Motility is a measure of what percentage of sperm are moving, and progressive motility is a measure of what percentage of sperm are moving in this optimal way. The proper sperm anatomy , according to male fertility company Legacy, looks like the following:.
Typically, a low semen volume—less than 1. In addition to volume, male fertility testing may evaluate the pH level and chemistry of the semen. Again, abnormalities in semen pH or composition may point to a problem in the testicles, such as an obstruction or infection.
The process goes something like this: the male patient receives a sterile specimen cup for his semen sample. The experience of producing or providing a semen sample at the office, while very common and nothing to be ashamed of, can be uncomfortable for many men. This eliminates the need to go into the office at all, making it more convenient and less awkward. A note of caution: many at-home male fertility testing products only test for sperm count, which—as we discussed above—is only part of the picture of male fertility.
Make sure that, if you go this route for male fertility testing, the product you choose offers a comprehensive report on all sperm parameters. Use the code extendlegacy at checkout! While semen analysis is the first step in male fertility testing, there are more advanced tests that can sometimes be used to diagnose less common conditions.
As discussed above, the sperm carry genetic material—half of it, to be exact—for the potential future offspring. Infertility is defined as the inability of sexually active couples who are not using contraception to get pregnant within one year.
Male factors contribute to approximately 40 percent of infertility cases. Male infertility is typically due to sperm abnormalities, but any of the following can play a role:. Learn More About Male Infertility. A small, lubricated wand is inserted into your rectum. The imaging helps your doctor to check your prostate and check that there are no blockages in the vas deferens.
Blockages can be corrected with surgery. However, injury, surgery, or prostate gland infections can interfere with this protective system. And when sperm comes into contact with your immune system, the body may produce anti-sperm antibodies. Your doctor may ask for an anti-sperm antibody test if the cause for infertility is still missing.
The test checks your semen for antibodies that fight against your sperm by using a substance that binds only to affected sperm. The higher the level of sperm affected by antibodies, the lower the chance of a sperm fertilizing an egg. These antibodies can also be found in women, so your doctor may ask for your partner to get tested too. Doctors are divided over whether this testing is advisable. In this test, a sample is removed from the testicle, either with a needle or through a small cut.
If the results of the testicular biopsy show that sperm production is normal, your infertility may be caused by a blockage or some other problem with sperm transport.
Following the development of in vitro fertilizing techniques, research on genetic causes for infertility has expanded. Genetic abnormalities are found in 10 percent to 20 percent of men who have severe disorders with sperm production. Genetic testing carried out on DNA can help rule out chromosomal abnormalities, especially in men with either azoospermia no sperm present in the semen or oligozoospermia low sperm count. Idiopathic infertility is an extremely common infertility diagnosis in both men and women.
Depending on your diagnosis, you may find that you need to draw on reserves that you never knew you had. But there are many options for medically assisted pregnancy. Genital tract infection is rarely linked to infertility. It's only found in about 2 out of men with fertility problems. In those cases, the problem is often diagnosed from a semen test. In the test, white blood cells are found. White blood cells make too much "reactive oxygen species" ROS.
This can damage sperm, lowering the chances of sperm being able to fertilize an egg. For example, a severe infection of the epididymis and testes may cause testicular shrinking and epididymal duct blockage. The infection doesn't have to be sudden to cause problems. Antibiotics are often given for full-blown infections.
But they're not used for lesser inflammations. Some antibiotics can occasionally harm sperm production or function. Non-steroidal anti-inflammatories such as ibuprofen are often used instead.
Inflammation from causes other than infection can also affect fertility. For example, chronic prostatitis, in rare cases, can also block the ejaculatory ducts. Hyperprolactinemia is when the pituitary gland makes too much of the hormone prolactin. It's a factor in infertility and erectile dysfunction. Treatment depends on what's causing the increase.
Drugs or less commonly surgery may be used to treat tumors in the pituitary if present. Hypogonadotropic hypogonadism is when the testicles don't make sperm due to poor stimulation by the pituitary hormones. This is due to a problem in the pituitary or hypothalamus. It's the cause of a small percentage of infertility in men. It can exist from birth,typically being apparent when the young man is supposed to go through puberty "congenital".
Or it can show up later "acquired". The congenital form, known also as Kallmann's syndrome, is caused by lower amounts of gonadotropin-releasing hormone GnRH. GnRH is a hormone made by the hypothalamus. The acquired form can be triggered by other health issues such as:. If hypogonadotropic hypogonadism is suspected, your health care provider may want you to have an MRI. This will show a picture of your pituitary gland.
You will also have a blood test to check prolactin levels. Together, an MRI and blood test can evaluate for pituitary tumors. If there are high levels of prolactin but no tumor on the pituitary gland, your provider may try to lower your prolactin first. Gonadotropin replacement therapy would be the next step.
During treatment, blood testosterone levels and semen will be checked. Chances for pregnancy are very good. The sperm resulting from this treatment are normal. The known causes of genetic abnormalities are most commonly detected in men with no sperm in the ejaculate azoospermia , where the condition affects sperm production e.
Genetic conditions can also affect the development of the male tract that carries sperm, resulting in failure of formation of the tubes that are supposed to carry sperm. Retrograde ejaculation, semen flowing back instead of going out the penis, has many causes. It can be caused by:.
Retrograde ejaculation is found by checking your urine for sperm. This is done under a microscope right after ejaculation. Drugs can be used to correct retrograde ejaculation. If medications don't work and you need assisted reproductive techniques ARTs , your health care provider may try to collect sperm from your bladder after ejaculation.
Varicoceles can be fixed with minor outpatient surgery called varicocelectomy. Fixing these swollen veins helps sperm movement, numbers, and structure. For more information on varicocele treatments please refer to our Varicoceles page. Even men who have low sperm production as a cause of no sperm in the ejaculate can be treated with surgery to find sperm, together with assisted reproduction, since several million sperm have to be made in the testicles before sperm survive to make it into the semen.
Vasovasostomy is used to undo a vasectomy. It uses microsurgery to join the 2 cut parts of the vas deferens in each testicle. For more information on this treatment please refer to our Vasectomy Reversal page. Vasoepididymostomy joins the upper end of the vas deferens to the epididymis.
It's the most common microsurgical method to treat epididymal blocks. For more information on this treatment please refer to our Vasectomy Reversal Page. Ejaculatory duct blockage can be treated surgically. A cystoscope is passed into the urethra the tube inside the penis and a small incision is made in the ejaculatory duct.
This gets sperm into the semen in about 65 out of men. But there can be problems. Blockages could come back. Incontinence and retrograde ejaculation from bladder damage are other possible but rare problems. Also, only 1 in 4 couples get pregnant naturally after this treatment. Sometimes it's hard to tell the cause of male infertility. This is called "idiopathic" male infertility. Your health care provider may uses experience to help figure out what works. This is called "empiric therapy. It's not easy to tell how well empiric treatments will work.
Each case is different. If infertility treatment fails or isn't available, there are ways to get pregnant without sex. These methods are called assisted reproductive techniques ARTs. Based on the specific type of infertility and the cause, your health care provider may suggest:. Intrauterine Insemination IUI. For IUI, your health care provider places the sperm into the female partner's uterus through a tube. IUI is often good for low sperm count and movement problems, retrograde ejaculation, and other causes of infertility.
IVF is when the egg of a female partner or donor is joined with sperm in a lab Petri dish. For IVF, the ovaries must be stimulated to produce multiple eggs ova. This is often done with drugs given as daily injections. It allows many mature eggs to be retrieved. After 3 to 5 days of growth, the fertilized egg embryo is put back into the uterus.
IVF can be used to treat many hormone conditions in women, for women with blocked tubes, or idiopathic infertility where there is no cause that explains the fertility problem.
But it's being used more and more in cases where the man has very severe and untreatable oligospermia low sperm count.
It has revolutionized treatment of severe male infertility. It lets couples thought infertile get pregnant. A single sperm is injected into the egg with a tiny needle. Once the egg is fertilized, it's put in the female partner's uterus. Your health care provider may use ICSI if you have very poor semen quality. It is also used if you have no sperm in the semen caused by a block or testicular failure that can't be fixed. Sperm may also be taken from the testicles or epididymis by surgery for this method.
Sperm Retrieval for ART. Many microsurgical methods can remove sperm blocked by obstructive azoospermia no sperm. The goal is to get the best quality and number of cells.
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