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Male Factor Infertility

At Monterey Bay IVF, we are able to test for semen quality. When it comes to infertility, we know that a male can be just as likely to be the source as the female. Research has shown that approximately one third of the causes of infertility are due to male factors and one third due to female factors. For men, one of the most important aspects of fertility is the creation of normal, mature sperm. For a man to be fertile, his sperm cells must be healthy and be transported to their destination—the egg. For the most part, causes of male infertility fall into four categories:

  • Low sperm count
  • Sperm that are immobile or with impaired movement
  • Abnormally shaped sperm
  • Delivery of sperm is impaired
  • Azoospermia or absence of sperm due to vasectomy or illness

Sperm must be present in large enough numbers, approximately 20 million or higher, in order for there to be sufficient fertility. In addition, they must be properly shaped (morphology) and able to move (motility) rapidly and accurately toward the egg.

Semen Analysis…testing for sperm density, morphology & motility:

At Monterey Bay IVF, we test sperm in our laboratory for sperm density, motility and morphology. Utilizing our state of the art semen analyzer, a quick and accurate determination can be made the same day.

An appointment is made for sperm analysis. For the patient’s privacy, we try to make this as easy and as comfortable as possible. The male patient will be escorted to a very private “collection room” which is located downstairs from our clinic in our surgery center. After a sample is obtained, it is dropped off for analysis with the results available the same day.

Sperm density refers to a measurement in millions of sperm per milliliter (mL) of semen. Normal is 20 million or more sperm per mL, with a total of 80 million or more sperm in one ejaculation. Fewer sperm and/or a lower sperm concentration may impair fertility.

Motility refers to how the individual sperm cell moves. Total motility results are listed on a scale from zero to 100%. For average fertility, at least 50% of the sperm should be active.

Morphology refers to the shape of the sperm cell when viewed under a microscope. A normal sperm will have an oval head with a long tail. Sometimes shape abnormalities can affect the way the sperm swims and/or fertilizes the egg. For a normal semen analysis at least 30% of sperm cells should be of normal shape.

Delivery: There are a variety of conditions that may block normal sperm from traveling from the testes to the ejaculate:

  • Obstruction in the vas deferens, sometimes a condition present from birth
  • Vasectomy, a surgical procedure done for contraceptive purposes
  • An infection of the epididymus, where sperm is stored, matures and transported between the vas deferens and the testes
  • Absence of the vas deferens (CAVD)

In some cases if the sperm cannot be extracted via different retrieval techniques and the condition not reversable, the couple may need to revert to donor sperm and undergo either an IUI (intrauterine insemination) cycle or an IVF (in vitro fertilization) cycle. They may also opt to do TESA or testicular sperm aspiration in conjunction with an IVF cycle and ICSI (intracytoplasmic sperm injection). See Infertility Services for more information.

Hormones: Creating sperm is a complicated process. The body must generate hormones at the right time and in proper amounts for healthy sperm production to occur. Some of the hormones the male reproductive system relies on are the same as a woman’s, including, gonadotropin releasing hormones, follicle stimulating hormones and luteinizing hormones. Any disruption in this process can make it difficult to conceive. Age and certain lifestyle choices, like smoking, drugs and excessive alcohol use, may also impact sperm production.