Male Fertility Services

Semen Analysis

The simplest evaluation of a male is the semen analysis (SA). Sperm density, motility, and morphology are assessed during the analysis. The SA is done by our andrology laboratory by appointment only. The male partner is required to have one to three days of abstinence prior to the day the analysis is to be done. Candidates for in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) and intrauterine insemination (IUI) will have additional testing performed that includes separating the more active sperm.
Please contact our office if you have any questions regarding specimen collection parameters, payment, and the process.

Male Hormone Testing

Hormonal testing of the male can help fertility specialists pinpoint conditions that may be contributing to their inability to conceive.Testosterone and various hormones made in the brain control sperm production. When an abnormal level of these hormones is discovered, specific therapies may be chosen. Hormonal dysfunction in men remains one of the uncommon, but treatable, causes of low sperm production. Consistent with our philosophy at Advanced Fertility Centers of West Texas, we prefer to evaluate the male also, to avoid delays and to manage the couple for best outcomes. Thus, it is a routine recommendation for the male to be present and be authorized for consultation along with the female.

Male Genetic Testing

“Male factor infertility” is the name for any condition in the man that may be a reason why a couple cannot have a baby. Certain conditions can increase these chances.

Our fertility specialist may recommend genetic testing if you have one or more of the following conditions:

Very low sperm count, or no sperm seen in the semen
Physical features that suggest a genetic cause
Several miscarriages

The chances of identifying a genetic cause for male factor infertility depends on the man’s laboratory results, physical exam findings, ethnic and racial background, and family history.

What genetic tests are recommended for men with male factor infertility?
The three most common genetic tests are:

Karyotype (chromosome analysis)
Y chromosome microdeletion test
Cystic fibrosis (CF) gene test

Increasing Sperm Production

Men who are attempting to conceive but who are found to have “low sperm counts” require detailed testing in an attempt to identify a specific cause. When the cause remains unknown and techniques are applied to utilize the current low counts. In other cases, sperm production can be increased over 2-4 months using fertility stimulating medications.
For men who have effective sperm-making machinery, the addition of medications will sometimes allow the natural increase in sperm production. Sperm requires 2-3 months to fully mature, so the treatment takes time, but in properly selected cases, this approach can be quite helpful, sometimes allowing for spontaneous conception.
There are always general recommendations for men with low sperm production that may be helpful toward improvement. These approaches include:

Eating a healthy diet, rich in anti-oxidants.
Maintaining a healthy weight.
Avoiding excess alcohol and tobacco exposure.
Increasing physical activity.

Semen Cryopreservation

When sperm is obtained for future reproduction, such as for men planning vasectomy or chemotherapy, Advanced Fertility Centers of West Texas assists in coordinating the cryopreservation and the long-term storage arrangements. This approach is also useful when the male’s availability at the time of ovulation is uncertain. Military personnel who deploy on short notice are examples where cryopreservation can avoid a prolonged delay in treatment or attempted conception.

Alternatives to Vasectomy Reversal

Men considering vasectomy reversal should also consider the alternative of direct sperm retrieval (without vas reversal) and should consult with an experienced fertility specialist who will discuss the advantages of BOTH approaches. Obtaining the most up to date information on outcomes and costs will help in selecting the best option for a couple’s unique circumstances.
The length of time since vasectomy is an important factor. With vasectomy more than 5 years duration, the chances of a successful conception and delivery decrease. This becomes particularly important when the female is over 30 years of age as sperm counts may not recover immediately.
To conceive after vasectomy, sperm retrieval is usually completed in an office setting, as with the original vasectomy, without the need for general anesthesia. There is no need for incisions or stitches with sperm aspiration and men return to routine activity quickly.

Infertility in Males

In order to impregnate an egg, several physical elements must work together. You must have at least one functioning testicle that produces healthy sperm. Enough sperm must be carried into the semen and then mix with the semen. The semen must be ejaculated in order to fertilize your partner’s egg. When all the right criteria are met, conception may occur.
At times, this natural process is disrupted by disorders and medical issues that prevent fertilization. According to studies, male factor problems account for 30% of infertility. Many men struggle with a wide variety of fertility issues and rely on Experts at Advanced Fertility Centers of West Texas for help.

Common Causes of Infertility:

Understanding reasons why male infertility may occur is a first step toward a solution.

Excessive exercise which can release high amounts of steroid hormones

Taking testosterone over-the-counter androgens, such as DHEA for weight training.

Heat from clothing that constricts, frequent bike riding, saunas, hot tubs, and hot baths

Stress

Obesity

Inadequate sleep

Inadequate nutrition

Exposure to pesticides, lead, mercury, radiation, radioactive substances, heavy metals

Use of drugs that can work against healthy sperm, such as marijuana, cocaine, tobacco and overuse of alcohol (more than two drinks daily).

Low Semen Parameters If you are experiencing symptoms of male infertility, the first thing you should do is see a specialist, typically a reproductive endocrinologist or urologist. After a physical examination, the specialist will probably order a semen analysis, which will check the quality and quantity of the sperm in the semen. He or she will want you to give the sample in the office, since it is important that the analysis take place as soon as possible. Please remember, as self-conscious as you might feel, a semen analysis is a commonplace test and the results could save you months of worry and stress.

If the first semen analysis is normal, your doctor may order a second test to confirm the results. Two normal tests usually indicate that you do not have any significant infertility problems. If something in the results appears irregular, your doctor might order further tests to pinpoint the problem.

The most common cause of male factor infertility is low sperm count. Male and laboratory evaluation can reveal reasons for low semen parameters. A semen analysis can determine whether male infertility is caused by a low or absent sperm count.

A less common cause of infertility is absence of sperm in the semen. This affects only 1 percent of all men and 10 to 15 percent of infertile men.

Obstruction

The excretory ducts of the male genital system may be at fault, despite the presence of a normally functioning hypothalamic pituitary testicular axis. The obstruction may be congenital or may follow chronic infection.

Structural problems, such as blocked ejaculation due to a surgical vasectomy, can affect fertility.

An absence of a vas deferens (a birth defect that may be associated with the cystic fibrosis gene) is another structural problem.

Retrograde ejaculation (the ejaculation of semen into the bladder rather than out through the penis) is also a structural problem.

Accessory Gland Disorders may be due to congenital absence of the vas and/ or seminal vescicles or due to chronic infection (i.e. prostatitis or seminal vesiculitis) leading to an increased number of WBCs and other inflammatory cells. The semen contains debris and pus cells which may affect the normal function and motility of the spermatozoa.

Primary Testicular DisordersProblems at the testicular level can cause infertility, as follows:

Spermatogenesis is the process in which spermatogonia development into mature spermatozoa. Cryptorchidism or undescended testes, if not treated properly in early life through hormonal and/or surgical treatment, may prevent spermatogenic capacity.

Physical and chemical agents can affect spermatogenesis, such as irradiation of the testes, the use of cytotoxic drugs, cimetidine (which competitively inhibits androgens), sulphasalazine (reversible on discontinuation), and spironolactone (which blocks androgen receptors).

Spermatogenesis is also inhibited by acute and chronic heavy metal poisoning (e.g. lead, arsenic, zinc, mercury), accidental inhalation of insecticides (1,2 dibromo-3-chloropropane, DBCP), herbicides (paraquat) or sterilization gas (ethylene oxide).

Immunological disorders may cause antibodies to inhibit spermatogenesis and attack sperm. Antisperm antibodies may be produced following infection or trauma to one or both testicles and in patients who had reversal of sterilization after a lengthy time lapse.

Varicocele is a mass of varicose veins in the spermatic cord. It is thought that the presence of a varicocele leads to an increased temperature of the testes and a suppressing effect on spermatogenesis. The optimum temperature for spermatogenesis is 29-35 °C and this is achieved by the extra-abdominal location of the testes. However, the relation between varicoceles and male infertility has been challenged (Vermeulen and Vandeweghe, 1984; Baker et al, 1985).

Chronic illness and general ill health, such as diabetes, hypothyroidism, malignancies and other debilitating diseases, may lead to deranged spermatogenesis.

Sperm immotility (lack of movement) can occur due to absence of dynein arms in the sperm tail. This occurs in some disorders including the Kartagener syndrome where the motility of all body cilia is impaired, leading also to sinusitis and bronchitis.

Sperm motility is also inhibited by the use of propranolol and other beta blockers, nitrofuranes, niridazole (an antischistosomal) and ethanol (which produces relative deficiency of vitamin A).

Chromosomal disorders can cause infertility, such as Klinefelter Syndrome in which the cells contain 47 chromosomes (44 autosomes and XXY sex chromosomes).

Genetic problems may cause infertility.

Orchitis is an inflammation of the testicles (traumatic and infective). In particular, mumps occurring in adult males may lead to permanent testicular damage. A vasectomy, an infection, or an injury to the testicles can cause infertility.

Cancer treatment with certain kinds of chemotheraphy or radiation can cause infertility.

Drug use (including marijuana, tobacco, alcohol and some prescription medications) may cause infertility.

Hormonal problems of the testicles or pituitary gland may cause infertility.

An idiopathic group remains in which no specific cause for the testicular disorder can be found.

Male Evaluation