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Male Infertility Is Common – The Sperm Story

Male infertility is common – It’ not just a female issue

Infertility is not just for women. Boys can have it too!  In fact, 40% of couples who seek evaluation will have some degree of a sperm problem. In 25% of cases, the only identified problem is a male factor. Clearly, male infertility is common.

The work-up involves a semen analysis and exam

The male collects a semen sample by masturbation after 2 or 3 days of abstinence.  Then, the lab reviews the sample for volume, concentration, motility (movement), and morphology (appearance). It also looks for the presence of infection.  If the initial test is abnormal, we recommend a second sample for confirmation.  If the second sample is also abnormal, we recommend further evaluation.

Typically, the evaluation of the male includes a physical examination to look for anatomic issues that might explain the findings, as well as blood tests to exclude a hormonal abnormality.  If the exam and hormones are normal, treatment recommendations will depend upon the degree of impairment in the sperm parameters.

Causes of Male Infertility

Varicoceles: The most common type of physical problem is the presence of a varicocele.  This is a protrusion of blood vessels into the scrotum, usually on the left side, that may cause dysfunction in sperm formation.  However, there is significant controversy over whether or not surgical repair of a varicocele results in improvement in fertility.  Most clinicians agree that if the varicocele causes pain, or if the testicle is very small, repair may help.

Hormone imbalances often respond to medication. As a result, it will improve semen analysis values in many cases.

Once the sperm production and function has been optimized. Or, in the absence of an identifiable problem, treatment options can be evaluated.  Based on the total number of motile sperm in an ejaculate, a determination can be made as to whether the sample is sufficient for conception by intercourse, sperm washing with intrauterine insemination (IUI), in vitro fertilization (IVF), or intracytoplasmic sperm injection (ICSI), a micromanipulation technique coupled with IVF.

Tighty Whities or Boxers?

In a nut shell, wearing boxer shorts and avoiding hot tubs will not change sperm that need ICSI, intracytoplasmic sperm injection into sperm that will work by themselves with intercourse .  Bottom line, the more impaired the sperm, the more complex the technology required to achieve success.

For more information on male factor infertility, contact us.

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