Male Factor Infertility

Some couples with infertility caused by disorders of sperm number or function may be successfully treated through intrauterine insemination (IUI). This is often performed during cycles in which the woman is taking fertility drugs to stimulate multiple egg development. Surgical repair of anatomic abnormalities may increase the chance of pregnancy in certain patients. However, IVF is the best treatment of infertile couples when there is severe impairment of sperm count, motility, or shape, or when sperm antibodies are present.

The laboratory technique of Intracytoplasmic Sperm Injection (or ICSI) has revolutionized the way we can treat male infertility. Even men with no sperm in their semen can father a pregnancy if the urologist extracts sperm from the man’s epididymis or testicle for use in IVF. With ICSI, an extremely sharp glass needle is used to inject one sperm directly into the center (cytoplasm) of the egg under the guidance of a specially fitted microscope. The success rate with this technique varies considerably among IVF programs and is highly dependent upon the skill of the embryologist performing the procedure.

Our excellent results have been documented in an article published in the medical journal Fertility and Sterility. Candidates for ICSI include men with (1) severely compromised sperm parameters, including concentration, motility, morphology, or antisperm antibodies; (2) blockage or absence of the vas deferens, where sperm is surgically collected by microsurgical epididymal sperm aspiration (MESA) or testicular biopsy for ICSI; and (3) those who had low or failed fertilization on prior IVF attempts; (4) unknown infertility after all diagnostic tests are completed. Our IVF pregnancy rates with ICSI are equivalent to those of couples with non-male factor infertility who do not require ICSI; and (5) certain medications or other medical history.