Other Treatments for Infertility in Men
Your healthcare provider may suggest that you use other methods, including assisted reproductive techniques (ART). These methods can improve your chances of conception.
This procedure may be used to produce ejaculation (production of sperm at orgasm) in men with neurologic dysfunction, such as spinal cord injuries, that prohibits normal ejaculation. An electrical probe inserted in the rectum generates a current that stimulates nerves and triggers ejaculation. Semen that is released from the urethra is then collected for in vitro fertilization.
Intrauterine Insemination (IUI)
In this procedure, a large number of specially processed sperm are deposited into the woman’s uterus at the optimal time in her menstrual cycle. This method can be useful if sperm have difficulty traveling through cervical mucus or if the woman’s cervical environment is otherwise difficult for the sperm to penetrate.
In Vitro Fertilization (IVF)
This technique involves removing an egg from the woman’s body and mixing it with sperm in a laboratory. The sperm from a semen specimen (produced by either you or a donor) are prepared and placed in the same dish as the egg or eggs (provided by your partner or an egg donor). After about 24 hours, the eggs are examined to see if they are changing in ways that indicate fertilization has occurred. In the next phase (anywhere from 2 to 5 days), fertilized eggs that have developed into multiple-cell embryos are drawn up into a plastic catheter that is passed through the woman’s cervix into the uterus, and the embryos are released.
Intracytoplasmic Sperm Injection (ICSI)
This is a type of IVF that involves microscopically injecting a single sperm into an egg, rather than just combining it with the egg. The resulting embryo can be implanted into the woman’s uterus within a few days or may be frozen for later use. This procedure improves the chance of fertilization of eggs even when very few sperm are available. Fertilization occurs 50%-80% of the time, with 30% resulting in a live birth.
Sperm Retrieval Methods
These procedures may be used to obtain sperm for IVF when no sperm are found in the semen. In testicular extraction of sperm (TESE), a doctor will remove samples of testicular tissue and give them to an embryologist, who will use a microscope to identify and collect live sperm from the testicular samples. Alternatively, the surgeon may make a small scrotal incision and aspirate sperm using a technique called micro epididymal sperm aspiration (MESA). A similar technique, percutaneous epididymal sperm aspiration (PESA) does not involve microsurgery. Instead, the surgeon uses a needle to penetrate the epididymis and draws sperm into a syringe. Usually only small numbers of sperm are collected using these techniques, and ICSI may be used to fertilize the egg. These procedures are usually performed under local anesthesia and take less than an hour. They cause some pain and swelling.
Gamete Intrafallopian Transfer (GIFT)
An egg is removed from the woman's body and mixed with prepared sperm in a laboratory. The egg and sperm mixture is then injected into the woman’s fallopian tube using laparoscopy.
Tubal Reconstructive Surgery
Nowadays with advances in assisted reproductive technoliges to treat the infertile female, only rarely is tubal reconstructive surgery performed.
American Society for Reproductive Medicine website. Available at: http://www.asrm.org/.
International Council on Infertility Information Dissemination website. Available at: http://www.inciid.org/.
Jose-Miller AB, Boyden JW, Frey KA. Infertility. Am Fam Physician. 2007;75:849-856.
Practice Committee of the American Society for Reproductive Medicine. The role of tubal reconstructive surgery in the era of assisted reproductive technologies. Fertil Steril. 2006; 86:S31-34.
RESOLVE. The National Infertility Association website. Available at: http://www.resolve.org/.
Van Voorhis BJ. Clinical practice. In vitro fertilization. N Engl J Med. 2007;256:379-386.
Last reviewed November 2008 by ]]>Adrienne Carmack, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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