Treatment Options for Male Infertility: From Medication to IVF & ICSI

Male infertility plays a significant role when it comes to family building, particularly in consideration of the fact that the man’s sperm is the other half of the fertility equation. While little is said about it, male factor infertility is common and even more importantly, there are treatment solutions for family building even in the light of male infertility. The beginning of this process is fertility tests or evaluations which determine what the cause of infertility is. Once this is clear, treatment options can be assessed and determined. Even before fertility evaluation can occur, one can improve their fertility naturally. So without further ado, let us get right into the treatment options for male infertility.

Medications and Lifestyle Changes for Sperm Health

Lifestyle Changes

A man’s health is central to the health of his sperm. Typically, the first line of treatment for sperm health improvement is in a person’s lifestyle, diet, exercise, and stress management. This approach has been found to be effective in improving fertility metrics, and in some cases, no further treatment would be required. So here are some ways to improve sperm health naturally:

• A nutrient-rich diet including supplements where need-be
• Sufficient sleep
• Avoid (or quit) using nicotine-based products or recreational drugs
• Reduce (or eliminate) alcohol consumption
• Adopt an exercise routine
• Wear breathable clothing around the scrotum
• Wear protective gear when working with toxic substances
• Maintain sexual health by avoiding contracting sexually transmitted infections
• Manage stress

Medical Intervention

Hormone therapy, prescription supplements and medications are some of the ways that male infertility can be treated medically. Where hormone production has been low, hormone therapy helps to improve the production and regulation of hormones in the body. Some situations that typically result in hormonal imbalances include high stress, nutritional issues, chronic disease, or the use of steroids or opioids in high doses (or for a long time).   

Medication can be used in the case where a man is experiencing erectile dysfunction, where they either struggle to get an erection, or to sustain one when they do get it. Alcohol and drug abuse, poor nutrition, stress and medical issues can contribute to this. Sometimes, nutritional supplements may be prescribed to improve one’s fertility. 

Surgical Treatments

Surgical interventions for male infertility are introduced when the cause of infertility still cannot be determined, or other approaches have not been successful. Blockages in any of the reproductive tubes - seminal vesicles, ejaculatory duct, or epididymal duct - could also require surgical interventions to resolve infertility challenges. Blockage in blood vessels around the scrotum could also cause infertility and require surgical intervention. 

Varicocele Repair

Blood vessel blockage around the scrotum is known as varicoceles, which is treated in a procedure called a varicocele repair or a varicocelectomy. There are different approaches to varicocele repair, depending on their location, which are surgical in nature. Varicoceles occur in different degrees and are graded from zero to three, where zero requires an ultrasound for visibility and three can be clearly seen as a swelling on the scrotum. Varicocelectomy could be done as minimally invasive procedures, or open surgery procedures, requiring sedation to minimize discomfort.

Minimally Invasive Surgery

Laparoscopic Varicocelectomy: 

The surgeon makes small incisions on the abdomen and inserts surgical instruments and a laparoscope through them to perform the surgery. A laparoscope is a rod with a camera on its end attached to a monitor where the surgeon can view the procedure as they perform it.

Microsurgical Varicocelectomy:

The surgeon for this procedure makes an incision on the upper part of the groin and uses very small surgical instruments and a surgical microscope to perform the procedure. 

Open Surgery

Open surgery for varicoceles is done by ligating the varicocele and depending on the location and grade, access to the varicocele can be from three main directions, as we shall see below. 

Inguinal Ligation accesses the varicocele from the lowest part of the groin 

Subinguinal Ligation accesses the varicocel from the lower part of the inguinal canal

Retroperitoneal Ligation accesses the varicocele from behind the peritoneum 

Sperm Retrieval Procedures

Sperm retrieval is used to retrieve sperm where natural sperm production is insufficient for natural fertilization. Retrieved sperm is used with assisted reproductive technologies to facilitate family building. 

• Testicular Sperm Extraction (TESE) retrieves sperm directly from the testicular tissue. 
• Micro-Testicular Sperm Extraction (Micro-TESE) is a more advanced TESE procedure which retrieves sperm at the microscopic level. 
• Percutaneous Epididymal Sperm Aspiration (PESA) retrieves the sperm from the epididymis.the
• Microsurgical Epididymal Sperm Aspiration (MESA): uses a microscope in a retrieval procedure similar to PESA.  

IUI & IVF for Male Factor Infertility

Family building using retrieved sperm addresses male factor infertility through the application of ARTs such as intrauterine insemination (IUI) and in vitro fertilization (IVF).

Intrauterine Insemination - IUI

IUI relies on a woman’s menstrual cycle, therefore is done during her ovulation window. It is non-invasive and typically painless, therefore does not require sedation. The procedure is usually conducted in a medical facility by inserting prepared sperm into the uterus using a catheter. 

In Vitro Fertilization - IVF

IVF is a multi-phase procedure which culminates in a fertilization procedure that is done using retrieved sperm in a controlled lab setting.

How ICSI (Intracytoplasmic Sperm Injection) Works 

Intracytoplasmic Sperm Injection (ICSI) is a variation of the IVF treatment where a single sperm is directly injected into the cytoplasm of an egg. Compared to regular IVF which places several sperm next to the egg for a brief ‘swim’ toward the egg for fertilization, ICSI does not require many sperm or good sperm motility in order to succeed.

Choosing the Right Treatment Path at Dallas Fertility Center 

In order to determine which treatment path is right for you, contact our fertility experts at the Utah Fertility Center. We are ready to walk with you on your journey of family building, supporting you to achieve your family building goals. We know that each case is unique, therefore a treatment plan will be tailored to your circumstances. Talk to us today.

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