Leaders in Fertility Research and Care
Timothy N. Hickman, M.D. | Laurie J. McKenzie, M.D. | Katherine K. McKnight, M.D.
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Male Infertility, Houston IVF

We now know that male infertility is manifested in many, and sometimes unexplained, ways. The semen analysis is one of the most important tests conducted during the evaluation of possible male infertility, Houston IVF uses what is known as the Kruger Strict Criteria to evaluate and identify many sperm disorders.

This criteria includes the quantity of sperm, the viscosity of the ejaculate, the shape of the sperm (morphology), an evaluation of how the sperm swim, and many other characteristics. Given the importance of the male infertility semen analysis, it should be performed by a reproductive laboratory.

In the male fertility evaluation, a precise history is taken, together with blood samples, to rule out sexually transmitted diseases (STDs). A fresh semen analysis is obtained in our Houston laboratory after two days of abstinence and the entire ejaculate is collected and assessed without delay.

According to the findings of the initial semen evaluation, the patient may be scheduled for additional tests. Unlike many commercial laboratories, we have dedicated andrologists in our Houston IVF clinic who perform the male infertility semen analysis according to World Health Organization criteria. Sometimes the analysis is repeated in three weeks, and we screen for sperm conditions caused by excessive alcohol, diabetes, marijuana and other drugs, medical diseases, etc.

There are many causes of male sub fertility and major ones include untreated infection with organisms such as syphilis or gonorrhea, childhood diseases such as mumps, a varicocele, genetics, congenital abnormalities, environmental influences causing abnormally elevated testicular temperature (i.e. prolonged sitting in a hot tub), hormonal imbalances, and many more.

While there are many reasons for male infertility, Houston IVF can find fertility treatments and options to achieve healthy pregnancies.  Some couples with male infertility caused by disorders of sperm number or function may be successfully treated through intrauterine insemination (IUI). This is often performed during cycles in which the woman is taking fertility drugs to stimulate multiple egg development. Surgical repair of a man's varicocele may increase the chance of pregnancy. However, IVF is the best treatment of infertile couples when there is severe impairment of sperm count, motility, or shape, or when sperm antibodies are present. Our Houston IFV laboratory technique of Intracytoplasmic Sperm Injection (or ICSI) has revolutionized the way we can treat male infertility. Even men with no sperm in their semen can father a pregnancy if the urologist extracts sperm from the man's epididymis or testicle for use in IVF. With ICSI, an extremely sharp glass needle is used to inject one sperm directly into the center (cytoplasm) of the egg under the guidance of a specially fitted microscope. The success rate with this technique varies considerably among IVF programs and is highly dependent upon the skill of the embryologist performing the procedure.

Candidates for ICSI include men with

  1. Severely compromised sperm parameters, including concentration, motility, morphology, or antisperm antibodies;
  2. Blockage or absence of the vas deferens, where sperm is surgically collected by microsurgical epididymal sperm aspiration (MESA) or testicular biopsy for ICSI;
  3. Those who had low or failed fertilization on prior IVF attempts; and Unknown infertility after all diagnostic tests are completed
  4. Our IVF pregnancy rates with ICSI are equivalent to those of couples with non-male factor infertility who do not require ICSI.