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In The NewsMale Factor Infertility Male factor infertility constitutes a significant cause of infertility, perhaps up to nearly half of the causes. Therefore, it is extremely important for the male partner to be evaluated. Important historical questions include symptoms such as decreased interest in intercourse (decreased libido) and/or decreased energy, which could suggest low testosterone levels. Low testosterone could indicate a problem with the testes and sperm production. This may require an office visit (which we can do in our practice) with a physical examination and laboratory evaluation. It is also important to ascertain if there are other medical problems that could contribute to the infertility. Sometimes, medications have adverse effects upon sperm, and the benefits and risks should be considered. The physical exam is important to help pinpoint any possible treatable cause. Particularly important is the testes size, as well as the presence or absence of a varicocele, which is a dilatation of testicular veins. Although there are a variety of available tests, a semen analysis is the most important one. Usually, the sample is provided after two days of abstinence. This two-day abstinence gives the most useful information, and it reduces the chance that the semen analysis will have to be repeated. The concentration, the percent motility, and the percentage of normal sperm will be examined and reported. Sometimes, the test will need to be repeated if it is abnormal. If the semen analysis is abnormal, laboratory blood tests for hormone levels may be performed. The most important tests are testosterone, follicle stimulating hormone (FSH), and luteinizing hormone (LH). If all three tests are low, medical treatment may increase testosterone levels and increase sperm counts, which is not true if the FSH and LH levels are high. It may also become necessary to check other blood tests. It should be remembered that treating men with testosterone has the opposite effect—it lowers sperm! The most common treatment for men with abnormal semen analyses is intrauterine insemination (IUI). This is true even if there is a varicocele is present—surgery is usually reserved for symptoms of pain (most studies show that surgery does not improve fertility). For IUI cycles, the female partner will take an ovulation medicine and at the time of ovulation, a sperm sample will be produced and the motile sperm will be selected for insemination into the uterus. The procedure usually only takes a few minutes, and is nearly always no more painful than a pap smear. IUI markedly increases the number of motile sperm that get into the tubes (where fertilization of the egg occurs). For IUI to be beneficial, usually at least 10 million motile sperm should be present in the prepared sample. Normally, this treatment will be tried for 3-4 cycles, and if pregnancy does not occur, then in vitro fertilization (IVF) will be considered. Although it is commonly thought that infertility is primarily the woman’s problem—this is not true. Evaluating and treating male factor infertility remains an important part of infertility treatment. Lawrence C. Layman, M.D. Baby Party a Success!
Photography by Sharon Tanner To start a family, more and more women are turning to fertility treatments to try and help get pregnant. Thursday night one of the only local infertility clinics is celebrating their success with a party, a party for everybody involved. Click Here to view story from WRDW Channel 12. |
