IVF treatment and male infertility

Around 40 per cent of couples presenting for IVF treatment do so due to male infertility. If you are not sure if it is the male or the female of the couple, there are some preliminary tests that can be done at home, before you go down the path to IVF.

There are several reasons for infertility in men, and there are also treatments available through IVF which yield high rates of success.

Causes of Male Infertility

The causes of male infertility in men presenting for IVF fertility treatment are many and can include:

  • lifestyle factors, such as recreational drug use
  • being overweight
  • age
  • smoking or alcohol intake.

There may also be problems with the actual sperm. Some common problems include:

  • sperm antibodies or sperm DNA damage
  • erectile or ejaculation difficulties
  • hormone problems also can play a part.

Whatever the cause, a diagnosis needs to be made and where possible a treatment undertaken before IVF treatment proceeds.

Testing the Sperm

The IVF treatment process for a male usually begins with a simple semen analysis. A semen analysis is conducted at a specialist andrology laboratory. An andrologist will check the semen sample for sperm density – there should be at least 20 million sperm per millilitre of semen.

When it comes to sperm motility or movement, at least half of the sperm in the sample should show forward progressive movement.  At least 15 percent of the sperm should have a normal shape (head and tail). The andrologist will also look for the presence of sperm antibodies, which if present, should affect less than 15 percent of the sperm.

If initial results indicate a problem with a man’s sperm, a repeat test is usually run some weeks later. This is because sperm has a life cycle of 72 days. Life experiences such as illness or stress can temporarily affect sperm production quality.

Sperm Antibodies

The presence of sperm antibodies has been linked to infertility. It has been estimated that as many one in 16 men produce antibodies to their own sperm. They are commonly found in men after a vasectomy, injury or infection of the epididymis, though in some cases, there is no explanation.

These antibodies can interfere with sperm motility and fertilisation. A blood test, in conjunction with the semen analysis, can confirm the presence of sperm antibodies. If present, conception is still possible using an advanced IVF treatment technique, known as ICSI (Intra Cytoplasmic Sperm Injection). This is a technique where a single sperm is selected for injection directly into an egg during the IVF treatment process.

DNA Damage

The sperm may also be checked for DNA damage prior to IVF treatment. This is accomplished using a recognised test called Sperm Chromatin Structure Assay (SCSA). If a SCSA test detects a significant level of chromatin damage, lifestyle changes and improvement of general health has been shown to improve this. There is also a belief that increasing the ejaculation frequency can help. Some antioxidant supplements have also been shown to be useful though this is not the case with all men.

So How Is Male Infertility Treated?

If the results show that the male has a degree of infertility, there are some treatments available. Whilst improving the quality of the sperm themselves can be difficult, there are a number of treatments available to help the couple to make the best of sperm quality and achieve a pregnancy using IVF fertility treatment.

Few simple drug treatments will increase sperm numbers or make sperm swim or look better. Some men produce low sperm numbers due to low reproductive hormone (gonadotrophin) levels. Gonadotrophin treatment can help them to produce more sperm in each ejaculation.

Where the semen abnormalities are not too severe the relatively simple IVF treatment procedure of washing and concentrating the sperm for direct insemination and transfer into the uterus of the female, is a good place to start.

IVF treatment can be very helpful in cases where semen quality is compromised. The semen is prepared to select the most strongly swimming sperm, which are then placed with the eggs in a knuc dish. This produces fertilisation in about 90 percent of male infertility cases, with the remaining 10 percent yielding no fertilisation.

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