Male Factor Infertility

Male infertility accounts for approximately 40 percent of the diagnosed infertility cases in the United States annually. Traditionally, couples with significant, uncorrectable male infertility had three options:

• using donor sperm,
• adopting or
• electing not to have children

The prospect of finding ways for men to have their own biological children has been a strong force in the development of new treatment approaches. Treatments for male infertility depend on the specific cause of the infertility, and have included:

• surgery,
• medical treatment and
  
• microinsemination techniques (microinsemination is laboratory assisted fertilization of an egg)   

Male infertility can be associated with the production of low numbers of sperm, sperm that do not "swim" properly or do not swim at all, and sperm that are abnormal in shape. These characteristics can be determined by a semen analysis. 

Poor-quality sperm have reduced ability to penetrate the egg. The normal male ejaculate contains more than 60 million motile sperm. A couple may have trouble conceiving when the number of sperm in the ejaculate drops below that level, or when sperm are not strong enough.

In some men, the tubes known as the vas deferens that transfer sperm from the testis are blocked or missing through a congenital abnormality, an accident, a disease or an irreparable vasectomy. In such situations, sperm may be obtained by a surgeon from the epididymis, the site where sperm are stored. The surgeon uses a process called epididymal sperm aspiration.

There is also unexplained infertility, where for unknown reasons the man’s sperm does not penetrate the woman’s egg even though the number, shape and motility of the sperm all appear normal.

In any of these circumstances, the appropriate treatment may be a laboratory process called intracytoplasmic sperm injection (ICSI) [link]. In ICSI, an embryologist uses a microscopically sized needle to inject a single sperm directly into the egg. This technique often removes the barriers raised by a low number of sperm, "poor sperm motility" and "poor sperm morphology,” allowing couples to have their own biological children.

This information is provided for general education purposes and is not intended to take the place of a discussion with your physician. If you have questions about any aspect of your health, you are advised to speak with your physician.