One in six couples will experience fertility problems, with 30% found to be secondary to a male factor. When dealing with infertile couples, we begin an evaluation to identify factors that may be contributing to each partnerís infertility, while offering much needed emotional support.
A careful history and physical examination begins the initial evaluation of the male partner, as past or present risk factors may be identified that may alter fertility potential. Serial semen analyses are obtained to establish a baseline with the results including sperm density, motility, morphology, and semen quality. A more extensive evaluation may include additional blood studies and x-ray examinations to rule out hormonal and genetic influences or structural abnormalities that may be affecting the abnormalities found in the semen analysis. The results of these studies will categorize the male factor into one of several categories including: Azoospermia (no sperm), Oligospermia (low sperm count), Asthenospermia (poor sperm function), Teratospermia (abnormal structural appearance of a sperm) or abnormal semen quality.
All of the results are analyzed to develop a plan for each couple. This may include medical therapy to stimulate sperm production or surgical treatment to correct specific abnormalities such as obstruction to sperm flow or the presence of a varicocele (dilated scrotal veins).
Treatment of infertile couples requires integrated care from several medical disciplines including a urologist, an obstetrician, a reproductive endocrinologist and an embryologist. In some cases it may be necessary to harvest sperm from the testes or other structures within the scrotum to be used for ART (Assisted Reproductive Technologies). This may include IUI (intrauterine insemination), IVF (invitro fertilization) or ICSI (intracytoplasmic sperm injection).
We understand that infertile couples are vulnerable at this time in their lives. As a result, a great deal of time is spent in much needed counseling and for the emotional support of both partners in addition to any prescribed medical or surgical therapy.