Male Factor

Abnormalities in the male partner are the sole cause of infertility in approximately 20% of infertile couples and are an important contributing factor in another 20-40% of couples with reproductive failure.

Many infertlie men have surgically or medically correctable  disorders, that, if properly diagnosed and treated , can be overcome to allow natural conception.

In others, there may be mild semen abnormalities which are amenable to intrauterine insemination (IUI).

If all the above is futile or fails, in vitro fertilization ( IVF ) with intracytoplasmic sperm injection ( ICSI ) offers men a realistic chance to father children.

Donor sperm remains an option of last resort.

Male factor problems may be related to :

• inadequate or abnormal sperm production and delivery

• anatomical problems,

• previous testicular injuries, or

• hormonal imbalances.

The initial step in the evaluation of the male partner is a complete history and physical examination followed by Semen Analysis.

The male partner provides a semen sample that is analyzed with a battery of advanced andrology tests in our fully-equipped laboratory. In addition to the standard semen analysis using Health Organization (WHO) criteria, we also analyze sperm to assess the number of motile sperm that can be extracted from the ejaculate.

• semen cultures to detect infections

• pre- and post-processing to determine what to expect for our IUI or IVF

procedures

• testing for antisperm antibodies and for IgA, IgM, and IG antibodies

• long-term survival studies

• detection of biochemical markers in the semen, e.g., fructose testing and also additional diagnostic testing for patients with severe male problems e.g. Hos Test.

In cases where the semen analysis is normal, treatment will focus on the work-up of the female partner only. According to WHO a normal semen analysis includes:

• a sperm concentration of greater than 20 million sperm per millilitre

• motility (movement) of greater than 40%, and

• a volume greater than 2cc.

Additionally, our laboratory uses the Kruger classification of more than 14% normal morphology.

Abnormal semen analysis-

An abnormal sperm analysis is repeated first for verification. Typically, the male partner is referred to a urologist for evaluation. If the urologic evaluation is normal, results of the sperm count determine further treatment.