Male Infertility
Common Signs of Male Infertility & Available Treatments
Once considered to be primarily a “female problem,” male infertility is now recognized as a major contributing cause to many couples suffering from infertility. In fact, male infertility has been shown, by well-controlled scientific studies, to be present in up to 47 percent of infertile couples. This fact makes the semen analysis one of the most important fertility diagnostic tests. Sperm abnormalities must be ruled out before any female therapy can be initiated.
Causes of Male Infertility
Male infertility can be caused by environmental factors such as certain chemicals, some occupations and routinely sitting for long periods in a hot bath or hot tub.
Male infertility can also be a consequence of a varicocele, which is a collection of varicose veins in the scrotum. A varicocele can interfere with blood flow and thus inhibit heating and cooling of the testicles. A urologist usually treats a varicocele surgically.
Male infertility can also result when antisperm antibodies are present. Antibodies “mistake” sperm as foreign pathogens and seek to destroy them. Rarely, a man may produce antibodies to his own sperm usually as a result of testicular trauma or surgery such as vasectomy. The antisperm antibody process is similar to the body’s response when challenged by virus or bacteria. The body makes antibodies to destroy the specific invading pathogens, and in cases of male antisperm antibodies, sperm.
Diagnosing Male Infertility
Mickey Coffler, MD – Explanation of Semen Analysis
Laboratories use different evaluative criteria but in general sperm count, volume, shape, viscosity, swimming ability and liquefaction are all important measurements for male fertility.
Male fertility requires that the male produce an adequate quantity of “quality” sperm that can be ejaculated into the vagina. Once ejaculated, the sperm must be capable of swimming through the cervix, into the uterus, and to the distal end of the fallopian tubes. A sperm must attach to, and penetrate, the zona pellucida (membrane surrounding the egg) and fertilize the egg.
Diagnosis of male infertility has a special caveat in that sperm examined today actually began their development three months prior. The quantity and quality of sperm seen today are influenced by factors that were present three months past, which may or may not still be present.
Male Infertility Treatment
Unfortunately, there are very few cases where fertility drugs are effective in treating sperm and/or semen abnormalities. If a drug is administered, it usually requires three months to exert its effects, is very expensive, and rarely significantly improves sperm parameters. The exception to this is the male who is severely hypogonadotropic (extremely low levels of FSH and LH).
ICSI
Moderate to severe male infertility can often be treated using in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI), where a single sperm is obtained from the male reproductive tract and injected directly into the egg. This means that a man with no sperm in his ejaculate may be capable of producing a genetically related child.
Vasectomy Reversal
Sometimes men who had a vasectomy want to have the procedure reversed. Although vasectomy should be considered a permanent means of birth control, life’s circumstances change and many men seek reversal. The vas deferens can sometimes be reconnected surgically.
Antisperm Antibodies
When antisperm antibodies are present, IUI is often the treatment of choice since the procedure avoids the cervical mucus, where the antibodies reside. The good news is that the vast majority of infertile men can father children with proper care from an experienced infertility specialist.
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