Male Fertility

 

IVF for Male Infertility

When the semen analysis is abnormal and identifies a male factor, it’s important to look for the cause.  If the low sperm count appears to hormone related or caused by an infection or anatomic abnormality of the male reproductive system, relatively simple treatments may be used. If these do not work, or if it is a more severe case of male infertility, in vitro fertilization (IVF) is usually the treatment of choice. 

For hormonal imbalances, such as a low testosterone level, Dr. Gehlbach may choose medications like Clomid or fertility shots. Men with decreased sperm counts but normal hormone levels will often undergo intrauterine insemination (IUI), which is a simple and relatively inexpensive treatment for mild cases of male infertility.

Anatomical abnormalities that contribute to male infertility often require further evaluation by a urologist. Urologists are specialists regarding the male reproductive system, and they will work with Dr. Gehlbach to determine what treatment is necessary.

If the sperm count is too low even for intrauterine insemination, IVF may be the best treatment option.  This type of therapy is a very successful option for couples with male factor infertility.
When Do We Recommend IVF for Male Factor Infertility? (H2)

If a semen analysis reveals a severely decreased concentration of normal sperm, Dr. Gehlbach often will recommend IVF because the chances of success are much better than with timed intercourse or IUI.  IVF is also recommended when there are multiple fertility factors, such as a low sperm count in combination with a blocked tube, difficulty in ovulation, or advanced age of the woman. IVF can be the most effective treatment for couples in these situations by increasing the chance for fertilization of the egg, which improves your chance of a successful pregnancy.

Fertilization is improved because:

  • Sperm with poor motility can still be used to fertilize eggs through IVF

    By placing sperm and egg in close proximity in the Petri dish, the poorly motile sperm do not have to travel far to reach the egg and fertilization is controlled in the lab.

  • Low sperm counts can still achieve fertilization through IVF

Because the egg and sperm meet in the lab, the sperm have no chance of “getting lost” along the female reproductive tract. Normally, sperm travel along the specific path to reach the egg, but many fall off during the trip. If there isn’t enough sperm that can make the trek to the egg, fertilization never happens.

  • Intracytoplasmic sperm injection (ICSI)

    For severe male factor, IVF with intracytoplasmic sperm injection (ICSI) will be performed.  ICSI involves carefully choosing a single sperm and injecting this sperm directly into the egg, which improves the chance for fertilization.

    ICSI is also performed when sperm is retrieved by performing a biopsy of the testicle, also known as TESE (testicular sperm extraction), or when a frozen sperm specimen is used.  Dr. Gehlbach has utilized ICSI in his program for many years; this procedure offers safe, effective treatment for male factor infertility.

Semen Collection for IVF

A sperm sample is collected on site at Midwest Reproductive Center through masturbation on the day of egg retrieval. In some cases, men with extremely low sperm counts may need to freeze a sample in advance as a backup for IVF, to ensure that the lab has enough healthy sperm on the day of the egg retrieval to fertilize the eggs.

Please see instructions for proper collection of sperm.

In an IVF cycle, our embryologist prepares the sperm specimen by washing it to sort for the strongest, most motile sperm.  This process increases the amount of motile sperm that will be exposed to the egg.  IVF also allows for the sperm to be placed directly in contact with the egg.   Both of these steps help to improve the chance for fertilization to occur.