Infertility is the failure to achieve pregnancy after regular unprotected sexual intercourse without any contraception for at least one year. It has been found that in 40% of infertile couples, the problem lies with the male.
The Causes of Male Infertility
Male fertility is dependent on the normal function of the hypothalamus and pituitary gland, which control the production of male hormones as well as the testes. Fertility problems in men are caused by the following:
- Problems in the testes, such as infection and varicocele (30-40%).
- Blockages in sperm-carrying tubes (10-20%).
- Conditions of the hypothalamus or pituitary gland (1-2%).
- Unknown causes (40-50%).
Evaluation of Male Infertility
When a couple suffering from infertility first seeks medical treatment, the doctor will first investigate any possible fertility problems of the male, as testing is less invasive than it is for a woman. If testing reveals no problems with the man, the woman will then be tested. Evaluation of male infertility includes:
- Personal history and physical examination.
- Blood tests to check for hormonal problems and other conditions.
- Semen analysis to examine the amount, shape and motility of sperm. This is the main procedure used to investigate male infertility.
- Other tests, such as transrectal ultrasound to check for blockages in the testis, the sperm-carrying tubes, and the testicular blood vessels.
Assisted Reproductive Techniques
If it is discovered that you have a sperm disorder, such as low sperm count, abnormal sperm, or sperm with poor motility, the following assisted reproductive techniques may help you and your partner conceive:
In IVF the sperm and egg are combined in the laboratory, and after fertilization the embryos are then implanted in the walls of the uterus.
- Intracystoplasmic Sperm Injection (ICSI)
ICSI is an aspect of IVF where the sperm is injected directly into the egg. When the egg is fertilized the embryos will then be implanted in the uterus. This method is suitable for a man who has a low sperm count and/or abnormal sperm motility.
- Intrauterine Insemination (IUI)
In IUI the sperm is concentrated for maximum potency and then directly implanted into the uterus.
- Percutaneous Epididymal Sperm Aspiration (PESA), Testicular Sperm Extraction (TESE) and Microsurgical Epididymal Sperm Aspiration (MESA)
PESA, TESE, and MESA are procedures to retrieve sperm from the testes or epididymis if sperm is not found in the ejaculate. These methods are used in conjunction with an ICSI procedure.