By Paul Zarutskie, M.D.
Infertility affects both men and women equally, with about half of all cases of infertility attributed the male partner, and about 20 percent of all cases are caused by a combination of male and female factors. Effective diagnostic and treatment techniques can improve the chances of conception for those couples where male infertility is a factor.
Causes
A variety of conditions can lead to male infertility, including problems with sperm production, blockages of the vessels that deliver sperm, hormonal disorders, and problems within the testicle itself.
A man's health history and lifestyle can also affect his fertility. A history of drug, alcohol or cigarette use, viral infections after puberty, previous urologic surgery, prostate infections, a history of sexually transmitted diseases and current medications can all impact sperm production or delivery.
Diagnosis
The following diagnostic steps are used to assess a man’s fertility:
1. A complete history and physical exam
2. Computer-Assisted semen analysis
3. Blood tests to measure hormone levels
4. Genetic assessment of the male, looking for specific gene defects
5. Sperm decondensation/fragmentation testing
Treatment
Treatment will depend on the causes of the man's infertility. Surgical therapy, treatment with medications, and assisted reproductive technologies (ART) can all help achieve pregnancy.Some useful ART techniques include:
Intrauterine Insemination (IUI) - IUI involves the placement of large numbers of healthy sperm inside the uterus during the most fertile time of the woman's cycle. It is performed in a physician's office without anesthesia.
In Vitro Fertilization (IVF) - IVF involves placing the couple's sperm and egg together in a laboratory dish to fertilize in vitro, or outside the woman's body. The fertilized eggs are then placed back into the uterus.
Intracytoplasmic Sperm Injection (ICSI) - This laboratory technique injects a single sperm into the woman's egg, bypassing the need for sperm to swim through the reproductive tract, locate the egg and penetrate it. This technique is useful for men with a low sperm count.
Sperm Aspiration Techniques MESA/PESA/TESA - These procedures require surgical recovery of the sperm from the male and can recover sufficient number of sperm for ICSI.
For more information or an appointment, please call (949) 448-7818.
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