Washington Center for Reproductive Medicine

Male Factor Infertility Evaluation and Treatment, Seattle WA

Male factor infertility is present in up to 47% of couples seeking fertility care. Unlike the female, the "normal" male remains fertile for his entire lifetime. He must produce enough sperm of sufficient quantity to cause fertilization and development of an egg.

Sperm require three months to develop so a sample taken today reflects the conditions at that time. There are several causes for male infertility:

  • Obstruction- Sperm must travel through the male reproductive tract and be ejaculated through the penis. The vas deferens is the "tube" that carries the sperm and blockage can lead to infertility. Blockages can be caused by many conditions including congenital deformations, or absence, of the vas deferens, or previous infections that caused scarring.
  • Ejaculation failure- Sperm must be ejaculated from the penis into the vagina. There is a small muscle that closes off the bladder during ejaculation. If this muscle fails, sperm may be ejaculated into the bladder. Failure to maintain an erection and ejaculate can also be caused by vascular, neurological, and psychological problems.
  • Temperature- Sperm are sensitive to temperature and the scrotum normally performs the heating and cooling functions. When the temperature needs to be lowered, the scrotum expands moving the testicles further away from the body. Conversely, when the temperature must be increased the scrotum draws the testicles closer to the body. Anything that interferes with this "heating/cooling" process can lead to infertility.
  • Routinely sitting in hot tubes for long periods or occupations, such as long distance truck driver, can interfere with quality sperm development. A varicocele is a collection of "blocked veins" in the spermatic cord that interferes with the blood flow necessary to produce healing and cooling. Sometimes a varicocele can be treated surgically.
  • Hormonal- rarely, there is a severe gonadotropin hormone deficiency leading to poor quality and reduced quantity of sperm. Unfortunately, medical treatment of this condition is rarely effective. IVF with ICSI is often the best treatment choice for these patients.

Environmental Factors Affecting Sperm Quality

Spermatozoa are relatively fragile cells and are easily damaged by a number of environmental and life style habits. Increased temperature resulting from illness, sitting in hot tubs, and saunas, or wearing tight clothing can affect sperm production and function. Strenuous exercise, such a long distance bicycling or marathon running, can also have damaging effects, as can recent significant weight loss or gain.

Drugs (including alcohol and nicotine) are proven to decrease male fertility and should be minimized or avoided while attempting to achieve pregnancy.

Men with poor semen analyses can often father children through the use ofintracytoplasmic sperm injection (ICSI) combined with IVF. In cases where an adequate number of sperm can be collected, intrauterine insemination (IUI) is sometimes the therapy of first choice.

Several tests will be ordered to rule out male factor infertility prior to treatment of the female.



Fifteen Years Experience In Preimplantation Genetic Diagnosis For Family Balancing And Chromosomal And Genetic Disorders.

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