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Male Factors

Approximately 40% of infertility problems are associated with male factor etiologies. Production of sperm can be injured or impaired by testicular injuries, surgery, infection, allergies, toxins, undescended testes, varicoceles, drugs, hernia, and athletics. It is well worth the time to ask questions regarding these factors at the time of an infertility evaluation.

Male Infertility Disorder Male Infertility Disorder. Sperm functional defects which may or may not correlate with abnormal morphologic characteristics can now be treated using intracytoplasmic injection or ICSI.
Credits: Serono Laboratories

When patients are sent for a semen analysis, we ask them to abstain from intercourse for two to three days and recommend that a sample be obtained by masturbation in the clinic. If it is collected at home, it needs to arrive in two hours and should be kept at body temperature. We consider a normal semen sample to have a volume of 2 to 6 ml, a pH between 7 and 8, a count greater than 20 million per milliliter, and a morphology of greater than 60% normal.

Instructions for Semen Analysis
  • Abstinence, 2-3 days
  • Sterile container (preferable)
  • Specimen to lab within 2 hours
  • Specimen kept at body temperature (protected from the cold)
  • 2-3 specimens as needed
  • Semen analysis.
    Credits: Serono Laboratories

    Many causes of infertility are amenable to treatment (e.g., surgery repair of varicocele or for obstruction of the vas deferens). In men with a lower-than-normal sperm count or other defects, intrauterine insemination to improve and concentrate the sperm are available.

    Indications for IUI
  • Male infertility
  • Cervical factor
  • Endometriosis
  • Unexplained infertility
  • Female humoral antisperm antibodies
  • Indications for intrauterine insemination.
    Credits: Serono Laboratories

    Assisted reproductive techniques such as in vitro fertilization with intracytoplasmic sperm injection are also options that are available to couples abnormalities of sperm parameters.

    Intracytoplasmic sperm injection Intracytoplasmic sperm injection.
    Credits: C. Matthew Peterson, M.D.