Fertility Options for Men
Some of the factors affecting fertility include mumps, high fever, diabetes, a previous injury or surgery, or infections such as sexually transmitted diseases, chemical exposure, stress, drug and alcohol use, medications, exercise habits, timing and frequency of sexual intercourse, and family fertility history.
A comprehensive testing of sperm evaluates the quality and quantity of sperm and seminal plasma. This may detect factors that impair the sperm's ability to travel to the fallopian tubes or penetrate the egg. Since sperm parameters may change daily, more than one testing may be needed.
The motility, count, and shape of sperm can affect the sperm's ability to function properly.
The postcoital test, performed 12 to 18 hours after intercourse, is used to evaluate male infertility, in addition to evaluating the receptivity of cervical mucus. There should be at least 5 progressively motile sperm 12 hours after intercourse. A poor postcoital test may be due to mucus factor (infection, too thick or too little mucus), poor semen quality, or mechanical problems (sperm not reaching Cervix).
Antibody tests determine whether the man or woman produces antibodies to sperm. Antibodies in blood, cervical mucus, or seminal fluid, may react to sperm as invaders and destroy or immobilize them.
Increased white blood cells (WBC) in semen indicate infection.
Male Infertility Treatments
Infections of the reproductive tract affecting fertility can usually be treated with antibiotics.
Improving Sperm Concentration
Sperm washing concentrates the more active sperm, which can then be inseminated into the woman.
In vitro fertilization (IVF) is often the only way to avoid sperm antibody problems.
Fertility problems related to varicoceles, ductal obstructions, or ejaculation can usually be treated. If a man chooses to reverse a vasectomy, the procedure itself is usually successful, but fertility may not be restored.
The Fertility Institute of New Orleans is pleased to work with the patient’s urologist or will recommend a urologist.
Artificial Insemination with Partner's Sperm (AI)
Artificial insemination with partner's sperm (AI) is most often successful in cases of cervical mucus infertility and problems of intercourse and may be successful if semen quality is only a little below fertility standards. When semen quality is too low for AI to be successful, in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) may still be successful. When no sperm are present, therapeutic donor insemination (TDI) may be an option. Intrauterine insemination (IUI), when prepared sperm is placed in the uterus, provides for more successful AI.
Semen Quality Required for Successful AI
Successful AI is dependent on five factors:
- Semen quality
- Method of preparing sperm for insemination
- Timing and method of insemination
- Number of preovulatory follicles
- Presence of pelvic disease
Parameters for AI
The Fertility Institute of New Orleans’ database contains complete records of sperm quality and treatment from more than 5,000 AI and TDI cycles. When initial semen quality is less than needed for at least a 4% pregnancy rate per cycle, we believe IUI should not be attempted. Instead, IVF, ICSI, or donor sperm should be considered.
Pregnancy rates per cycle may be doubled when fertility medications are used. Results can be compromised by endometriosis or tubal adhesions.
The semen parameters for IUI are concentrations within normal limits pregnancy rates with one follicle range from four to ten percent.