THE MALE FACTOR
There are many reasons why you may not be getting pregnant. One of these reasons could have to do with the quality of the male partner’s sperm. If this is the case, we have many options available to help you and your partner create the family you want. Please call us to discuss your options.
Surgical Sperm Retrieval
This procedure retrieves sperm from the testicle or epididymis for obstructive azoospermia (no sperm due to blockage after vasectomy) or for non-obstructive azospermia (no sperm on ejaculation with no prior vasectomy).Our physicians can perform the surgical sperm retrieval in PREG’s surgery suites in Greenville or Columbia, with PREG’s andrologists available to perform immediate sperm cryopreservation (if sperm suitable for cryopreservation is found). The cryopreserved (frozen) sperm can then be used later with the intracytoplasmic sperm injection (ICSI) technique in an IVF cycle to achieve fertilization of eggs obtained by transvaginal ultrasound follicle aspiration resulting in embryos.
PREG does NOT perform this procedure. A urologist would perform a vasectomy reversal. Before vasectomy reversal is performed, evaluation of the female partner’s reproductive potential is recommended. The alternative to vasectomy reversal – epididymal or testicular sperm aspiration or extraction and IVF with ICSI- should be presented and discussed. The prognosis for success after vasectomy reversal declines progressively as the interval between vasectomy and its reversal increases. There are significantly lower pregnancy rates when the reversal was performed 10-15 or more years after vasectomy. The inverse relationship between success rates and the interval of obstruction may reflect progressive testicular damage. The age of the female partner has important prognostic value with women older than 37 having a progressive decline in fertility and IVF may be the better option. Other female factors such as tubal disease, anovulation, diminished ovarian reserve, or endometriosis may make IVF with ICSI the more preferred route to achieve a successful pregnancy.
Evaluation of the Azoospermic Male
Azoospermia is when no spermatozoa (or sperm) is seen on one semen analysis. This is even after centrifugation of the semen sample in an attempt to concentrate the sperm, if present, in very low numbers (oligospermia). Azoospermia occurs in approximately 1% among all men and 10-15% among infertile men.
Semen Analysis (SA)
Semen Analysis (SA) should be performed in a qualified andrology lab for best evaluation of male infertility. A semen analysis is an important test for males to give the best indications of any sperm abnormalities. History of a pregnancy by the male does not necessarily equal a normal semen analysis. An adequately performed SA should include:
- Sperm count (normal: >20 million sperm/ml semen).
- Sperm motility (movement of sperm, usually >45% motility is normal)