Infertility Issues Faced By Men

While not as often discussed, male infertility can be as prevalent – and as difficult for couples to deal with emotionally – as female infertility. Male infertility occurs in approximately one-third of couples struggling to conceive – virtually the same as the incidence of female infertility. Despite this, for many men the ability to father a child is a physical expression of their masculinity. As a result, men facing infertility issues may feel embarrassment, frustration, or even anger that can hinder relationships and bring even more stress to an already stressful situation.

As with female infertility, the causes of male infertility are numerous and varied. Studies have pointed to everything from the use of laptop computers to environmental toxins as potential causes. However, most data indicates that hormone disorders and reproductive anatomy trauma and obstruction, as well as illnesses like mumps or common sexually transmitted diseases, play the biggest role in causing male infertility.

Diagnosing Male Factor Infertility

To determine if you and your partner are dealing with an issue of male infertility, the Fertility Partnership will run a Semen Analysis (SA) on location at its St. Peters, Mo., clinic as a standard first step with all new patients. This simple diagnostic procedure will gauge whether sperm quality is sufficient to fertilize an egg and achieve pregnancy.

Our embryologist will perform extensive tests on a semen sample, analyzing a number of factors including:

• Sperm Density (sperm count) – measures the number of sperm in the ejaculate and given as the number of sperm per milliliter; normal sperm count is typically considered to be 20 million sperm per milliliter (ml)
• Sperm Motility (the activity of the sperm) – the ability of sperm to propel themselves forward to reach the goal of fertilizing the egg. Sperm motility is measured on a scale of A to D – A sperm move the quickest, while D sperm don’t move at all.
• Sperm Morphology (the shape of the sperm) – analyzes the physical structure of sperm; results from this exam will be reported as a percentage of sperm that appear normal. According to the World Health Organization, healthy semen contains about 60 percent normal sperm morphology.

Occasionally more elaborate testing is required and is available at the Fertility Partnership. For example, sperm chromatin structure assay (SCSA) is a test that looks at DNA fragmentation of the sperm and is one we may choose to use if deemed helpful to your particular case. Also, anti-sperm antibodies are sometimes tested in cases where the sperm are extremely agglutinated (stuck together). Virtually any test, no matter how rare, is available at the Fertility Partnership or through our network of resources.

Thankfully, today male infertility is a much less significant problem than in the past. In the spring of 1994, the first intracytoplasmic sperm injection (ICSI) was performed in the United States in conjunction with in vitro fertilization (IVF), and Fertility Partnership Founder and Medical Director Dr. Simckes was a team member involved in one of the first groups of ICSI cycles to collect individual sperm, "stun" them and then place them directly into the egg. This technique has improved our ability to fertilize eggs so much that the Fertility Partnership, as many other fertility programs do, will perform ICSI on all eggs unless otherwise requested by the couple.

The big difference at the Fertility Partnership is that we do not charge extra for this service, while almost all other fertility centers charge a significant fee. We have chosen not to charge for this service because the advances in science have significantly lowered the actual costs to the program, and as a result we can absorb the expense. Many programs perform ICSI at no cost to couples who have normal sperm counts because it improves the overall success rates, but only charge ICSI costs to couples with low sperm counts. In other words, if it is necessary, there's a cost involved; if it's not necessary, it's free. This kind of billing practice is contrary to the Fertility Partnership's mission to provide top quality medical care at a significantly lower cost. At the Fertility Partnership, ICSI is free for every couple.

Beyond sperm selection and concentration, the Fertility Partnership can provide additional male infertility treatments and procedures, including testicular sperm aspiration (TESA). In some cases, the man has sperm, but the sperm is unable to reach the ejaculate. There are a number of causes for this, including a birth defect or a prior vasectomy. The treatment for the blocked transfer of sperm is simple - we numb the area and draw the sperm directly from the testicle or epididymis. Again, the Fertility Partnership will provide this treatment at a significantly reduced cost compared to other programs. For specific information about this or any of our treatments and services, please contact us.

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