What is male infertility?
Male infertility is the term doctors use when a man has trouble getting a woman pregnant. In order to get a woman pregnant, a man needs to have a normal number of healthy sperm. Doctors call this a “normal sperm count.” Men with infertility can have one of the following problems with their sperm:
- They have no sperm at all
- They do not have enough sperm – this is called having a “low sperm count”
- They have unhealthy sperm – the sperm might move abnormally or have abnormal shapes
There are many reasons that men can have an abnormal sperm count. These include:
- Problems in the testicles, such as a block in the path the sperm takes to reach the penis (figure 1) – For example, a block can be caused by a past infection or by a vasectomy. A vasectomy is a surgery a man can choose to have so that he can’t get a woman pregnant. In a vasectomy, a doctor cuts or blocks the sperm’s path.
- Having low levels of hormones
- Genetic problems that men might be born with
But most of the time, doctors cannot explain why a man has an abnormal sperm count.
What treatments can help men with infertility?
Different treatments can help men with infertility still be able to father children. These can include:
- In vitro fertilization, also called “IVF” – During IVF, a doctor takes an egg or eggs from a woman and sperm from a man. He or she puts them together in a test tube so that the sperm can fertilize an egg. Then the fertilized egg is put into the woman’s uterus to grow (figure 2). Many times, a doctor will do a treatment called “intracytoplasmic sperm injection,” or “ICSI,” along with IVF. During ICSI, a doctor takes only one sperm and puts it right next to an egg. IVF with ICSI is often used for men who have low sperm counts or abnormal sperm. But this treatment can also be used for men who seem to make no sperm. This is because these men might still have sperm in their testicles that a doctor can take out and use for the procedure.
- Surgery to open up a block in the testicle – For example, a man who had a vasectomy in the past can have surgery to reopen the sperm’s path.
- Hormone treatment to increase sperm counts – Some men have low hormone levels in the brain and can be treated with hormone shots.
What choices do I have if I choose to stop or not have treatment?
Couples who choose to stop or not have treatment have other options. They can:
- Try to have a baby using another man’s sperm, such as sperm from a sperm bank
- Adopt a child
- Not have children of their own
Couples can have a tough time making these decisions. You might find it helpful to talk to a counselor or go to a support group for people who are facing the same issues
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