Nearly 1 in 10 men  experience infertility

Millions of couples face fertility struggles, and contrary to old belief, it isn’t just a woman’s problem. Male factor infertility can be either the sole cause or a contributing cause in about 40% of cases and nearly 1 in 10 men will experience infertility.

We at Precision IVF know that a diagnosis of male infertility may be surprising at times and feel devastating to hopeful parents. Dr. Arya is highly experienced in evaluation and treatment for all hopeful parents going through male infertility. When it is necessary, she coordinates a treatment plan with a skilled male reproductive specialist. Some examples of such referrals and coordination of care are when a gentleman has possible anatomic factors such as an obstruction or varicocele (when no sperm is found in ejaculate), endocrine factors such as complications from diabetes, and functional factors such as erectile dysfunction.

Diagnosing male infertility

We begin the process of diagnosing male infertility by obtaining a thorough medical history and exploring lifestyle factors that can influence fertility. Then we perform a semen analysis to assess the volume, concentration (the number of sperm per volume of semen), motility (the percentage of sperm that are alive and swimming) and morphology (the percentage of sperm with a normal shape).

Probable Causes

• Genetic disorders (eg. Cystic Fibrosis, chromosomal abnormalities like Klinefelter syndrome) 
• Infections of the prostate or testicles
• Anatomical issues (blockages, varicocele, tumors)
• Previous surgery or vasectomy
• Undescended testicles with late repair
• Injury (testicular or pelvic trauma, heat, irradiation, etc.) 
• Radiation therapy and chemotherapy
• Hormonal disturbances (obesity, diabetes)

Lifestyle Factors

Smoking:  Smoking has been shown to lower sperm count and affect male fertility.

Excessive Heat Exposure: Potentially increased scrotum temperature due to frequent use of saunas or hot tubs may lower a man’s sperm count. 

Excessive Alcohol: Alcohol has been shown to lower testosterone levels, lower sperm count, and potentially cause erectile dysfunction. Men with liver disease caused by excessive drinking may also have trouble conceiving.

Stress: Emotional stress disrupts the body’s hormone production, which can affect the production of healthy sperm.

Treating male infertility

At Precision IVF we offer a number of proven treatments to overcome male infertility. These options range from intrauterine insemination (IUI) to in vitro fertilization and intracytoplasmic sperm injection (ICSI). 

Absence of sperm in the ejaculate (azoospermia) due to either an obstruction or blockage (obstructive azoospermia) is often caused by a previous vasectomy or congenital-birth defect. A surgical option can retrieve sperm from either the vas deferens, epididymis or testis to be used in IVF to conceive. Surgically retrieved sperm are immature and fertilization is achieved by injecting selected sperm directly into the egg (ICSI). 

Males considering this option will be referred to a urologist to help determine the best approach for retrieving sperm including:

Microsurgical Epididymal Sperm Aspiration (MESA)

MESA is used in cases of obstructive azoospermia. It involves collecting sperm by aspirating fluid from the epididymis of the male reproductive tract. A fine needle is inserted through the scrotum into the epididymis and sperm are obtained by gentle suction. 

Testicular Sperm Aspiration (TESA) or Testicular Sperm Extraction (TESE)

TESA is used for cases of non-obstructive azoospermia, where a fine needle is inserted into the testis, a sample of tissue is obtained by gentle suction and then examined under the microscope. If sperm are not found, a small tissue sample (testicular biopsy or TESE) is taken through a small incision in the scrotum and testis, where sperm can then be extracted. 

MESA and TESA procedures are timed to coincide with the egg retrieval step during the IVF cycle. For some, scheduling may be an issue.  In those cases surgical sperm retrieval can be completed before the IVF cycle begins and frozen (cryopreserved) for future use. The extraction of sperm completed by MESA and TESA typically results in enough sperm to allow several IVF cycles. 

Contact us to schedule a consultation with Dr. Arya at Precision IVF to discuss your evaluation and get the compassionate and best care you deserve.