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MALE INFERTILITY AND TREATMENT

Sometimes couples are unable to conceive even after full investigation and no medical cause has been found. This does not mean that the cause is psychological or that the couple is trying too hard. While psychological issues may contribute to some infertility, we believe that in some cases of unexplained or poorly explained infertility, investigations may not be sensitive enough to diagnose the problem.

The causes are not always known. Some men may have suffered trauma or infection in their testicles or prostate leading to a low sperm count, others may have a genetic problem and some may have undergone a vasectomy in the past.

How is male infertility assessed?
A semen analysis test is the best way. Our scientists assess the shape and number of sperm, their swimming ability (motility) and the presence of antibodies. The results of semen analysis can vary. If the initial test is abnormal, it is important to repeat the test.
If abnormal sperm counts are detected, additional blood tests are needed to assess the level of function of the testis. Occasionally our urologist / andrologist (male fertility specialist) will advise a man to have a sample of tissue taken to be assessed under a microscope.

What does a semen analysis test measure?
Per ejaculate, this test measures
> volume
> count (including dead sperm) Normal value is 20 million+ sperm/ml
> motility (moving sperm) Normal value is 50%+ motile & 25%+ with good, progressive movement
> morphology (shape and size) Normal value is 50% binding or less
> sperm antibodies that may be present in the semen or blood. They attach to the head or tail of sperm and can affect their ability to move freely and their ability to enter the egg. The most common cause of sperm antibodies is a previous vasectomy. It is often the reason why pregnancy may not follow a successful vasectomy reversal Normal value is 50% binding or less.

Can men who have had a vasectomy have fertility restored by microsurgery?
Yes. In about 70% of cases sperm reappear, but in half of these there are high levels of sperm antibodies which reduce the capability of the sperm to fertilise an egg.