Out of all causes of infertility, male infertility is a leading cause of infertility. It is the sole cause in 20 percent of infertile couples and is a contributing factor in 30-40 percent of cases. Male infertility is evaluated by semen analysis if couple has failed to achieve fertility in one year of unprotected intercourse. It should be done earlier if other risks factor like previous history of infertility with other partners or female fertility issues are already identified like age over 35 or infrequent or absent ovulation. At Arizona Associates for Reproductive Health, we work one-on-one with each patient to determine the factors causing infertility for male and female patients alike. We offer diagnosis and treatment for male infertility at our Phoenix and Gilbert offices. Contact us today to schedule an appointment.
Initial evaluation of male infertility should include detail history of male partner including current and childhood medical conditions, past history of infertility, frequency of intercourse, environmental exposure like heat or chemicals and use of drugs like Testosterone or Marijuana. Past history of fertility should not exclude male fertility evaluation.
First step towards laboratory testing is semen analysis. Semen is collected by masturbation or intercourse in special container after two to seven days of abstinence. If condom is used, both condom and container should NOT have any substances which are toxic to sperms. Specimen should be transported at room temperature and is processed in an hour of collection. Our laboratory personnel will give you appropriate instructions and semen collection container.
Semen should be analyzed by Clinical Laboratory Improvement Amendments (CLIA ) certified laboratory which has strict quality control program. Standard semen analysis should provide information on volume (amount of semen), concentration of sperms (number of sperms per milliliter of volume), motility (percentage of live sperms) and sperm morphology ( shape of the sperms). Though WHO criteria for sperms morphology is most commonly used, at (AZARH) , we use Kruger Strict Morphology (KSM). KSM is a better predictor of spontaneous fertilization during IVF and need for assisted fertilization with Intra Cytoplasmic Sperms Injection ( ICSI). Normal semen analysis should show at minimum 2 cc of volume, 20 million sperms per milliliter of semen, 50 % motile sperms and Kruger morphology over 4-14%.
Abnormal semen analysis should be repeated in about one month. It is not uncommon to find large sample to sample variation in same person. Depending upon semen parameters found and clinical history from male and female partners, at (AZARH), we make individualized recommendations. Some of the semen parameter abnormality can be treated with life style modifications. Some with severe abnormality i.e. persistent low volume, azoospermia (complete lack of sperms in sample), severe oligospermia (less than 10 million sperms/ milliliter) or asthenospermia (low motility), will need further evaluation by a urologist.
Usual urological evaluation may include further detailed history, physical examination, laboratory evaluation of hormones and chromosomes as well as ultrasound. Depending upon the evaluation, many male infertility causes can be treated by a urologist with medical treatment (use of hormones or hormones modifying agents) as well as surgical treatment (varicocele repair). In certain cases of severe compromise of sperms, urologist need to obtain sperms with surgical procedures like PESA and TESE.
Due to advances in male infertility treatment, many cases of male infertility can be helped. Male infertility with minimum compromise of sperms parameters can be treated with Artificial Insemination (Intrauterine Insemination). Even patients with severe compromise can be treated with Intra Cytoplasmic Sperm Injection (ICSI).
To learn more about male infertility diagnosis and treatment, contact (AZARH) today and schedule an appointment.