About 15% of all married couples will experience reproductive difficulty.
Causes of Male Infertility
Male infertility has been found to be a major factor in a couple’s inability to conceive in 50% of childless marriages. There mare many causes of male infertility including:
- deficient sperm production
- blockage of the ducts through which sperm are transported from the testicles
- hormonal abnormalities
- chromosomal/genetic abnormalities
- failure of sperm to mature properly
- anti-sperm antibodies.
- systemic disease
Deficient Sperm Production
Blockage of Ducts
Hormonal and Testicular Abnormalities
There are hormonal and testicular causes of male infertility. The many hormonal causes can be evaluated at Avant Grade Urology.
Chromosomal or Genetic Abnormalities
Similarly, chromosomal or genetic abnormalities that result in inadequate sperm production can also be diagnosed at the Center. Some of these disorders include Klinefelter’s Syndrome, due to the presence of an extra X chromosome in the male. This syndrome is characterized by small, firm testes, delayed sexual maturation, azoospermia and gynecomastia. Noonan’s Syndrome is the male counterpart of Turner’s Syndrome. These individuals are characterized by short stature, webbed neck, low-set ears, and cardiovascular abnormalities. Other chromosomal abnormalities include myotonic dystrophy, bilateral anorchia, sertoli-cell-only syndrome.
Failure of Sperm to Mature Properly
The exposed position of the testicles makes them susceptible to injury and atrophy as a result. Surgery to the testicles, for any reason, may compromise the blood supply and subsequently the development, growth and maturation of sperm.
Systemic disease that may affect male fertility include Renal failure, Cirrhosis of the liver, Sickle-cell disease, Defective androgen synthesis, Cryptorchidism, Varicocele.
Read more about varicoceles, which are thought to play a major role in male infertility.
Male Infertility Treatment Strategies
Sperm aspiration and testis biopsy
Surgical Procedures:Vasectomy reversal.
Vasectomy &, vasectomy reversal. Vasectomy reversal (also called vasovasostomy or epididymovasostomy) is receiving increasing attention in urologic practice. The most common situation involves the remarriage of a man who has previously had a vasectomy and now desires additional children. Vasectomy reversals are also requested by couples who have long-standing marriages but simply have decided to have additional children. Fortunately, microsurgery has advanced significantly in the past several years so that reversing a procedure once thought of as permanent is now highly possible.
A vasectomy cuts the vas deferens to prevent the flow of semen out of the penis during ejaculation. A vasectomy reversal simply opens the sealed ends of the vas deferens and reattaches them. When the vas is opened, fluid will flow from the testicular side of the vasectomy site. If sperm are present, then we expect roughly 90% of patients to demonstrate a return of sperm with as associated 60-70% pregnancy rate.
Vasectomy reversal can generally be performed on an outpatient basis, with operating time of approximately 3 hours. A general anesthetic is generally used. Postoperative care should include an evaluation of wound healing at 10 days and a semen analysis at 6 weeks. Monthly semen analyses are then obtained for approximately 4-6 months or until the analysis results stabilize.