When we talk about infertility we focus on female infertility whereas about 10% of infertility can be attributed to male factors only, while 35% of cases involve both male and female factors. Thus, almost half of all couples with infertility may have a male factor.
Causes of Male Infertility
Male factor infertility is most commonly due to problems with the sperm by a variety of conditions; some of these can be corrected, while others cannot. Problems may exist in sperm production, ejaculation, or motility.:
- 30-40% of cases problems in the testes
- 10-20% blockage in the pathway that allows sperm to exit the testes during ejaculation
- 1-2% of cases problems in the pituitary or hypothalamus
- 40-50% of cases no identifiable cause, even after evaluation
Before treatment, it is also important to consider potential issues related to sexual behavior, such as erectile or ejaculatory dysfunction, or lack of sexual desire due to depression or medication use. Treatment for male infertility depends upon the underlying cause. Treatments may be depending upon whether the semen contains few sperm (oligozoospermia), no sperm (azoospermia), abnormally shaped sperm (teratozoospermia), and/or sperm with poor motility (asthenozoospermia). Treatment often involves both male and female partners.
The best treatment for problems with sperm motility or concentration is intrauterine insemination. At the time of ovulation, the most active sperm are focused and placed within the uterus of the female partner. You can utilize intrauterine insemination with or without treating the female partner.
In vitro fertilization (IVF)
Male tubal blockage and unexplained infertility are two conditions that frequently require the use of in vitro fertilization (IVF).
Intracytoplasmic sperm injection (ICSI)
This technique involves injecting one sperm into each egg. ICSI is typically advised if a couple has already decided to proceed with IVF and the semen analysis is abnormal.
Testicular extraction of sperm
When a man’s sperm count in the ejaculate is completely absent, (TESE) is performed. Under local anesthetic, sperm can be aspirated directly from the testes using a needle or through a very small incision. Depending on the cause of male infertility, sperm may not always be found during this technique. If sperm is found and retrieved, ICSI utilizes it.
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