Treatment Options For Male Infertility

Male and female infertility present a daunting and stressful challenge for couples trying to conceive. Fortunately, in many cases, infertility is treatable, is correctable, or there exist alternative ways to conceive. This article will explore treatment options for male infertility.

Medications/Fertility Drugs

Male infertility is often the result of poor sperm quality. Some men with low sperm counts or low sperm motility have been treated with fertility drugs such as Clomiphene Citrate (known also as Clomid) in an attempt to improve the semen. However, while there is some evidence that Clomid helps, other studies indicate that Clomid does not significantly increase pregnancy rates.

Given that most sperm defects are largely genetic in origin, there is to date no "cure" for sperm abnormalities. In these cases male infertility is often addressed via assisted reproduction techniques such as in vitro fertilization (IVF) or intrauterine insemination (IUI).

Surgical Treatment for Varicocele Ligation

This male infertility condition involves an abnormal dilation of veins within the spermatic cord. While varicoceles can be treated surgically, studies are inconclusive as to whether or not surgery increases pregnancy rates.

(IUI) Intrauterine Insemination

Some moderate sperm abnormalities can be successfully treated with IUI. This procedure is more commonly known as Artificial Stimulation (AI) - IUI and AI refer to the same treatment.

In IUI treatment, specially washed sperm are transferred by a tube directly into the uterus. Due to its relative simplicity and low cost, IUI is often tried before more complex assisted reproductive technologies.

In Vitro Fertilization (IVF)

More severe cases of sperm abnormalities, or if female infertility is a contributing factor, often require IVF in order for a couple to conceive. In IVF the couple has a choice between inseminating by intracytoplasmic sperm injection (ICSI) or by a sperm donor.

ICSI involves injecting a single sperm into an egg via a special needle. If a man is producing sperm but the sperm do not appear in the ejaculate, a doctor can take the sperm directly from the testicles. In the case of retrograde ejaculation, sperm is taken from the bladder. If neither of these is an option, a couple can opt for a sperm donor.

In both cases, eggs are removed from the woman's body and fertilized in a lab by the sperm. After careful culture for three to five days, one or more of the most "promising" embryos are transferred back into the woman's uterus. By transferring already fertilized embryos directly to the uterine cavity, sperm and fertilization defects are circumvented, improving the odds of a couple trying to conceive.

IVF is complex and expensive and thus IVF treatment is usually used as a last resort, once other treatments have failed. Note that IVF is often not successful on the first try. When IVF fails it is not always known if the failure to implant was due to a problem with the embryos or with the uterus. However, most IVF specialists maintain that 95% of IVF failures can be attributed to the embryos. That is, the transferred embryos were too weak to implant and to develop normally.

If IVF fails on the first attempt, couples should have their specialist review the failed cycle in order to investigate what might have gone wrong. There are several possible contributing factors that can be identified and addressed, and many couples have a successful second IVF.

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