- Fertility Treatment Options
- Ovulation Induction
- Intra Uterine Insemination (IUI)
- In Vitro Fertilization (IVF) ± ICSI
- Male Infertility Treatment
- Reproductive Surgery
- Embryo Transfer
- Blastocyst Transfer
- Assisted Hatching
- Embryo Freezing
- Fertility Preservation
- PGD/Genetic Diagnosis of Embryos
Male Factor Infertility
In approximately 30-50 percent of infertile couples, the husband is either the sole or a contributing cause of infertility. Therefore, a semen analysis is mandatory. The man is usually asked to abstain from ejaculating for at least 48-72 hrs although that is not mandatory in all cases. He will then produce a semen sample by masturbating in to a clean labeled plastic specimen pot provided in a private room at our center or at home. Sometimes two semen analyses (2-3 months apart) are recommended, since sperm quality can vary over time.
Abnormal / Insufficient Sperm count / quality
- The most commonly encountered problems in men involve abnormal or insufficient sperm count. Problems can be either not enough sperm is being produced, or the sperm is of poor quality. The quality is usually determined by motility and shape. A normal sample will show 20 million sperm per millilitre at least half of which will be active. Depending upon the count / shape / motility different terminologies are used like oligospermia (low count), asthenospermia (poor motility), teratospermia (abnormal shapes).
- Further, various specialized sperm functional tests like sperm Hypo-osmotic swelling (HOS) test, DNA fragmentation Index (DFI), Reactive oxygen species (ROS) assessment, Nuclear chromatin decondensation test (NCD), Acrosome Intactness Index (AI), can be performed to predict the capacity of sperm to fertilize the oocyte (egg) but unfortunately there is not which can be done to treat the abnormalities in sperm. Some fertility drugs and antioxidants might improve count and volume. Majority of male infertility problems requires advanced assisted reproductive technique called Intra-Cytoplasmic Sperm Injection (ICSI).
Absent sperm (Azoospermia)
- The absence of sperm in the semen analysis sample is termed as azoospermia. It can be due to blocked or absent tubes (vas deferens) or damaged testicles. The vas deferens does sperm transport function (and also storage) from the testicles (the site of sperm production) to the ejaculate
- Hence, related investigations for the above conditions like genetic screening cystic fibrosis, chest X ray for bronchiectasis are done
- If all the investigations are normal then a simple surgical procedure called surgical sperm retrieval (SSR) procedures like percutaneous sperm retrieval (PESA) / testicular sperm aspiration (TESA) / testicular biopsies can be performed to retrieve the sperm from the site of blockade or from the site of production
- If absence of sperms are due to the defect in the spermatogenesis (production of the sperm in the testes), then chromosomal analysis especially Y chromosome and its associated genes responsible for spermatogenesis are done to evaluate the cause and also it will predict the possibility of sperm retrieval by SSR. Usually, this is followed in severe oligoasthenoteratozoospermia (< 3 million count with low motility and severe abnormal forms).
- Smoking, Alcohol, recreational drugs (Cocaine and Marijuana), environmental pollutants, sedentary life style have negative effect on the semen parameters. Certain medications like sulfasalazine used to treat Rheumatoid Arthritis and Crohn's Disease can decrease your sperm count, however the effects are only temporary and you should return to normal after your course of treatment. Long-term use and abuse of Anabolic Steroids will reduce the number of sperm you produce and affect their motility. The cancer treatment sometimes can severely reduce your production of sperm, however advances in sperm freezing can take the precaution of freezing sperm in advance to cancer treatment for future fertility.