Overcoming Male Infertility
Male infertility is a very common problem. Some level of male factor is involved with probably 60% or more of in vitro fertilization cases that we see here at MCRM Fertility. Sperm quantitative (count and concentration) and qualitative factors (morphology and DNA Fragmentation) are often at play. The basic/traditional semen analysis that is usually done is simply inadequate in evaluating male factor in modern IVF/reproductive centers as it only evaluates quantitative factors.
DNA fragmentation assessment and other such qualitative factors, such as the CAP-Score assay, are extremely useful adjuncts in addition to the traditional count, motility, morphology assessments that are done. These qualitative tests, which in addition to the two that I mentioned, are extremely useful in giving further detail on male factor issues, but also can predict the probability of natural conception and intrauterine insemination (IUI) success.
Depending upon these results, there are medical therapies that are often useful in addition to IUI and IVF to enhance the probability of success depending upon the individual situation.
Thus, proper evaluation of male factors is critical because individualized treatment options can be applied. Medications, supplements, sperm preparation techniques, various options with intrauterine insemination, etc. are all potential options that need to be investigated and considered for each case.
Proper evaluation and assessment of test results lead to optimal care on an individualized basis.
Finally, sperm cryopreservation is an underutilized technique and adjunct as well. Testicular dysfunction, like any other glandular dysfunction, is a process that declines over time. As such, if count, motility, etc. are low today, then one can expect down the road, a year or two later, things could quite possibly decline, and in some cases, the result might be the complete absence of sperm (azoospermia). This is something we have observed. The overall advice to overcoming male infertility is to complete proper evaluations and have a discussion with a specialist to review the optimal care with which to proceed.
Peter Ahlering, M.D.