일산차병원

Introduction

Male Infertility

Male infertility accounts for 30-50% of infertility.

Male infertility is often the result of a combination of various factors, including lifestyle, rather than a single reason.

Cause

In general, causes of male infertility may be due to an inherited disorder, a hormonal imbalance, dilated veins around the testicle or a condition that blocks the passage of sperm, low sperm production erectile dysfunction, or difficulty with ejaculation

Exams and
Diagnosis

Medical questionnaire asking for medical and reproductive history, medications, past surgical history, and physical examinations of the scrotum, testes, epididymis, and vas deferens are an important part of the diagnosing male infertility.

Semen analysis: Semen analysis is one of the most important evaluations to determine the cause of male infertility. It provides crucial information about the quantity and quality of both semen and the sperm it contains. You may be asked not to release sperm (ejaculate) for 3 to 4 days before you have a semen analysis. Occasionally you will be asked to visit twice to collect two different samples. Combination of the analysis results and your lifestyle
Hormone Exams: testing hormone levels that control sperm production
Genetic testing: genetic tests to determine male infertility
Radiology imaging exams: transrectal ultrasound, vesiculography, etc.

Treatment

Medical Treatment: The drug treatment for male infertility includes specific drug therapy and non-specific empiric therapy for endocrine diseases, spermatozoa caused by pathogen infection, immune infertility caused by antisperm antibodies, ejaculation disorders, and etc.

Surgery Treatment

Vasovasostomy
In the case of sperm passage obstruction due to vasectomy, reconstruction surgery using a microscope can be performed, and the duration of vas deferens blockage may affect the restoration time.
Epididymovasostomy
This is procedure is done if the testis biopsy is normal and the vas deferens is not blocked nor have any problems with ejaculation.
Varicocelectomy
This procedure obstructs the refluxing venous drainage to the testis while maintaining arterial inflow and lymphatic drainage, which can result in increased sperm and testosterone production. Varicocelectomy often results in a 60–80 % improvement in semen analysis results.
Sperm retrieval technique (Testicular sperm extraction, TESE)
In the case of obstructive azoospermia or non-obstructive azoospermia, which cannot be surgically corrected, sperm is extracted from the testes or epididymis to attempt pregnancy through in vitro fertilization.

For the treatment of male infertility, it is important to consult with specialists in the field of OBGYN, urology, along with the help of assisted reproductive technology such as in vitro fertilization. In addition, in-depth studies on the causes and treatment of male infertility, testicular and sperm dysfunction due to genetic abnormalities must be accompanied to increase the likelihood of treatment for male infertility.

Process of Sperm Production

Sperm develop in the testicles for 64-70 days.
Varicocelectomy

Varicoceles occur in about 15 percent of adult men. It is a commonly found in 35% in primary infertility and 75-81% in secondary infertility. Varicocele blocks blood flow to the rest of the reproductive system, therefore, blood pools in the scrotum increasing temperature. This can decrease your sperm production and growth. Varicocelectomy often results in a 60–80% improvement in semen analysis results. Instances of pregnancy after varicocelectomy often rise anywhere from 30-40%.
Vasovasostomy, Vasoepididymostomy

‘Vasovasostomy’ is a surgical procedure designed to bypass an obstruction in the male genital tract and is usually performed to restore fertility. In a vasovasostomy, an incision is made in the scrotum at the site of the vasectomy scar. The spermatic cords are located, and the two vas deferens are reconnected with two layers of suture that is thinner than hair. The rate of sperm return if a vasovasostomy is performed within ten years of a vasectomy is 80-90% and the pregnancy rate is 40-70%.
Sperm Retrieval (TESE)

This is an optimal form of sperm retrieval for men with no sperm during ejaculation (azoospermia) due to problems with sperm production.
Electroejaculation

Electroejaculation is most often treatment of option in patients after spinal cord injury. This procedure obtains semen samples through electrical stimulation.
Transurethral Resection of the Ejaculatory Ducts

When the ejaculatory duct is obstructed and sperm cannot pass, this procedure will allow normal flow of ejaculation and semen.
Information on Sperm Freezing and Sperm Bank

Typical cases that require sperm freezing includes upcoming cancer treatments (chemotherapy and radiation therapy) and when couples planning for IUI or IVF procedure and needs to collect and store sperm in advance due to husband's overseas travel plans. Storage duration of frozen sperm can be extended and frozen sperm can be thawed to be used for future IUI or IVF procedure.

In addition, infertile couples due to male factors can try to conceive through sperm banks. The Sperm Bank at CHA Ilsan Medical Center’s Fertility Center is committed to achieving reputable results for all couples based on accumulated skills and experience.

Male Fertility Clinic