Infertility can be defined as the inability to conceive a child for any person who has attempted a pregnancy for one year or more without success or the inability to carry a pregnancy to term, although conception is possible. In around 50% of these cases, a male is the sole or contributing factor. It is imperative that the male partner (if there is one), be present at the initial consultation.
At the time of this consultation it will be determined the possible participation of the male in the infertility diagnosis. There may be a need for hormonal tests and an initial physical examination to be performed. More importantly, it will be suggested if an assessment by a urologist (Male Fertility Specialist) is also required. We work in collaboration with excellent urologists to ensure that the male and female care, do not get disjointed.
The main cause of infertility in the male is defective sperm production. This can be related to previous exposure to chemicals or radiation, lack of descent of the testis to the scrotum, infection or inflammation of testicles, lack of hormones (brain or testicles), and/or obstruction at different levels. This may result in very few sperm (oligozoospermia) or complete absence of sperm (azoospermia). There may be also associated genetic abnormalities chromosomal in nature or others such as cystic fibrosis that may need to be assessed during the investigation.
A vasogram (x-ray of the vas) may rule out obstruction and allow us to see if it may be treatable by surgery. In addition, when there is obstruction we can almost always retrieve sperm with a needle (PESA), or with testicular biopsy combined with testicular sperm extraction (TESE). If no sperm is found in the ejaculate and no obstruction is found, a testicular biopsy may still define if the testicles are producing sperm (25% of the time). Under any of these conditions we can perform InVitro Fertilization
and Intracytoplasmic Sperm Injection
Unfortunately the empiric use of medications (clomid, etc.) is not very useful in treating most cases of male infertility. At ReproMed, we have developed an approach for the management of male infertility that encompasses a variety of diagnostic procedures and treatment options through our Andrology Laboratory
and Assisted Reproduction Unit.
The initial step for a fertility evaluation is to schedule an Appointment with one of our Male Fertility Specialists who will provide a comprehensive, individualized evaluation and treatment to optimize a couple’s chance of achieving a pregnancy.