Carolinas HealthCare System

Male Factors

Male factors contribute to infertility in about 40 percent of couples. A semen analysis may be performed to evaluate several semen parameters including sperm count, motility (movement) and morphology (shape). Semen parameters can vary over time, so additional semen analyses may be recommended to more thoroughly evaluate a male's infertility. A consultation with a urologist for additional evaluation may be recommended. A history and examination will be performed to determine if infection, obstruction of the ducts, varicoceles (varicose veins in the scrotum) and/or hormonal disorders exist. Treatments will be directed at the cause of the abnormality, although in some instances, it may remain unexplained.

For couples with male factor infertility, intrauterine sperm insemination (washing the sperm and placing it into the uterine cavity at ovulation), or in vitro fertilization (IVF) may be recommended. IVF along with an assisted fertilization technique (ICSI) has helped many couples achieve pregnancy. During ICSI, medicinal stimulation increases egg production. The eggs are retrieved during a minor outpatient procedure, and ICSI is then performed by directly injecting a single sperm into an egg in the Reproductive Biology Laboratory. Successfully fertilized eggs, now embryos, are then transferred to the woman's uterus in hopes of achieving a pregnancy.

Some men have no sperm in their ejaculates. Their reproductive ducts may be absent or blocked (obstructive azoospermia), or others may have no or low sperm production with normal anatomy (non-obstructive azoospermia). Sperm has been successfully obtained from the male reproductive tract of men with obstructive and non-obstructive azoospermia and used as part of IVF since the late 1980s. Your reproductive endocrinologist, reproductive urologist and the Reproductive Biology Laboratory experts work as a team to provide the best treatment plan and results. For cases where no sperm are present, our andrology laboratory can provide donor sperm.