Male Fertility Treatment Options
Male infertility is as common as female infertility; accounting for half of all conception problems for couples trying to become pregnant.
At Dallas-Fort Worth Fertility Associates, the first step in the evaluation of males involves a thorough medical history and review of semen analysis results. There are treatments currently available to overcome virtually all forms of male factor infertility. Once a cause is determined, a treatment option can be recommended.
The main causes of male infertility surround sperm presence, amount and quality. The most common and successful treatments are as follows:
Intrauterine Insemination, IUI
IUI is a common first line fertility treatment with a 20 percent chance of becoming pregnant with each cycle. An average ejaculate contains over 100 million sperm. It takes a minimum of 20 million sperm for effective conception to occur with intercourse. IUI takes that minimum number to half, needing only 10 million sperm to achieve conception.
IUI treatments simply decrease the distance sperm must travel to reach and fertilize an egg.
First, semen is collected by masturbation and ejaculation into a sterile container and then sent off to our andrology laboratory to be prepared and washed. Next, in a 2-3 minute procedure, the prepared semen is sent through a long, thin, flexible tube inserted into the vagina, directly placing the sperm in the women’s uterus.
Because a semen sample is necessary for this treatment, it is not a good option for men with erectile dysfunction, premature ejaculation or retrograde ejaculation.
Clomid to Stimulate Sperm Production
While often used for female infertility, the oral medication clomiphene citrate (which goes by the brand names Clomid™ or Serophene™) is also used to treat male factor infertility related to sperm quality and motility. The prescribed drug stimulates the pituitary gland to increase production of the hormones that manufacture testosterone. This boosts healthy sperm count, increasing the chances for conception.
IVF, In vitro fertilization
In severe male factor infertility, IVF may be needed. IVF uses sperm and eggs to create embryos in a laboratory setting. This treatment requires harvesting eggs from the women’s ovaries, a process called transvaginal oocyte retrieval. This procedure requires an operating room and light sedation so the oocytes can be aspirated from the ovarian follicles. The oocytes are then joined with the prepared sperm, fertilizing them outside the body, hence the name “in vitro” or outside of the body. Embryos are then incubated for three to five days before being placed directly into the womb.
IVF with ICSI, intracytoplasmic sperm injection
Specialists at Dallas-Fort Worth Fertility Associates, when warranted, can take the IVF procedure to the next level, actually injecting a single sperm directly into an egg (oocyte) to create the embryo. This process is called intracytoplasmic sperm injection or ICSI.
Males with very low sperm count, abnormally shaped sperm or sperm with little or no movement can father healthy babies with ICSI. In cases where the male has no sperm or is perhaps a paraplegic, sperm will need to be harvested surgically by a partner urologist in the Dallas-Fort Worth surgery center.
Sperm retrieval procedures include MESA (Microscopic Epididymal Sperm Extraction), which uses a surgical microscope to look for sperm in the small tubes of the epididymis and TESE (Testicular Sperm Extraction), which takes tissue directly from the testicles to acquire sperm.