Male Infertility Treatments
What you need to know about treatments for male infertility
Common causes of male infertility continued...
In some cases, these problems can be reversed, but other times they can’t.
An evaluation by a physician is the only way to sort it out.
Sometimes, making sperm isn't the problem. The problem is getting the sperm
where they need to go. Men with this type of male infertility have normal sperm
in the testicles. But the sperm in the semen are either abnormal, very low in
number, or not there at all. Causes of this kind of infertility include:
- Retrograde ejaculation. In this condition, semen ejaculates
backwards into the bladder instead of out the penis. Usually previous surgery
is the cause.
- Absence of the main sperm pipeline known as the vas deferens. This
condition is a genetic problem.
- Obstruction. An obstruction can occur anywhere in the plumbing
between the testicles and the penis.
- Anti-sperm antibodies. Antibodies can abnormally attack a man's own
sperm on their way to the egg.
Up to 25% of infertile men have idiopathic infertility. That means they have
abnormal or low sperm counts for no identifiable reason.
Male infertility tests: Going under the microscope
Identifying the cause of a man's infertility is as much an art as a science.
“The first step is an evaluation by a physician specializing in male
infertility,” says Stephen Shaban, MD, a urologist specializing in male
reproductive medicine and microsurgery in Raleigh, North Carolina. Experts
differ in their approach, but here are some of the tests you can expect:
- Sperm and semen analysis. They provide a private room (and
magazines). You provide a fresh sample of semen. Experts then assess your sperm
count, their shape, movement, and other variables.
“Generally, a higher number of normal-shaped sperm means higher fertility,”
says Shaban. But exceptions are common. Many men with low sperm counts or
abnormal semen are still fertile. And about 15% of infertile men have normal
semen and plenty of normal sperm.
Surprisingly, the complete absence of sperm in the semen (a condition known as
azoospermia), can be a good thing. Ross says it might suggest a blockage in the
“plumbing” that can be corrected with surgery.
- Physical examination. A thorough physical exam can detect varicocele
and give clues to hormone problems. This should ideally be performed by a
- Hormone evaluation. Testosterone and multiple hormones made in the
brain control sperm production. However, hormones are not the main problem in
97% of infertile men.
- Testicular biopsy. This is done for men with very low or no sperm in
their semen. A needle biopsy of the testicle can show whether a man is making
healthy sperm. If abundant good sperm are found in the testicle, there's likely
a blockage somewhere.
- Genetic testing. Genetic tests can identify specific obstacles to
fertility and problems with sperm. Experts differ as to when genetic tests
should be done.