Most fertility investigations have focused more on female factors than on male factor largely because there has not been much available to assist males with. 45-50% of fertility issues are related to male factor and 35% of infertility involves both the male and the female.
A variety of factors can effect male fertility including:
- Environmental issues
- Anatomical and physiological problems
- Trauma or injury
- Genetic or congenital abnormalities
- Medication adverse effects
- Smoking, Alcohol, or drug use
- Surgical disruption
- Stress related
Each of the above have numerous subcategories which are further discussed in the office but includes varicoceles, cystic fibrosis, hormone deficiencies, prostatitis, absence of the vas deferens, chromosomal microdeletions, immotile cilia syndrome, mumps, radiation, toxic exposures, pesticides, grass or weed killer, excess heat or dietary extremes, etc.
- Eliminating toxins and sperm toxic substances
- Treating infections
- Adjusting medications and avoiding certain medications
- Selective varicocele/hydrocele repair
- Adjusting hormone imbalances
- Stress reduction or management
- Addition of appropriate vitamin, mineral, and amino acids to allow better building and repair of damaged sperm
Sperm develop their ability to mature, become motile, and gain their fertilizing ability through the male reproductive tract from germinal cells to the vas deferens over a period of 74-90 days. Once they reach the vas deferens, sperm are combined with seminal fluid, prostatic fluid, and mucous before exiting the penile urethra. Severe infections, stresses, extremes of heat or cold, reduction in normal genital blood flow or nerve damage can alter the sperm production and travel within that 90 day period. The healthiest and most concentrated sperm are collected within 2-4 days after the last ejaculate. Intercourse frequency should not be mandated for fertility because it causes undue stress on the couple. It is more important to have Intercourse at the couples leisure until 2-3 days before intrauterine inseminations or an egg retrieval (in vitro fertilization).
If sperm is not improving through various treatment approaches, the following options are available:
Intrauterine inseminations for mild to moderately abnormal sperm issues including low sperm concentration, low motility, and/or slightly low morphology. The male partner collects a semen sample and the sample after liquified is placed above sperm density gradient medias and spun at the correct rpm for a short time until the healthiest sperm reach the bottom. The semen, poorer sperm, and other debris are caught in the upper layers and the sperm then are removed and placed through 2 more spin sessions in nutrient media. This final sample is then placed into a small catheter and inserted into the uterus near ovulation. When 1-3 eggs are available for ovulation in that cycle success rates have been reported between 8-28% depending on the age of the husband and wife, and their particular infertility factors. Couples with no infertility issues and who are in their 20’s have near 30-35% chance of conception per menstrual cycle.
In vitro fertilization and embryo transfer for moderate male factor infertility. After stimulating several eggs to develop and once the eggs are retrieved, washed sperm is combines with each of them in the right laboratory conditions and in the proper medias which allows them to fertilize on their own. Once fertilized, the best few embryos are transferred into the uterine cavity.
ICSI (intracytoplasmic sperm injection) sperm micromanipulation (the sperm is injected into the egg to fertilize it) for moderate to severe male factor when combined with in vitro fertilization and embryo transfer. ICSI allows males with very few sperm, or with very poor motility/progression, and low morphology to still have successful pregnancy outcome and is a huge benefit to those who otherwise had no options in using their own sperm for procreation. This science has only been available in the United States since its infancy in 1992.
Percutaneous sperm aspiration or open testicular biopsy is available to obtain sperm from the male partner if he has had a previous vasectomy or if his vas deferens are blocked or missing. The collected sperm can be cryopreserved for future and/or used fresh with an in vitro fertilization/ICSI cycle.
Donor sperm allows couples with severe male factor or azoospermia (absence of sperm) to conceive. Donor sperm can be obtained through donor sperm banks around the country and are quarantined and frozen. These cryopreserved samples can be sent for use as an intrauterine insemination, a cervical insemination, or for use with in vitro fertilization and embryo transfer. A couple can select their sperm donor from a large pool of donors and closely approximate the characteristics to most resemble their male partner. Eye color, hair color, height, weight, grade point average, interests, occupation, hobbies, etc.
Sperm Selection methods for gender are available but not guaranteed. PGD (pre-genetic diagnosis) is the most accurate method of selecting a specific sex if necessary but is expensive. More commonly PGD is used to select out and prevent significant inherited genetic abnormalities.
We have several affordable IVF pricing options.
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At East Bay Fertility and Wellness Center we share a common goal with you of helping you achieve a successful and healthy pregnancy. Since 1997 we have helped hundreds of couples realize this goal. We have helped bring hundreds of beautiful babies into the world.