Causes of male infertility

   Male factor infertility is a sensitive issue that is often ignored. Many men are not offered the explanation as to the cause of their condition, and are not made aware of their options for treatment.

   Male infertility can be due to a low sperm count, poor sperm motility, low number of normal sperm or even no sperm whatsoever (azoospermia). Sperm counts do vary significantly, so it is important to repeat the sperm sample, if it is abnormal before reaching a diagnosis.

   No sperm (azoospermia)

  There are two types of conditions which result in no sperm being in the ejaculate. Either no sperm is being produced by the testis, or whilst sperm is produced, there is a blockage stopping the sperm.

  In some men the sperm passes into the bladder at ejaculation rather than out (retrograde ejaculation).

  Other causes include hormonal imbalances, chromosome abnormalities (variations in the way the genetic material is arranged), and a special type of carrier status for Cystic Fibrosis.

  Depending on the cause, treatment is either by treating the cause such as removing an obstruction or hormone treatment, or by retrieving sperm for use in IVF techniques . Obtaining sperm from the testis is done by a simple procedure under local or general anaesthetic. Such sperm is then used for a special form of test-tube baby treatment, called ICSI (intracytoplasmic sperm injection). In ICSI a single sperm is injected into the egg to fertilise it and make an embryo.

  Severe sperm problems

  This is where there is sperm in the ejaculate, but it is of very low count/ very slow or of poor quality. In such circumstances, we check for chromosome abnormalities. Treatment is with a special form of test-tube baby treatment, called ICSI (intracytoplasmic sperm injection).

  Mild - moderate sperm problems

  Treatment is either with IVF (in vitro fertilisation) or artificial insemination , depending on the severity of the problem. In artificial insemination the sperm are prepared in special way and injected into the womb of the female partner at time of ovulation.