Male Fertility

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Male Infertility Treatment at Pacific Fertility Center

Perhaps because the woman carries the baby, we often consider infertility solely a female problem. In fact, up to 50% of all infertility cases involve the male partner.

If male fertility issues are suspected based on the results of a semen analysis, we may refer him to a male fertility specialist or an andrologist, who specializes in male reproductive problems. Just as reproductive endocrinologists are gynecologists sub-specialized in treating female infertility, andrologists are urologists specially trained to treat male infertility. PFC works closely with the following male fertility specialists in Northern California:

Male Fertility Evaluation

As with female infertility, there are several treatments to successfully address various male infertility diagnoses. When recommending a given male fertility treatment option, we consider three important factors:

  • Cause of infertility, if identifiable
  • Severity of the sperm abnormality
  • Age of the female partner

Because male infertility may require months of treatment, any treatment plan will consider the age of the female partner, as this is a crucial element in fertility success.

The male fertility evaluation will include a sperm count, and usually a panel of hormone blood tests, a physical and urogenital examination, and possibly genetic tests and/or sperm function testing.

Learn More About Male Infertility Diagnosis

Fertility Treatment Options

  • In cases where the patient has a low sperm count or diminished motility, a urologist may prescribe Clomid, an infertility pill commonly used to treat ovulation issues in women. For men, Clomid can stimulate the hormones responsible for sperm production. Sperm counts are re-analyzed 3-6 months after the medication is started to evaluate any improvement in sperm production.

  • Many cases of male factor infertility, even after a full evaluation, are labeled "idiopathic," which means that we do not know why there is a low count, low motility, or poor sperm morphology (abnormally shaped sperm). It may be environmental factors (e.g., pollutants, toxins, etc.) or related to lifestyle (e.g., hot tub or hot bath use, smoking, etc.). If such causative issues are identified as contributing factors, our doctors typically offer advice on how to address these challenges. 

    However, even men without known toxic exposures or lifestyle factors can have low sperm parameters. Many dietary supplements are known to improve sperm production and function, such as L-carnitine and zinc. A reproductive endocrinologist or andrologist may recommend starting a vitamin and mineral supplement regimen to help improve sperm production and parameters.

  • When there is mild, unexplained low sperm count or motility, we may recommend an intrauterine insemination (IUI) cycle. Sperm is processed and placed into the female partner's uterus around the time of ovulation, giving sluggish sperm a head start toward the egg or eggs.

    What to expect from the IUI procedure

    The male partner will be asked to provide a sperm sample through masturbation either at home or in our clinic. His sperm is then sent to our laboratory where it is prepared for transfer into the female partner's uterus. The most active, motile, and healthy sperm are extracted; this optimal sperm sample is placed into the uterus via a catheter.

    Before the IUI procedure, the male partner will be asked to abstain from ejaculation for 2 to 5 days. Please note that abstaining for more than 7 days can result in decreased motility.

    Learn More About the IUI Procedure

  • When surgical and medical treatment does not improve sperm production, many couples find success through in vitro fertilization with intra-cytoplasmic sperm injection (IVF with ICSI). To aid in the IVF process, the embryologist injects the healthiest, most motile sperm directly into each egg.

    Learn More About Fertility Treatment

    Learn More About ICSI

  • Two procedures known as MESA and TESE are very effective at treating more problematic male infertility diagnoses, by enabling doctors to obtain healthy sperm directly from the male reproductive tract in cases where sperm is not able to travel on its own. After sperm is retrieved, it is injected directly into individual eggs through the ICSI procedure. The doctor may recommend MESA or TESE for patients who have had vasectomies but reversal is not an option, congenital absence of the vas deferens, or non-obstructive azoospermia.

    What to expect

    The MESA (microsurgical epididymal sperm aspiration) procedure is performed under local anesthesia and general sedation and is usually performed in an outpatient surgical center. Here, a small incision is made above the testicle, enabling millions of sperm to be collected. While this sperm may be perfectly healthy and strong, it is not yet mature, so embryologists help it along by injecting it into the egg in an ICSI procedure. Sperm collected in this manner can also be frozen, should the patient and his partner undergo further IVF cycles.

    In TESE (testicular sperm extraction) sperm is either removed directly from the testicles or obtained through a biopsy (tissue sample). This surgery is usually performed under local anesthesia with no general sedation and can be done in the procedure area at Pacific Fertility Center. 

    As with MESA, retrieved sperm is injected into the egg through ICSI. TESE is often recommended for men with poor sperm production in the testicles and no sperm in the ejaculate. It is also recommended in cases of Azoospermia, where there are no sperm in the epididymis, the tube connecting the testicle with the vas deferens. Usually, the TESE procedure releases only enough sperm for one round of IVF, thus it may need to be repeated for subsequent rounds.

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