May 08, 2014 12:00 PM

Author: Jim Hotaling, MD, MS

Infertility is a common problem that impacts up to one in five couples. It’s defined as the lack of successful pregnancy after 12 months of trying. Typically, couples have a 20–30 percent chance of getting pregnant per cycle, with infertile couples having only a 4–5 percent chance per cycle. When struggling with this issue, many couples are surprised to learn more than one-third of infertility cases are caused male reproductive issues. The good news is, there are many more options today for men than there were even just a decade ago.

In the past, men with poor quality sperm often had to turn to donor sperm when seeking infertility treatments with their partner. Today, there are alternatives that exist beyond using donor sperm, through medication and surgery. The first step in this process is to see a specialist in male infertility and undergo diagnostic testing, which consists of one or two semen analyses (sperm tests), some hormone testing (blood work) and a general evaluation. Once this is completed there are several options for improving your chances of conceiving.


The majority of men with the most severe form of infertility in which they have no sperm in their ejaculate can undergo microTESE, which is a surgical procedure to extract sperm directly from the testicles and is successful 60-70 percent of the time. The sperm obtained from this procedure is then frozen and used for in vitro fertilization with the woman’s eggs. Many men with less severe forms of infertility can often undergo surgical repair of dilated veins in the scrotum (varicocele). This is a simple outpatient procedure that can dramatically improve the quality of the sperm.


Some men may be put on medications to increase their sperm count—10 percent of whom have sperm return to normal levels while on medication.  

If you are struggling with infertility or are concerned about your reproductive potential due to advanced age or other medical conditions, make an appointment to see an expert in male infertility for the male and a reproductive endocrinologist for the woman.

infertility urology

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