The cause of this is not always obvious. In most cases of male factor infertility, abnormalities of sperm counts, shape or motility are present when semen is examined by a Scientist.   In general, the more abnormalities found, the less fertile is the semen sample. However there are naturally fertile men with abnormal semen samples and infertile men with apparently normal samples.

Sperm quality varies from sample to sample and often deteriorates following acute illness so impairment of male fertility should not be diagnosed on examination of a single sample.

Many men who have had a previous vasectomy will require assisted reproduction with IVF and ICSI because of the presence of antibodies on their sperm, or because the "vasectomy reversal procedure" is unsuccessful.

Since 1992 in Australia a method of sperm micro-injection has been used which involves the injection of a single sperm into the egg. This method is called Intra Cytoplasmic Sperm Injection (ICSI) and has proven to be very successful. It is available at Ballarat IVF.   Up to half of Ballarat IVF clients use ICSI to achieve egg fertilization and pregnancy.

ICSI is used for couples where there has been difficulty in achieving fertilisation with routine IVF methods or where semen tests show that routine IVF would not give satisfactory results.

ICSI can now be used to help couples who in the past would have had very little chance of achieving a pregnancy.   Men who have had a vasectomy may have their fertility restored by microsurgery.   Sperm reappear in about 70%, but half of these have high levels of sperm antibodies which vastly reduces the capability of the sperm to fertilize an egg. Microinjection (ICSI) is used in this case to fertilize oocytes.

For men who cannot produce sperm, (for example if a vasectomy has been performed) a surgical procedure called microsurgical sperm aspiration (PESA) or testicular needle biopsy may be undertaken. Both these procedures are available at Ballarat IVF. Sperm are retrievable in approximately 85% of cases.