure can lead to erectile dysfunction. A well established innovation for the treatment of severe male factor infertility is called intracytoplasmic sperm injection (ICSI). It involves capturing and injecting a single sperm cell directly into the female egg cell. Our program enjoys an 95% fertilization rate using the ICSI technique. Read more about ICSI and IVF