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New Solutions for Male Infertility


WRITTEN BY: Urology
Monday, November 11th, 2013

Sometimes fact is stranger than fiction. It would seem reasonable that with millions of sperm and only one egg the majority of infertility problems would lie with the female.

Not true, according to the National Library of Medicine. Difficulties with fertility are evenly split:

  • One third of the time the source of fertility problems being linked to the male
  • One third of the time the difficulties are linked to the female
  • The final third is a mixture of situations where both parties have infertility issues, or where the cause is indeterminate.

The good news is that there is hope for men who wish to start a family. Director of Male Reproductive Medicine Surgery at UPMC, Thomas Jaffe, MD, offers a hopeful perspective for males experiencing difficulties with reproductive issues. “Because of many technologies and treatments, many men who previously had no hope of fathering a child now have treatment options that can be [effective.]”

One important advancement is a relatively new diagnostic test called the DAZ test. The DAZ test detects a genetic mutation in the Y chromosome for sperm production. This test is ordered when sperm production is unusually low. Another important factor in analyzing sperm is motility or movement. Generally, sperm with greater motility are able to more easily fertilize an egg.

What Impacts Male Fertility?

  • Type 1 or juvenile onset diabetes. Individuals with diabetes may experience retrograde ejaculation. This is when the bladder stays open so ejaculatory fluids washing back into the bladder rather than exiting the body. “This problem can be treated with Sudafed which helps the bladder to stay closed during ejaculation,” explains Dr. Jaffe. Retrograde ejaculation can also be a problem with:
    • Spinal cord injuries
    • Nerve damage
    • Medications that contain alpha blockers such as high blood pressure medications.
  • Little to no sperm production. “Even with no sperm, we have found that men still produce limited numbers of sperm within the tissues of the testicles.” This sperm can be extracted from the tissue and remains viable to fertilize an egg.
  • Enlargement of a vein in the scrotum. These veins become dilated as a result of back pressure from the gonadal vein above.  When the veins dilate the valves, which normally keep the overheated blood, filled with the breakdown products of sperm and testosterone production out of the testicle, are now out of position and allow this blood to reflux back into the testicle.  This process leads to the overheating of the testicle and delivery of toxins to the testicle. This makes the environment for sperm production suboptimal.
  • Chemotherapy and radiation treatments. “Ideally, we [harvest] sperm prior to treatment. We work with the Pittsburgh Cryobank to store the sperm until needed,” explains Dr. Jaffe.

Although no treatment is an absolute guarantee, male infertility can often times be overcome with the right evaluation and treatment.

For more information about Dr. Jaffe and treatment of male infertility, call 412-692-4100.

urology

Urology

The Department of Urology offers a multidisciplinary approach to care, with a team of nationally recognized experts working together to deliver the very latest in diagnostic and treatment options for urologic disease. The experts in the Department are renowned for their expertise in highly specialized technologies and minimally invasive surgical techniques, clinical care, and research. Read More