Male infertility is involved in approximately 40% of the 2.6 million infertile couples in the U.S., according to the National Institute of Health. Almost half of these men have irreversible infertility and cannot father children, and a small number of these cases are caused by a treatable medical condition.
The evaluation of men for fertility begins with his fertility history, examining elements such as his past reproductive history (e.g. has he ever had children) and a current complete semen analysis to determine sperm count and motility.
We recommend that you find a physician with specific training and expertise in the diagnosis and treatment of male infertility. Usually this will be a urologist specializing in andrology.
For a list of specialists in the area of male infertility and other resources, please click here.
Assisted reproduction can help induce ejaculation, manage erectile dysfunction and aid insemination.
Electroejaculation is used to produce ejaculation when it’s prevented by various erectile disorders. It’s usually carried out under a general anesthetic. An electric probe is inserted into the rectum; the probe delivers a slight electric current to stimulate nearby nerves, resulting in ejaculation; the semen is then collected.
Candidates for Electroejaculation include men who have/had:
Sperm retrieval is used to acquire semen from the testes or epididymis when there’s an obstruction, failed vasectomy reversal, inadequate sperm production or even azoospermia (absence of sperm in seminal fluid). It may involve several surgical and non-surgical methods, including:
Micro epididymal sperm aspiration (MESA): A surgeon makes an incision in the scrotum and gathers sperm from the epididymis , an elongated, coiled duct that matures, stores, and passes sperm from the testes .
Percutaneous epididymal sperm aspiration (PESA): A physician penetrates the scrotum and epididymis and draws sperm into a syringe.
Testicular sperm extraction (TESE): A physician removes a small amount of testicular tissue. It’s usually implemented to retrieve sperm from men with impaired sperm production, or when MESA fails.
These procedures usually take about 30 minutes to complete, may cause pain and swelling and use local anesthesia.
Sperm retrieved from any of these methods may be used in:
Leftover sperm from MESA or PESA can usually be frozen for future use but sperm from TESE generally isn’t high enough quality or quantity for frozen storage (cryopreservation).
Repetition of MESA or PESA procedures is not recommended as it can lead to scarring.
Sperm washing is the process of preparing sperm for intrauterine insemination by removing the seminal plasma. This method separates sperm from white blood cells and fatty acids in semen that may impede sperm motility. It also concentrates sperm, increasing the chances of conception.
Drug therapy may be one of the options you discuss with your doctor when considering ways to increase your fertility. Medications exist that can help improve sperm production, treat hormonal dysfunction, cure infections that compromise sperm and fight sperm antibodies.
Here are some common infertility medications you may come across:
Here is a list of some of the most important questions to ask your doctor when you go to a fertility clinic for infertility-related issues. Feel free to print this list out - we've added spaces for you to fill in your own answers to these questions:
1. What are the common causes for male infertility?
2. What does male infertility diagnosis involve?
3. What types of diagnostic tests will be used to determine the underlying cause?
4. Is my infertility the result of a congenital condition or an acquired condition?
5. Might my fertility change over time with or without treatment?
6. Is the cause for my infertility treatable?
7. With treatment, what are the chances that my partner and I will be able to conceive?
8. Why do you recommend this treatment?
9. What are the benefits, disadvantages, and possible risks of this fertility treatment?
10. What is the pregnancy success rate following this treatment?
11. If this treatment is not successful, what other types of treatment are available?
12. What is the usual cost for infertility treatment?
13. Are these costs usually covered by insurance?
14. Can you recommend a local or online support group or a counselor who specializes in male infertility?
15. Can you recommend additional sources for information about male infertility?
Asking these questions will help you feel more in control, become an informed patient and aid you in the rest of your journey to conceive.
Various types of surgery may be conducted to combat male infertility, including: