1. Male Infertility Evaluation
After 12 months of trying to conceive, you should consult your gynecologist for a referral to a fertility specialist. A series of tests will need to be performed on you and your partner. They will give clues to the particular cause of your infertility and ultimately a treatment plan to overcome the problem.
Firstly, the specialist will look at both your medical histories. For the woman, this includes any previous pregnancies, regularity of periods, painful periods, pelvic pain, infections, or surgery. For the man this will include whether he has fathered children previously, testicular injury, developmental problems, infections, surgery and exposure to certain environmental factors.
A physical examination will also be performed which may include:
- Blood tests. A series of tests will be performed to establish if there is a hormonal basis for your infertility that may be corrected by hormonal supplements. You may also be tested for rubella, blood group, sperm antibodies and sexually transmitted diseases such as HIV, Hepatitis B and Hepatitis C.
- Ultrasound examination. This examination will give information on what the ovaries and uterus look like. Your doctor will look at the growth of eggs, the thickness of the lining of the uterus (if thin, it can indicate hormonal problems), the presence of fibroids or polyps on the uterus, as well as signs of endometriosis or ovarian cysts. Surgical laparoscopey may also be used to identify endometriosis or blocked fallopian tubes.
- Semen analysis. A semen sample from the man is required to assess the number of sperm, how well they swim (known as ‘motility’) and their fertilisation capacity.
2.Get a Second Opinion
Although medical advice can get complex, for the most part, the discussion that you have with your doctor should make sense to you and you have a right to have all of your questions answered so that it does make sense to you.
Sperm production is hormonally driven. Brain hormones govern sperm production and are precisely controlled. The male genitalia are responsible for sperm and ejaculate production.
Oligospermia is a male fertility issue defined as a low sperm concentration in the ejaculate. Low sperm concentration or “sperm count” is the number of sperm in a prescribed volume of ejaculate.
Azoospermia is the complete lack of sperm in the ejaculate. It occurs in 5% of infertile men. If this is the case, then one or both of two conditions may be present.
6. Testis Biopsy
A testis biopsy is helpful in many cases of azoospermia. If an evaluation of azoospermia is not clearly showing whether there is a problem with sperm production or one of a blockage in the ducts of the reproductive tract, then the next step is to examine the testis itself and assess sperm production.
7. Non-Surgical Male Fertility Treatment
Only about 20% of young men actually know the exact time to have sex during the female cycle to achieve a pregnancy. The critical period can be assessed by either basal body temperature charting or home kits that detect the LH surge in the urine immediately (24 hours) prior to ovulation.
8. Surgical Male Fertility Treatment
Surgical treatment options include varicocele repair, ejaculatory duct resection and vasectomy reversal. What is nice about surgical treatments for male infertility is that they can “cure” the problem and allow for conception at home and not in the laboratory.
9. Sperm Mapping
Sperm Mapping is a technology that “maps” the location of sperm in the testis. The technique is designed to benefit severely infertile men. It is a minimally-invasive, non-surgical procedure performed under local anesthesia in the office.
10. Sperm Retrieval
Sperm retrieval procedures are designed to collect sperm from organs within the male reproductive tract. First developed in 1985, sperm retrieval combined with in vitro fertilization (IVF) and ICSI are invaluable for allowing infertile men without ejaculated sperm the opportunity to be fathers.