Infertility is an issue that can affect both men and women. When a couple has difficulty conceiving, it is easy to believe that the female has an issue that is impacting conception. However, in 30 to 50 per cent of cases, the male is the one with fertility issues.
If you are having trouble conceiving, a thorough analysis of semen may help determine the possible cause of male-factor infertility. Semen analysis provides a cost-effective method to gather useful information that may be used to select the best IVF treatments.
Common Reasons for Male Infertility
There are four main causes of infertility in men. If you have fertility issues, one or more of the following may contribute to infertility.
- Men that have had a vasectomy, may experience inhibited sperm production. Inhibited sperm production is the result of nerve damage to the various nerves located in the testicles and reproductive tract. The veins in the scrotum may also become enlarged and issues with sperm production may arise.
- Another potential cause of infertility in men, is a structural abnormality in the male’s reproductive tract. The presence of obstructions may restrict the passage of sperm, which limits the chance of success in fertilization. Other structural abnormalities may occur due to surgeries or previous medical issues, such as an infection. Some men are also born with structural abnormalities that impact fertility.
- Impotence and other ejaculatory disturbances also limit the chance of conception by preventing the sperm from reaching the female. This also includes retrograde ejaculation, which occurs when the semen travels through the bladder instead of the urethra.
- The fourth common cause of male infertility is an immunologic disorder. These disorders may keep the sperm from penetrating the egg, preventing successful fertilization. Immunologic disorders include DNA fragmentation and endocrine disorders.
Testing for Male Infertility Issues
Before deciding on treatment options, patients need to be tested to evaluate the current health of the sperm. At First Fertility, experts perform tests to evaluate the motility and concentration of healthy sperm. If the sperm count is low, additional testing may be required.
Genetic testing helps rule out the possibility of genetic abnormalities. A blood karyotype test may be used to analyze chromosomes and determine if a genetic abnormality is causing low sperm production. A blood karyotype test may be followed by a test for DNA fragmentation.
Hormones are also evaluated, when testing for male infertility. This includes testosterone, follicle-stimulating hormones, thyroid-stimulating hormones, and luteinizing hormones. Testing the levels of these hormones help to determine if hormonal issues are causing a reduction in sperm production.
If no issues with sperm production are discovered with the testing, another issue may be causing male infertility. At this point, First Fertility will find a different solution to help increase the chance of a successful fertilization.
Common Treatments for Male Infertility
After completing the testing, a treatment plan is developed. There are five primary treatment options, and the team at First Fertility Clinic, Bangkok can help determine the best solution.
Intracytoplasmic Sperm Injections
Intracytoplasmic sperm injection (ICSI) is a treatment option that is commonly used for men dealing with sperm motility problems. For successful fertilization, the sperm needs to travel through the vagina and fallopian tube to the egg. With limited sperm motility, the sperm will not reach the egg quickly enough for fertilization. With ICSI, one sperm cell is injected into the female’s egg.
The healthiest sperm is then selected for injection to increase the chance of success. An embryologist analyzes a sperm sample to examine the characteristics of the sperm and choose the best one.
After injecting the egg with a healthy sperm cell, an incubator is used to store the egg. Three to five days later, the embryo is placed into the uterus.
Only a single sperm cell is needed for ICSI, and many men have had success with this treatment option. Motility does not have to impact fertility in males when ICSI remains an option.
Intracytoplasmic Morphologically-Selected Sperm Injections (IMSI)
Another form of injection is the IMSI. While ICSI addresses motility issues, IMSI helps to address a wide range of fertility issues, including low sperm count, and abnormally shaped sperm cells.
The shape or morphology of the available sperm is also a crucial factor in fertilization, as abnormally shaped sperm cells may have difficulty fertilizing the egg. When an abnormal sperm cell fertilizes the egg, abnormalities in the embryo may develop, which can result in a miscarriage.
With IMSI, an embryologist thoroughly examines the sperm sample to select the highest quality sperm. They examine the shape of the sperm cell to choose the sperm that has the best chance of fertilizing the egg. After selecting the sperm cell, the injection is prepared. As with the ICSI treatment, many men with abnormally-shaped sperm cells have had success with this treatment.
Testicular Sperm Extraction (TESE)
Testicular sperm extraction (TESE) refers to a treatment option for severe cases of male infertility. If you have experienced a failed reversal of a vasectomy or have previously had a vasectomy, TESE may provide an effective treatment.
With TESE, sperm cells are extracted from the testicular tissue and analyzed by an embryologist. Again, the highest-quality sperm is selected for fertilization. The ICSI treatment procedure is then used to inject the sperm into the egg. At First Fertility, the TESE procedure typically only takes about 15 minutes to complete.
Percutaneous Epididymal Sperm Aspiration (PESA)
PESA involves the extraction of fluid from inside the epididymis of a male patient. Sperm travels through the epididymis, to the testes, and from there to the ductus deferens. Similar to other treatment options, an embryologist analyzes the fluid to find the highest-quality sperm cells. Again, the sperm cells are injected using the ICSI method.
Micro-Epididymal Sperm Aspiration (MESA)
When the sperm cannot travel from the testicles toward the urethra, the MESA procedure may be required. This method requires the extraction of sperm cells from inside the epididymis. ICSI is then used to inject the sperm into the egg, instantly. Instantly injecting the egg increases the chance of a successful fertilization.
Aside from these treatments, there are additional solutions to help address male infertility issues. The use of supplements may help treat some of the root causes of infertility. The team at First Fertility Clinic can assess your current health, and the health of your sperm, to begin discussing potential treatment options and arrange an appointment, contact us here.