Male Fertility Therapies

What therapies are available to improve male fertility?
There are a variety of different things that someone can do to improve their fertility, but before you start with improving your fertility we need to test fertility by doing several semen analyses, and if those are abnormal there are a variety of other tests that could or should be done to try to diagnose the problem. So, number one diagnosis, number two treatment for the specific problem, and number three general therapy, which includes modification of lifestyle: staying out of hot tubs and jacuzzis, it means eating healthy, it means taking certain supplements that can help improve the sperm, so it's a variety of different things. It means stopping smoking, it means limiting alcohol intake; all these things are potentially bad for sperm.

What is "assisted reproduction"?
Assisted reproduction is any technique or technology that we use short of natural conception, and it includes intrauterine insemination or sperm washing or IUI, or the turkey baster as it's commonly known. Other assisted reproductive technologies include in vitro fertilization, which means the fertilization is not done in the woman's body, it's done in the lab in a Petri dish.

What is "electroejaculation"?
Electroejaculation is a technique that's used to treat men with a condition called anejaculation, where they're unable to have an orgasm and an ejaculation. This is usually due to a few different types of conditions. Number one, it could be due to a spinal cord injury, where a man had, his spinal cord is severed so the signal from the brain to get to the testicles and the penis to tell them to ejaculate does not go through. It, it's also seen in some men with diabetes, or men who've had different types of surgery and, and the retroperineum, the area behind the abdomen, where the nerves that control ejaculation are, some surgeries can damage those nerves. So in men who can't ejaculate, what happens is, there is a device that is an electrostimulator that is applied to the back of the prostate and by passing current to those muscles it actually causees those muscles to contract in an ejaculation to ensue.

What is "sperm retrieval"?
Sperm retrieval describes a series of techniques used to obtain sperm from the testicle in men who are azoaspermic, or don't have sperm in the ejaculate.

What is "sperm washing"?
Sperm washing is a technique that we use in the laboratory, where a man provides a semen sample and we go ahead and let that liquefy because semen comes out as a gel like substance and over a half an hour to 45 minutes, enzymes that are derived from the prostate, actually cause that gel to liquefy. We let the sperm swim out and we're able to separate the moving sperm from the non moving sperm. We then put it in a centrifuge. To do that we decant off the dead sperm, we take the live moving sperm and we suspend it in a very small amount, a half a cc or a half a milliliter of culture media that supports the sperm with nutritional fluids. That half a cc is then loaded up into a little catheter and is placed inside a womans uterus.

What is "Intracytoplasmic sperm injection"?
Intracytoplasmic sperm injection or ICSI as it is known, is a technique of advanced reproductive technology, and it's a technique of in vitro fertilization. The sperm are taken into the lab, the eggs are retrieved from a woman's ovaries after she goes to a series of fertility treatments, and under a microscope a single sperm is picked up in a very, very tiny needle and is then directly injected directly into the cytoplasm inside of the egg, allowing it to fertilize.

What types of drugs are used to treat male infertility?
Most of the drugs are hormonal based therapies. Meaning if a man has a hormone problem those hormones can be supplemented or replaced to try and improve their sperm counts and the quality of their sperm. In some men we try a medicine called clomid which women frequently use for fertility problems and sometimes that helps improve the numbers of sperm they produce many times it does not. There are a variety of other medications that can be used but they are also situational specific if a man has a prostate infection or a urinary tract infection that can be causing damage to the sperm then treating that person with the appropriate antibiotics can help.

What surgeries are performed to treat male infertility?
There are a variety of different surgeries designed to treat male infertility, but they're based on, and broken down into, three different categories. Number one is the treatment of varicocele or varicose veins around the testicle, and there are several different procedures to block those veins; to block the abnormal blood flow and stop damage to the testicle, so that the testicle can make sperm that are in bigger quantities. The other type of surgery that is done for male infertility is microsurgery to relieve a blockage in either a man who has had a vasectomy and wants it reversed, or in someone who has a blockage either in their epididymis, or in their vas, from either an infection or other types of surgery. The last types of surgery that we do to treat male infertility are sperm retrieval techniques for men who have a condition called azoospermia, where we're able to go into the testicle or the epididymis and get the sperm directly out from there by doing a small, outpatient, microsurgical procedure. Those sperm are then used in combination with in vitro fertilisation and ICSI, where we take the sperm, and then we inject the sperm directly into an egg.