It Takes Two - Male Infertility

While much of assisted reproductive technology deals with correcting problems on the female side of infertility, the fact remains that within all diagnosed cases, male factors can be equally responsible for fertility problems. This high probability of both partners having infertility factors makes participation by both the man and the woman crucial to success.

Even if couples learn that male factor is not their issue, fertility experts want men to clearly understand treatment-related demands on their partner. For example, he may still need to participate in postcoital diagnostics, inseminations, or injectable meds.

When a couple starts wondering if their inability to get pregnant warrants special assistance, the most accurate starting point for possible diagnosis and satisfactory treatment is both partners.

However, because woman are usually more proactive about managing their reproductive health through recommended gynecological exams, some couples make the mistake of forgetting the other very important half of the equation. Also, if the woman is seeing only her OB/Gyn and not a reproductive specialist, she may agree to undergo a myriad of tests, some which are especially invasive, before even considering having the man go through simpler tests of his own fertile capacity.

In the science and art of making babies, time is of the essence. The most efficient way to explore possible infertility causes is to equally engage both partners in the diagnostic process.

Typical Male Causes

Fortunately, men's reproductive issues are a bit less complex than women's -- there are fewer components that can go awry. Essentially, diagnostics look at the quantity and quality of a man's sperm cells and at his delivery system.

A man's initial evaluation can be conducted rapidly, non-invasively, and in a cost effective manner. A very thorough patient history includes past illnesses and injuries (even prenatally, if that information is available,) date of pubertal changes, any long-term or acute exposure to known toxins (including prescribed and non-prescribed drugs, other chemicals, alcohol, tobacco, and more), and general lifestyle issues. The physical examination will include the patient's total body and reproductive organs. Analysis of the patient's semen will look at the number of sperm cells present, how the cells are formed, and how they move.

Probably the most common reasons for men to be reticent about fertility treatment are concerns about privacy and the dreaded semen sample.

While clinics vary in their approach to specimen collection protocol, there are different ways to help men feel more comfortable with the process. Many patients live close enough that they can collect their sample at home, sometimes using a special kind of condom. Less frequently, some clinics offer a special room-temperature substance in which samples can be collected the night before going to the lab. Another option that's available, especially for men who travel frequently or who are in the Armed Forces, is the use of frozen samples. It's another way of providing a semen specimen in as non-instrusive a manner as possible.

Correcting the Causes

In addition to making lifestyle changes that may positively impact fertility for some men, there are a number of ways that reproductive specialists can assist in cases of male-factor infertility.

Intrauterine insemination (IUI) can be used to counter mild to moderate sperm count or motility problems. By using a highly concentrated amount of sperm and positioning it closer to where it needs to be for conception, odds for conception are increased.

One of the most dramatic procedures available today is known as ICSI, or intra-cytoplasmic sperm injection. With ICSI, men who have either low sperm count or poor quality sperm cells can become biological fathers via the direct injection of a single sperm into each egg. Used in conjunction with in vitro fertilization (IVF), ICSI can even be used in very extreme cases of male infertility, since only one good sperm cell is needed to produce a pregnancy.

Sometimes, men with no sperm present in their ejaculate may actually be producing the cells, but their delivery system is not working adequately. There are a number of sperm aspiration techniques that allow specialists to retrieve sperm cells directly from the man's testicles.

For some men, infertility is a direct and expected result of their own previous decision to undergo vasectomy, a commonly used microsurgery for purposes of contraception. When some vasectomy patients later yearn to become a biological father, the process of microscopic vasectomy reversal is available.

A True Team Effort

Infertility can present a true test of a couple's ability to be a team. For both teammates, the thought of seeking assistance for one of life's most intimate choices is often embarassing and, at times, demoralizing. This may be even more so for men, for many cultural and medical reasons. As with any struggle, when both participants are equally engaged in the problem-solving process, the chances are less that more tangled relationship issues, such as resentment and related discord, will develop. Also, it cannot be over-stressed that the most efficient path, especially regarding time and money, toward accomplishing a couple's conception goals is that taken hand-in-hand.