Wednesday, October 14, 2009

Male Factor Infertility

Male infertility

When a couple has been trying to get pregnant for a long time, the partners often try to figure out the reason for their lack of success. Statistically, the reason involves male infertility about one third of the time, female infertility about one third of the time, and a combination of male and female infertility factors the remaining one third of the time. Consulting with a Reproductive Endocrinology and Infertility expert can significantly help to determine the range of causes and develop an infertility treatment plan.

Male infertility can be due to difficulty in completing intercourse, an inability of the sperm to live within the female reproductive tract long enough to fertilize the egg within the fallopian tube, or a problem with the production of normal sperm.

Difficulty with completing intercourse can be due to an erectile or an ejaculatory problem. Sometimes these problems can be effectively treated with medication. When treatment is not possible, but the man is able to produce a semen sample into a container, then intrauterine inseminations (IUI) that are timed at ovulation are often effective.

The sperm normally fertilizes the egg within the woman’s fallopian tube. There is usually a tremendous decrease in the number of motile sperm along this journey from the initial placement within the vagina (where sperm is usually destroyed within about one hour due to a difference in acidity between the semen fluid and the vaginal vault) to residing within the uterine cervical mucus (where sperm can usually survive comfortably for several days) to passage through the uterus and into the fallopian tube. Generally, it is estimated that if 50 million sperm are placed within the vaginal vault during intercourse only a few thousand of these sperm ever reach the fallopian tube, where they have a chance to fertilize the egg. When this type of male factor is a cause of infertility, then IUI (intrauterine insemination) procedures to place the sperm near the egg at the time of ovulation can be helpful.

The semen analysis is the most common test to determine whether normal sperm are being produced. The major variables that are tested include volume (amount of semen in the ejaculate), concentration (number of sperm per unit volume of semen), motility (percent of sperm that are moving), and morphology (shape of the sperm present). When these numbers fall within the normal range for semen analysis, the sperm is thought to be “good.” But really only a history of proven fertility, such as having achieved a pregnancy with someone in the past or having fertilization at IVF (in vitro fertilization), demonstrates that the sperm is actually capable of fertilizing a human egg. For most mild to moderate male infertility problems involving the production of normal sperm, IUI (intrauterine insemination) is a reasonable treatment alternative. If there is a severe male infertility problem with the sperm, then ICSI (intracytoplasmic sperm injection, which is a form of assisted fertilization) or the use of donor sperm may need to be considered.


Dr. Eric Daiter at The NJ Center for Fertility and Reproductive Medicine, LLC has extensive experience with male infertility and has personally performed thousands of semen analyses. He would be happy to help you. For an appointment to discuss your situation with Dr. Daiter, please call the office at 908 226 0250. Visit us on the web at http://www.drericdaitermd.com/or http://www.ericdaiter.com

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