Male infertility

How is male infertility diagnosed?

Diagnosis starts with a physical examination to evaluate your general state of health and identify any physical problems that may have consequences on your fertility. The doctor required the presence of the two partners and some tests:

Semen Analysis

Semen analysis is a routine lab test that helps to determine:

– Sperm volume, concentration, and count per ejaculation.

– PH of the sperm.

– Velocity: how fast your sperm travels.

– Morphology: Size and shape of your sperm.

– Color.

– Viscosity: liquefaction time of the sperm.

– Motility of the sperm.

– Viability of the sperm.

If the semen test shows low sperm numbers or the total absence of the sperm, it may not mean you are permanently infertile; more testing may be needed.

Transrectal Ultrasound

Your doctor may order a transrectal ultrasound. A probe is inserted in the rectum, and sound waves are delivered to the nearby ejaculatory ducts. This imaging technique can help the doctor to see if some structures such as the ejaculatory duct or seminal vesicles are blocked or present some problems.

Testicular Biopsy

If semen analysis shows oligospermia or azoospermia; you may need a testicular biopsy, which can be done with general or local anesthesia. A small cut is made in the scrotum, and a small piece of tissue from each testicle is removed and evaluated under a microscope. The biopsy helps to find the cause of male infertility; and to collect sperm for use in assisted reproduction (such as in vitro fertilization; IVF).

Hormonal Profile

The health care provider may check your hormones to know how well your testicles make sperm; by evaluating the FSH level (FSH is the pituitary hormone that tells the testicles to make sperm).

Can male infertility be treated?

When the diagnosis of male infertility is confirmed, the curative phase begins to increase the couple’s chance of having a child.

Depending on the cause of infertility, treatments may include:

Medications:

– Hormone therapy to increase the number of sperm, when infertility is caused by high or low levels of certain hormones.

– Treatments for sexual intercourse problems; when certain sexual problems in men cause infertility (premature ejaculation or erectile dysfunction), and in some cases the couple should consult a sexologist.

– Antibiotic treatments if there is an infection.

Surgical treatment : 

For example, a varicocele can often be surgically corrected or an obstructed vas deferens repaired. Prior vasectomies can be reversed. When there is no sperm in the ejaculation, sperm can often be retrieved directly from the testicles or epididymis using sperm retrieval techniques.

– Assisted reproductive technology (ART): in ART sperm can be obtained through normal ejaculation, surgical extraction, or donor individuals, depending on your specific case and wishes. The sperm is then inserted into the female genital tract or used to perform in vitro fertilization or intracytoplasmic sperm injection (ICSI).

In IVF, the egg and sperm (of which there are many) fertilize on their own in the laboratory. In ICSI, the selected sperm is directly injected into the egg.

What about Fertility Preservation?

When you have medical and sexual issues that affect your fertility; freezing your sperm is the best method to preserve your fertility and increase the chance of having a child.

WHO IS A CANDIDATE FOR FERTILITY PRESERVATION?

Fertility preservation is an option when a man:

– Is diagnosed with cancer at a young age.

– Has sexual dysfunctions.

– Expects to have surgery especially a vasectomy.

– Has an autoimmune, hormone, or genetic disorder.

– Experienced trauma.

– Hopes to have children later in life.

– Has high-risk occupations.

– Have low sperm counts for no known reason.