Management of Male Infertility

Treatments for male infertility range from surgical intervention or intrauterine insemination (IUI) to in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Depending on the source of the problem, sperm can be taken from the man's ejaculate for use in assisted fertilization procedures. One treatment option for men who do have sperm in the ejaculate is intrauterine insemination (IUI). Intrauterine insemination is an infertility treatment in which sperm are placed directly into the upper uterine cavity near the time she ovulates. IUIs are commonly performed when there is a low sperm count or low motility. The sperm that will be injected during the procedure are prepared using a process called sperm washing. The sperm are "washed" to remove any extra cells and debris in an effort to obtain the greatest concentration of the highly motile sperm that will be used for the insemination. One of the most common problems affecting male sperm levels is a varicocele, a tangle of swollen veins surrounding the testicle. Surgical correction of large varicoceles may improve sperm DNA quality and semen analysis results, as well as restore fertility in about two-thirds of cases.
In some cases there is no sperm in the ejaculate so surgical options for sperm retrieval are explored. Advanced sperm retrieval techniques, including TESA, PESA testicular microdissection and testicular biopsy, combined with IVF and ICSI, now allow men with either a low sperm count or no sperm in their ejaculate the chance to produce a child. For some couples, the use of donor sperm remains the best option for building a family. Obviously, donor sperm is the only option for men whose testicular biopsy reveals complete azoospermia - no trace of sperm in the testicular tissue. The use of donor sperm may also be considered when genetic screening indicates a possibility of passing on hereditary conditions such as cystic fibrosis to male offspring.
An increased understanding of male factor infertility and the recent advances made in assisted sperm retrieval techniques are now giving men who never thought they could have biological offspring the chance to father a child. Successful fertility outcomes at Rotunda-The Center For Human Reproduction result from a combination of technological advances, scientific expertise and consistent andrology laboratory standards.