Materiały źródłowe

• #1 Male Infertility: Causes, Symptoms, Tests & Treatment

  https://my.clevelandclinic.org/health/diseases/17201-male-infertility

  Infertility is a common problem for many men. […] Fortunately, if you have male infertility, you may be able to have a biological child with your partner. Treatments that can increase your chances of conception are available. […] Yes, many different treatment options can reverse male infertility. Depending on the cause, your treatment may include: […] You may be able to increase the production of healthy sperm by making certain lifestyle changes, including: […] Hormone therapy can regulate hormone levels that are too high or low and affect your sperm quality. […] Surgical treatments may include: […] Assisted reproductive technology (ART) procedures involve removing an egg from your partners ovaries and combining it with your sperm in a lab. […] Just because you have male infertility, it doesnt mean youll never be able to have a biological child. Treatment options are available.

• #1 Patient education: Treatment of male infertility (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-male-infertility-beyond-the-basics/print

  Patient education: Treatment of male infertility (Beyond the Basics) […] If you and your partner have been trying to get pregnant without success, talk to a health care provider. They can talk with you and run tests to try to determine the cause and whether treatment may be helpful. […] The treatment options for male infertility depends upon the underlying cause. The decision to pursue treatment depends on other factors as well, including personal preferences and cost. […] While there are some situations in which male infertility can be reversed with medication or surgery, in many cases, assisted reproductive technology (ART; for example, in vitro fertilization [IVF] or IVF with intracytoplasmic injection [ICSI]) is the recommended approach. […] Lifestyle changes—Although there is limited evidence that specific lifestyle changes improve fertility, it is reasonable to take steps like avoiding smoking, limiting alcohol intake (to less than 24 ounces of beer, 10 ounces of wine, or 2 ounces of hard alcohol daily), avoiding any marijuana or recreational drugs, eating a healthy diet that contains fresh fruit and vegetables, and maintaining a healthy weight.

• #1 Infertility Treatments in Men | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/urology/infertility-female-male/treatments

  There is increasing evidence that lifestyle can have a large impact upon male fertility. For example, weight loss and regular exercise can have a direct, positive effect on hormone levels and sperm production. Quitting smoking, including tobacco and marijuana, can have similar effects. […] Medical therapies can be very effective for men with certain causes of infertility, such as hormonal abnormalities. For men with low testosterone, a number of medications, such as clomiphene citrate, human chorionic gonadotropin (HCG) and anastrozole, can help to boost the bodys natural production of testosterone. […] Testosterone supplementation through gels, injections or other methods can have a negative effect on fertility. These supplements can signal to a mans body that it should stop its own production of testosterone, which can be bad for sperm production. In fact, testosterone supplementation can have such a negative impact on fertility that scientists have studied the possibility of using testosterone as a male contraceptive.

• #1 Male Infertility Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/436829-treatment

  Treatment of hyperprolactinemia is with dopamine antagonists, such as bromocriptine or cabergoline. […] Use of steroids in patients with antisperm antibodies is controversial, with some studies showing improvement in spermatozoal quality and conception rates and others showing no benefit in rates of conception. […] Imipramine or alpha-sympathomimetics, such as pseudoephedrine, may help close the bladder neck to assist in antegrade ejaculation. […] Patients should be encouraged to stop smoking cigarettes and marijuana and to limit environmental exposures to harmful substances and/or conditions. […] Oxidative stress causes suboptimal levels of fertility in men; therefore, the idea of antioxidant supplementation to improve male subfertility has theoretical merit. […] Successful varicocelectomy results in improvement in semen parameters in 60-70% of patients.

• #1 10 Ways to Boost Male Fertility and Increase Sperm Count

  https://www.healthline.com/health/boost-male-fertility-sperm-count

  Staying active, minimizing stress, and making changes to your diet and lifestyle may help support male fertility. […] Male infertility is when a person assigned male at birth is unable to initiate a pregnancy with their partner after 1 year of continuous sexual activity. […] While infertility is not always treatable, there are some things you can do to boost your chances of conceiving. […] Here are 10 science-backed lifestyle factors, foods, nutrients, and supplements to help boost male fertility. […] Some animal studies suggest that taking D-AA supplements may help increase testosterone levels, which is the male sex hormone that plays an essential role in male fertility. […] However, the evidence is not consistent. […] Research suggests that regular physical activity may help boost testosterone levels and improve semen quality.

• #1 Low sperm count – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/low-sperm-count/diagnosis-treatment/drc-20374591

  You may learn that you have a low sperm count if you get a healthcare checkup because you’re having trouble getting your partner pregnant. […] This can help guide fertility treatment options for you and your partner. […] Treatments for low sperm count include: […] Surgery. For example, a varicocele can often be fixed with surgery. […] If no sperm are present in the semen, sperm often can be collected directly from the testicles or epididymis. […] Antibiotics can cure an infection of the reproductive tract caused by germs. […] Medicine or counseling can help improve fertility in conditions such as erectile dysfunction or premature ejaculation. […] These treatments can help if you have infertility caused by high or low levels of certain hormones. […] Assisted reproductive technology (ART). Some couples have trouble becoming pregnant despite frequent sex. […] If this happens to you, it’s still possible to have a child. You and your partner can think about using sperm from a donor or adopting a child. […] What treatments are available to raise my sperm count? Which do you recommend?

• #1 Infertility in Men | Male Infertility Treatments and Clinics | SRM

  https://www.seattlefertility.com/understanding-fertility/infertility-in-men/

  The standard test to check for male fertility is the semen analysis. A variety of parameters are assessed including concentration (number of sperm), motility, and morphology (shape). Preferably this would be done at a fertility center such as SRM to ensure reliable, standardized results and a better patient experience. At SRM, you will have a quick follow-up phone consultation to go over your test results a few days after your appointment. […] Yes. There are many things we can do to improve sperm counts including: lifestyle changes, medications for erections or ejaculation, hormonal medications, and sometimes surgery. A few examples of lifestyle changes are to exercise regularly, at least 30 minutes 5 days per week if possible; decrease stress, eat a healthy and balanced diet, lose weight (if needed), avoid substances and activities known to have a negative impact on male fertility, like tobacco and marijuana use, certain medications, regular use of hot tubs; avoid medications or supplements that contain testosterone or its precursors (DHEA). […] A few reasons would be if you need a semen analysis, if you had an abnormal semen analysis, if you have a varicocele, if you have a history of or are currently using testosterone, or if you are concerned about your fertility.

• #1 Medical treatment of male infertility – Dabaja – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/3512/html

  The majority of male infertility is idiopathic. However, there are multiple known causes of male infertility, and some of these causes can be treated medically with high success rates. […] In cases of idiopathic or genetic causes of male infertility, medical management is typically empirical; in most instances medical therapy represents off-label use that is not specifically approved by the FDA. Understanding the hypothalamic-pituitary-gonadal (HPG) axis and the effect of estrogen excess is critical for the assessment and treatment of male infertility. The use of certain medical treatment has been associated with an increase in sperm production or motility, and primarily focuses on optimizing testosterone (T) production from the Leydig cells, increasing follicle-stimulating hormone (FSH) levels to stimulate Sertoli cells and spermatogenesis, and normalizing the T to estrogen ratio.

• #1 Medical treatment of male infertility – Dabaja – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/3512/html

  The use of AIs seems to be effective in restoring LH, FSH, and T levels, improving semen parameters, and re-establishing fertility. […] SERMs, such as clomiphene citrate (CC), tamoxifen, and toremifene, have been widely used in women for the treatment of breast cancer and osteoporosis, their use in the treatment of male hypogonadism and infertility is currently off-label. […] In a recently published meta-analysis that summarized the latest available randomized controlled trials regarding the use of estrogen antagonists (CC or tamoxifen) as empirical medical therapy for idiopathic male infertility with oligo and/or asthenoteratozoospermia, the pooled data showed that estrogen antagonist use was associated with a statistically significant increase in pregnancy rates compared with controls.

• #1 Fertility Pills for Men & Medication Monitoring | University of Utah Health

  https://healthcare.utah.edu/fertility/treatments/male-fertility-drugs

  Anastrozole reduces low testosterone symptoms such as low energy, reduced muscle mass, low libido, and erectile dysfunction. Men who have a low sperm count or no sperm also produce more sperm while on anastrozole. […] Human chorionic gonadotropin stimulates your testes to make their own testosterone and produce more sperm. […] Research shows that hCG increases the energy, libido, strength, and mood in men with low testosterone. HCG can help you build testosterone no matter what causes your low testosterone levels. […] We check a semen analysis three months after your hormones are at optimal levels. It takes at least three months to see improvement in the sperm counts.

• #1 Patient education: Treatment of male infertility (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-male-infertility-beyond-the-basics/print

  Hypothalamic or pituitary deficiency—In a small percentage of cases (2 to 5 percent), male infertility is due to problems in the hypothalamus and pituitary gland. In this situation, treatment with human chorionic gonadotropin (hCG) that acts like LH, often in combination with recombinant human follicle-stimulating hormone (rhFSH), is given. […] Treatment with hCG with or without rhFSH is often called „gonadotropin treatment.” […] Varicocele—A varicocele is a dilation of a vein in the scrotum. […] Varicocele can be treated with surgery to cut the veins connected to the varicocele. […] Blockage or abnormality of the reproductive tract—Sometimes, infertility is related to a blockage in the ducts that allow sperm to mix with the semen before ejaculation; this can happen as a result of certain infections.

• #1 Medical treatment of male infertility – Dabaja – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/3512/html

  The medical treatment of known causes of male infertility tend to have targeted and high success rates. In cases of idiopathic or genetic causes of male infertility, the medical management tends to be empirical and is directed for the purposes of optimization. […] The therapeutic goal is the maintenance of the reproductive axis to increase testicular T. […] This review article will focus on the non-surgical treatments currently available for male infertility and review the data on the efficacy of those therapies. […] The goal of GnRH therapy is to stimulate the release of gonadotropins from the anterior pituitary and subsequent pathways in the HPG. […] Pulsatile GnRH therapy induces spermatogenesis in about 85% of patients, and on average 60% of couples will achieve pregnancy after nine months of treatment, and can take up to two years.

• #1 Testosterone use and male infertility patient education fact sheet | ReproductiveFacts.org

  https://www.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/testosterone-use-and-male-infertility/

  Testosterone replacement comes in many forms, including shots, gels, patches, or implantable pellets. However, it is important to know that testosterone treatment usually leads to either low sperm counts, or no sperm seen whatsoever in the semen. […] There are some medications that can lower estrogen levels in your body. All men have estrogen in them but lowering it may help with sperm production. These meds include clomiphene citrate, letrozole or anastrozole and are pills. There are also injectable drugs that act like the hormones sent down from glands in your brain that will increase sperm production. […] Male Factor Infertility is responsible for about 30% of infertility cases and can contribute infertility to an additional 20% of cases.

• #1 Medical treatment of male infertility – Dabaja – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/3512/html

  A variety of clinical trials have suggested that the use of antioxidant supplements have a slight benefit in improving sperm function and DNA integrity. However, most of these studies are not randomized controlled trials, and to date there are no convincing trials that have demonstrated a significantly higher unassisted pregnancy rate after treating men with antioxidant therapy. […] The use of medical therapy to optimize surgical sperm extraction is based also on the concept that spermatogenesis is dependent on high levels of intratesticular T and FSH stimulation of the Sertoli cells. […] Understanding the HPG axis and the effect of estrogen excess is critical for the assessment and treatment of male infertility. However, the goal of infertility treatment in all these men is to optimize LH levels to stimulate T production from the Leydig cells, FSH levels to stimulate Sertoli cells and spermatogenesis, and eliminate any estrogen excess.

• #1 Male infertility – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/male-infertility/diagnosis-treatment/drc-20374780

  Diagnosing male infertility problems usually involves: […] Treatments for male infertility include: […] In cases of infertility, it’s recommended that the female partner also be checked. […] Your doctor might recommend additional tests to help identify the cause of your infertility. […] Often, an exact cause of infertility can’t be found. Even if an exact cause isn’t clear, your doctor might be able to recommend treatments or procedures that will lead to conception. […] Surgery. For example, a varicocele can often be surgically corrected or an obstructed vas deferens repaired. […] Assisted reproductive technology (ART). ART treatments involve obtaining sperm through normal ejaculation, surgical extraction or from donor individuals, depending on your specific case and wishes. […] Hormone treatments and medications. Your doctor might recommend hormone replacement or medications in cases where infertility is caused by high or low levels of certain hormones or problems with the way the body uses hormones. […] In rare cases, male fertility problems can’t be treated, and it’s impossible for a man to father a child.

• #1 What treatment options are available for male infertility? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/menshealth/conditioninfo/treatments

  Treatments for male infertility may be based on the underlying cause of the problem, or in the case of no identified problem, evidence-based treatments that improve fertility may be recommended. […] Medication can treat some issues that affect male fertility, including hormone imbalances and erectile dysfunction. […] Surgery can be effective for repairing blockages in the tubes that transport sperm. […] Surgery can also be used for repair of varicocele. […] Assistive reproductive technologies, such as in vitro fertilization, can be effective if other treatments do not restore fertility.

• #1 Diagnosis and treatment of infertility in men: AUA/ASRM guideline part II | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/diagnosis-and-treatment-of-infertility-in-men-aua-asrm-guideline-part2/

  Varicoceles have long been recognized as a condition that can affect male fertility, where correction of a clinical varicocele can result in substantial improvements in semen parameters and the chance of achieving a pregnancy. […] For men with NOA undergoing sperm retrieval, microdissection testicular sperm extraction (TESE) should be performed. […] Infertility associated with retrograde ejaculation (RE) may be treated with sympathomimetics and alkalinization of urine with or without urethral catheterization, induced ejaculation, or surgical sperm retrieval. […] Male infertility may be managed with ART. […] Clinicians may use aromatase inhibitors (AIs), human chorionic gonadotropin (hCG), selective estrogen receptor modulators (SERMs), or a combination thereof for infertile men with low serum testosterone.

• #1 Male Infertility Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/436829-treatment

  A meta-analysis that compared the various varicocelectomy approaches found that pregnancy rates increased in inguinal, subinguinal, open inguinal, and laparoscopic approaches. […] Robotic-assisted microsurgery has been shown to be safe and efficacious, with one group reporting improved sperm parameters in 76% of patients. […] These microsurgical techniques are performed in patients with known epididymal or vasal obstruction, both congenital and acquired. […] Testicular sperm extraction (TESE) is performed at the time of testicular biopsy or as a separate procedure using the same technique. […] ICSI involves the direct injection of a sperm into an egg under microscopy.

• #1 Infertility Treatments in Men | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/urology/infertility-female-male/treatments

  For men who do not have any sperm in their ejaculate, sperm extraction may be an appropriate option. During this procedure, a surgical microscope is used to open the testicle and extract sperm, if they are present. These sperm can then be used to fertilize an egg through in vitro fertilization (IVF). […] Men who have had a vasectomy have a blockage that does not allow sperm in the ejaculate. Vasectomy reversal is a good option for these men. Using a surgical microscope, the two ends of the vas deferens are repaired using very small sutures the size of a human hair. If the reversal is successful, men may be able to conceive naturally with their partner. […] For men with this condition, we can perform a microsurgical procedure to ligate the enlarged veins, which can lead to healthier semen and even the possibility of natural conception as soon as three months after the procedure. […] Using a small camera through the urethra, a number of techniques can be used to open the obstruction and restore the path for semen to exit the body.

• #1 Male Infertility Treatment – NYC | ColumbiaDoctors

  https://www.columbiadoctors.org/specialties/urology/our-services/sexual-function-and-infertility/treatments/infertility-treatments-men

  Following vasovasostomy sperm appears in the semen in 85% to 97% of men, and about half of couples achieve a pregnancy. […] To help couples achieve pregnancy, doctors sometimes fertilize the egg outside the woman’s body, then place it in the uterus to complete gestation. […] IVF and ICSI are most successful when doctors collect and choose the man’s healthiest sperm.

• #1 Male Infertility: Facts, Myths, and Treatment

  https://www.keckmedicine.org/centers-and-programs/male-infertility/

  Up to 6% of men who have had a vasectomy desire fertility in the future. We offer fertility options for men with a history of vasectomy. These options include microsurgical vasectomy reversal and minimally invasive sperm extraction using testicular sperm extraction (TESE) or percutaneous sperm aspiration (PESA). […] We offer fertility treatments for men with cystic fibrosis, including minimally invasive sperm extraction, percutaneous sperm aspiration (PESA) and microsurgical epididymal sperm aspiration (MESA). […] At our center, we offer fertility preservation options to safeguard your ability to have children post-treatment. This typically involves sperm banking (cryopreservation) during which sperm is collected and frozen for future use. […] To preserve your fertility before starting treatment, we offer sperm banking (cryopreservation) during which sperm is collected and frozen for later use.

• #1 Male Infertility Treatment | Baylor Medicine

  https://www.bcm.edu/healthcare/specialties/urology/mens-health/male-infertility-treatment

  Varicocele ligation is a surgical procedure that repairs these veins. […] Obstructed ejaculatory ducts are usually diagnosed by transrectal ultrasound imaging or special radiographic tests called vasograms. […] Obstructed ducts are treated by a simple transurethral procedure whereby the obstructed part of the duct is removed, leaving normal, unobstructed ductal tissue behind. […] Vasal obstruction, and even secondary epididymal obstruction, usually can be corrected using special microsurgical techniques to bypass the obstruction. […] Surgical procurement of sperm, also known as surgical sperm retrieval, is a medical procedure performed to obtain sperm directly from the reproductive tract of a male patient. […] It is essential for couples seeking surgical sperm procurement to consult with a qualified fertility specialist to determine the most appropriate method for their specific situation.

• #1 Patient education: Treatment of male infertility (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-male-infertility-beyond-the-basics/print

  If tests show that the male partner’s semen contains no or few normal sperm, assisted reproductive technologies (ART) can often help. […] In vitro fertilization (IVF)—IVF is a commonly used technique for a variety of infertility problems, including female tubal blockages and unexplained infertility. […] IVF success rates depend upon a number of variables, including the age and health of the female partner, the health of the egg and sperm, and, to some extent, the experience of the infertility center. […] Intracytoplasmic sperm injection (ICSI)—With ICSI, a single sperm from the male partner is injected directly into an egg in the lab. […] Testicular extraction of sperm—If a man’s semen contains no sperm or very few sperm, sperm can sometimes be directly removed from the testicles. […] If sperm can be found and extracted from the testis, the sperm can be used for ICSI.

• #1 Infertility in men | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/infertility-in-men

  Around 30% of fertility problems originate in the man. […] Treatment options for poor sperm quality include inseminating the mans partner with a concentrated sample of the mans semen and intracytoplasmic sperm injection (ICSI). […] In most cases, couples with male factor infertility can be helped with assisted reproductive technologies (ART). […] The reproductive technologies available to infertile men include: surgery, hormone therapy, artificial insemination, in-vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI). […] The pituitary gland in the brain releases hormones called gonadotropins, which stimulate the testicles to produce sperm. […] Taking these hormones as medication may boost sperm production. […] The man’s semen is collected, washed and concentrated, then introduced into his partner’s uterus through the cervix. […] In In-vitro fertilisation (IVF) sperm is collected from the man and is placed in a special incubator. […] In ICSI each egg is injected with a single sperm using a microscopic needle.

• #1 Male Infertility Treatment in San Francisco Bay | Pacific Fertility Center

  https://www.pacificfertilitycenter.com/fertility-care/male-fertility

  If such causative issues are identified as contributing factors, our doctors typically offer advice on how to address these challenges. […] However, even men without known toxic exposures or lifestyle factors can have low sperm parameters. […] Many dietary supplements are known to improve sperm production and function, such as L-carnitine and zinc. […] A reproductive endocrinologist or andrologist may recommend starting a vitamin and mineral supplement regimen to help improve sperm production and parameters. […] When there is mild, unexplained low sperm count or motility, we may recommend an intrauterine insemination (IUI) cycle. […] Sperm is processed and placed into the female partner’s uterus around the time of ovulation, giving sluggish sperm a head start toward the egg or eggs.

• #1 Male Infertility Treatment in Atlanta, GA | ACRM

  https://www.atlantainfertility.com/treatments-services/fertility-testing/male-fertility-testing/male-fertility-treatment/

  The treatment of male factor infertility is dependent on patients specific condition. Sexual dysfunction, for example, is often treated by infertility counseling rather than by „medical” therapies. Most commonly, however, we will be treating male factor infertility with therapies such as inseminations or In Vitro Fertilization. […] Treatment for male factor infertility will depend on how many healthy sperm are produced and released by the patient. […] In order for intrauterine insemination (IUI) to be successful, as a general rule, roughly 3 million healthy, motile sperm must be available. […] Although we usually must have 3-5 million sperm available for IUI success, there are always exceptions to this. […] Using donor sperm may be an option for couples who are dealing with severe cases of male factor infertility.

• #1 Male Fertility Program > Departments > Yale Medicine

  https://www.yalemedicine.org/departments/male-fertility-program

  Couples experiencing difficulty achieving pregnancy, despite trying for six months to a year (depending on their ages), should seek guidance from a fertility specialist. Male infertility contributes to about half of these cases. Still, numerous treatments are available that may enable men to become parents, even if they have been diagnosed with conditions such as a low sperm count. […] Poor semen quality is often the primary factor contributing to male infertility. Some patients may have insufficient sperm production or a complete absence of sperm. Others may produce enough sperm, but with abnormalities in morphology or motility. Anatomical abnormalities may also obstruct sperm passage or semen ejaculation. […] Following a diagnosis, our reproductive specialists collaborate with patients to enhance their chances of achieving parenthood. In cases with a reduced but sufficient number of motile sperm, intrauterine insemination (IUI) may be recommended. Here, ejaculated sperm is washed and directly injected into the uterus by a clinician. IUI is often combined with ovarian stimulation medications to increase the chance of achieving a pregnancy.

• #1 Male Infertility Treatment – Dallas-Worth Fort – Male Fertility Treatment

  https://www.fertilitytexas.com/fertility-treatments/male-infertility-treatment/

  Learn all about male infertility treatment. Three significant factors influence male infertility treatment. For mild male factor, unexplained cause, intrauterine insemination (IUI) is usually the first-line recommendation. However, most authorities consider (IUI) to be ineffective in cases of severe male infertility. Intracytoplasmic sperm injection (ICSI) has revolutionized the treatment of male infertility. The ideal treatment, when surgical and medical management fails to improve sperm function, is in vitro fertilization (IVF). Many men also opt for intracytoplasmic sperm injection (ICSI) as part of IVF. ICSI bypasses sperm defects because embryologists select a single sperm and place it inside the egg. IVF/ICSI can help in cases of severe male factor infertility. Couples have the option of a vasectomy reversal or IVF-ICSI with epididymal or testicular sperm extraction. Microepididymal sperm aspiration (MESA) and testicular sperm extraction (TESE) are outpatient procedures to retrieve sperm special circumstances. A TESE or testicular sperm extraction is a male infertility treatment that entails directly aspirating the sperm from the testes or retrieving sperm from a testicular biopsy. TESE or testicular biopsy is usually the only option for them as there are no sperm in the epididymus and even testicular sperm production can be “patchy” and scarce within the testes. The andrology department at Fertility Specialists of Texas performs semen analysis, semen cryopreservations, intrauterine insemination (IUI) preparations, and in vitro fertilization (IVF) sperm preparations.

• #1 Male Infertility – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562258/

  The ultimate ART currently available, ICSI, is similar to the IVF described above but involves the use of a microscope and micropipette to inject a single sperm taken from the male partner directly into an egg from the female partner that has been surgically extracted. […] Overall, IVF with ICSI is preferred when there are very significant male factors that cannot be overcome by other means, but at least a few viable sperm can still be retrieved.

• #1 Male Infertility Treatment in Atlanta, GA | ACRM

  https://www.atlantainfertility.com/treatments-services/fertility-testing/male-fertility-testing/male-fertility-treatment/

  Intracytoplasmic Sperm Injection (ICSI) is a technique that involves injecting a single sperm into the egg at the time of in vitro fertilization. This technology has revolutionized the treatment of male factor infertility. Now, as long as the husband has sperm, pregnancy is possible. […] The reproductive health of the female partner is an important determining factor when figuring out if ICSI is a viable option. ICSI requires the couple to undergo in vitro fertilization and allows men to establish pregnancies who previously would never have been able to do so.

• #1 Treating Male Infertility

  https://www.webmd.com/men/features/male-infertility-treatments

  These high-tech and expensive male infertility treatments give sperm an artificial boost to get into an egg. ARTs have made conception possible even for men with very low or abnormal sperm. […] Shaban says that by using some combination of ARTs for several months, most couples can expect a pregnancy between 40 to 50% of the time. […] But are there things you can do on your own to maximize your fertility? Yes. […] Ross reminds men that most problems with reproduction do not affect their ability to produce male hormones, their sexual function, or their maleness.

• #1 Male Infertility > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/male-infertility

  Treatment includes medication, surgery, sperm retrieval, or reproductive technologies. […] Treatments will vary depending on the cause of the infertility. Some common treatments include: […] Medication: A regimen of drugs to improve sperm production, correct hormone imbalances, treat infections that affect sperm or bolster testosterone. […] Repair of a varicocele: A minor procedure to correct a physical condition that can heat up the testicles and affect sperm quality. […] Surgery: A surgical approach can remove barriers that may be blocking sperm production, maturation or ejaculation. […] Microsurgical fertilization procedures: These techniques involve sperm retrieval through a minimally invasive approach, developed by Dr. Honig, or a more extensive approach based on the patient’s specific condition. Typically this is an out-patient procedure and men may be able to go home the same day.

• #1 Male Infertility San Diego | Testing & Treatment in La Jolla

  https://www.fertilityclinicsandiego.com/understanding-fertility/infertility-in-men/

  Sperm freezing offers a safe and reliable option. […] Our San Diego fertility clinic provides a comfortable, private experience, ensuring your sperm is safely stored for future use. […] The following procedures are performed either in our facility or in an operating room at the UC San Diego Health System: […] PESA is a non-invasive technique used to retrieve sperm in the event of a blockage. […] TESA is another in-office procedure focused on sperm retrieval this time directly from the testes. […] This is the most widely used technique for diagnosing an obstruction within the male reproductive system. […] Patients who have problems with sperm production may undergo this technique. […] A slightly more invasive technique than PESA, this procedure uses microsurgical techniques to collect sperm from the epididymis. […] This allows men who have undergone a vasectomy to become fathers again. […] This is the most common surgical procedure used to treat male infertility. […] Our skilled fertility specialists are here to help.

• #1 Male Infertility Treatment – Tennessee Fertility Center

  https://www.nashvillefertility.com/treatment-and-care/male-infertility/

  IVF with intracytoplasmic sperm injection (ICSI). This extra IVF step involves injecting sperm directly into an egg. […] Microsurgical epididymal sperm aspiration (MESA) or testicular sperm extraction (TESE). This process involves surgical or needle retrieval of sperm for use in IVF with ICSI. We recommend this option for men whose semen analyses find too few or no sperm (oligospermia or azoospermia). […] Your fertility specialist will work closely with you and your partner to evaluate all possible male infertility treatment options and choose the best approach to achieving your family-building goals. […] To learn more about male infertility treatment, contact our Tennessee fertility center.

• #1 Patient education: Treatment of male infertility (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-male-infertility-beyond-the-basics/print

  Risks of ART—Most patients who undergo assisted reproductive technologies (ART) have no major complications. […] Sometimes, infertility treatments are not successful, or treatment is not an option. […] Artificial insemination with donor sperm—Some couples may choose artificial insemination of the female partner with donor sperm. […] The use of donor sperm (if the woman is producing eggs) results in overall pregnancy rates that are approximately 50 percent after six cycles of insemination.

• #1 Male Infertility Treatment Options at MFS | San Diego, CA

  https://www.malefertility.com/male-infertility/treatment-options

  Less than a decade ago, male infertility treatment options were limited to insemination(s) or IVF using donor sperm. Today, significant advances in male fertility treatments have introduced innovative therapeutic options that offer men, including those with no sperm in their ejaculate due to genetic conditions, a greatly improved chance to conceive their own biological offspring. […] There are several treatment options for male factor infertility including non-surgical medication therapy, surgical procedures and various assisted reproductive technologies. […] Electroejaculation allows the retrieval of sperm in more than 90% of patients and up to 40% of couples will achieve pregnancy with IUI. ICSI (a form of IVF that injects a single sperm into an egg) gives the remaining couples a 50% chance for pregnancy. Overall, the chances for pregnancy for informed and motivated patients are similar to those of a healthy male.

• #1 Male Infertility Treatment in Atlanta, GA | ACRM

  https://www.atlantainfertility.com/treatments-services/fertility-testing/male-fertility-testing/male-fertility-treatment/

  There are multiple causes of infertility. The three most frequent individual causes are abnormalities of ovulation, abnormalities of the fallopian tubes, and male factors. These three causes account for some 80% of infertility cases, with male factors accounting for 20-35% of these cases. Male infertility testing should be one of the very first tests carried out in the diagnostic process of the couple experiencing infertility. […] At ACRM, we work with several Board certified urologists specializing in male fertility throughout the Atlanta area. We offer several treatments for male infertility so that you and your partner can explore all the options. […] The type of treatment used will depend directly on how many good quality sperm are available. In situations where sperm numbers are low but close to normal, the option of Intrauterine Insemination (IUI) is available. In situations where sperm numbers are markedly reduced, the best option is ICSI during a cycle of in vitro fertilization.

• #1 Infertility in men: assessment and treatment – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/infertility-in-men-assessment-and-treatment

  Spermatogenesis induction is performed using human chorionic gonadotropin (hCG) with or without rFSH or hMG. […] Medical therapy for erectile dysfunction includes two main classes of medicine: phosphodiesterase type-5 inhibitors (PDE5is) and synthetic forms of prostaglandin E1 (PGE-1). […] Medical therapy for oligospermia and non-obstructive azoospermia remains controversial. Treatment with selective estrogen receptor modulators (SERMs), aromatase inhibitors and hCG has been explored in patients with oligospermia and in those with non-obstructive azoospermia prior to testicular sperm extraction. […] Where medical and surgical treatment fail, assisted conception using donor sperm can be considered. […] Surgical sperm retrieval is the mainstay of treatment for obstructive azoospermia with success rates of 100%. It can also be used for non-obstructive azoospermia with significantly lower success rates depending on the underlying diagnosis.

• #1 Infertility: Types, Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/16083-infertility

  Treatments for infertility in men include: Medications: Medications can raise testosterone or other hormone levels. There are also drugs for erectile dysfunction to help you maintain an erection during sex. Surgery: Some men need surgery to open blockages in the tubes that carry sperm or to repair structural problems. Varicocele surgery can make sperm healthier and improve the odds of conception. […] Some couples need more help conceiving using assisted reproductive technology (ART). ART is any fertility treatment that involves a healthcare provider handling the sperm or egg. To increase pregnancy odds, you can take medications to stimulate ovulation before trying one of these options: In vitro fertilization (IVF): IVF involves retrieving eggs from your ovary, then placing them with sperm in a lab dish. The sperm fertilizes the eggs. A provider transfers one to three of the fertilized eggs (embryos) into your uterus. […] Yes, but it depends on the cause. In 85% to 90% of cases, lifestyle modification, medication, ART or surgery can treat infertility and allow a woman to conceive.

• #1 How Cancer and Cancer Treatment Can Affect Fertility in Men | American Cancer Society

  https://www.cancer.org/cancer/managing-cancer/side-effects/fertility-and-sexual-side-effects/fertility-and-men-with-cancer/how-cancer-treatments-affect-fertility.html

  Some cancers and cancer treatments can cause changes in your body that affect your fertility (your ability to have a child). […] Certain cancers, and some cancer treatments, can cause infertility. […] If you want to have children after cancer treatment, talk to your doctor or cancer care team while you are deciding on treatment. Ask them how treatment might affect your fertility and if there is anything you can do to preserve it. […] It’s best to have these discussions before starting treatment. […] For this reason, sperm banking before a testicle is removed is now recommended for men and boys who want to preserve their fertility. This is called fertility preservation. […] If you have testicular cancer, you will most likely need at least one of your testicles removed. […] If you have this surgery, you won’t be able to make sperm cells, so you won’t be able to father children. Sperm banking before surgery may be an option if you want to father children in the future.

• #1 How Cancer and Cancer Treatment Can Affect Fertility in Men | American Cancer Society

  https://www.cancer.org/cancer/managing-cancer/side-effects/fertility-and-sexual-side-effects/fertility-and-men-with-cancer/how-cancer-treatments-affect-fertility.html

  Radiation aimed at the testicles, or nearby pelvic areas, can kill the stem cells that make sperm. This can affect your fertility. […] Chemotherapy (chemo) works by killing cells in your body that divide quickly. This includes cancer cells, but also the cells that make sperm. With some chemo, your sperm production might slow down or stop. […] Permanent infertility can happen if the cells in your testicles that divide to make new sperm (spermatogonial stem cells) are damaged to the point that they can no longer produce maturing sperm cells. […] Hormone therapies used to treat prostate cancer or other cancers can decrease levels of the male hormones needed to make sperm and get an erection. This can affect your ability to have a child. […] If you have trouble getting your partner pregnant after cancer treatment, think about meeting with a reproductive endocrinologist. This is a doctor who treats fertility issues. […] Cancer and cancer treatment could affect your fertility, but there may be ways to improve your chances of fathering a child in the future.

• #1 Male Infertility: Causes, Symptoms, Tests & Treatment

  https://my.clevelandclinic.org/health/diseases/17201-male-infertility

  Male infertility can be very challenging. It affects up to 15% of males in the United States who are attempting to have a biological child. But because of modern technology, many couples have the potential to conceive a biological child. […] Talk to a healthcare provider if your partner cant get pregnant after a year of trying. Lifestyle changes may be able to prevent infertility, and surgeries and procedures can treat the causes.

• #1 Male Infertility – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562258/

  An undescended testicle, whether unilateral or bilateral, can affect male fertility even when surgically repaired. […] Varicocele repairs are generally only recommended in infertile men with abnormal semen parameters who have large, clinical grade 3 varicoceles. […] Varicocele repair is also reasonable if the varicocele is causing symptoms with or without infertility. […] Overall, varicocelectomy is expected to ultimately improve semen parameters in at least 60% to 70% of patients with clinically significant varicoceles. […] A recent, comprehensive meta-analysis demonstrated that all significant standard sperm characteristics in infertile men with significant varicoceles improved after varicocele surgery. […] IVF can be used in couples when IUI with ovarian stimulation has failed, in women over 40 years of age, or when there are known conditions precluding the use of simpler techniques, such as bilateral tubal disorders.

• #1 Infertility in men: assessment and treatment – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/infertility-in-men-assessment-and-treatment

  Management of male infertility should be individualised, taking into account the underlying aetiology, the partner’s age, causes of female factor infertility, cultural and religious beliefs and eligibility for NHS-funded assisted conception treatment. […] The only licensed male medical treatment is for hypogonadotropic hypogonadism. Use of SERMs, AIs and hCG for oligospermia or prior to surgical sperm retrieval for non-obstructive azoospermia is off-license and with limited evidence to support its use.

• #1 Male Infertility Treatment in San Francisco Bay | Pacific Fertility Center

  https://www.pacificfertilitycenter.com/fertility-care/male-fertility

  Because male infertility may require months of treatment, any treatment plan will consider the age of the female partner, as this is a crucial element in fertility success. […] The male fertility evaluation will include a sperm count, and usually a panel of hormone blood tests, a physical and urogenital examination, and possibly genetic tests and/or sperm function testing. […] In cases where the patient has a low sperm count or diminished motility, a urologist may prescribe Clomid, an infertility pill commonly used to treat ovulation issues in women. […] For men, Clomid can stimulate the hormones responsible for sperm production. […] Many cases of male factor infertility, even after a full evaluation, are labeled „idiopathic,” which means that we do not know why there is a low count, low motility, or poor sperm morphology (abnormally shaped sperm).

• #1 Male Infertility Program

  https://www.massgeneral.org/urology/treatments-and-services/male-infertility-program

  We are highly skilled in microsurgical techniques that can repair or address various reproductive tract obstructions. […] Varicoceles, a network of abnormally dilated veins in the testes, can have a negative impact on sperm or testosterone production and are the most common cause of male infertility. […] This delicate operation can restore sperm to the ejaculate in men who previously have had a vasectomy. […] We understand the profound impact infertility can have on a couple. That’s why we work as a team to provide you with expert medical care and psychological and emotional support throughout your journey to parenthood. […] Patients typically are referred to us by community physicians or from elsewhere in Mass General. […] At your initial visit, program director Ajay Nehra, MBBS, will conduct a thorough history and physical/urological examination.

• #1 Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I (2020) | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/diagnosis-and-treatment-of-infertility-in-men-auaasrm-guideline-part-i-2020/

  Just as all infertile women are treated by those with specialized gynecologic training and expertise, all infertile men be evaluated by specialists in male reproduction. […] Clinicians should counsel infertile men or men with abnormal semen parameters of the health risks associated with abnormal sperm production. […] Infertile men with specific, identifiable causes of male infertility should be informed of relevant, associated health conditions. […] Clinicians should advise couples with advanced paternal age (R40) that there is an increased risk of adverse health outcomes for their offspring. […] Over 50% of the time, the cause of a man’s infertility can be attributed to one of several conditions many of which have health implications beyond fertility. […] It is important for the clinician to understand the various etiologies of male infertility and provide adequate counseling regarding associated conditions or consider referral to a specialist for the diagnosed conditions.

• #1 Male Infertility Services | UCI Health | Orange County, CA

  https://www.ucihealth.org/medical-services/conditions/male-infertility

  At UCI Health Center for Urological Care, we are experts in the evaluation and treatment of male infertility. […] As such, it is crucial for men in infertile couples to be screened and treated by urologists who specialize in male infertility. […] Our multidisciplinary team of experts uses the latest techniques to diagnose the cause, rule out other underlying conditions and provide the latest infertility treatments and services. […] UCI Health urologists are leaders in the treatment of male infertility disorders. […] Our male infertility team uses the latest diagnostic techniques and treatment methods. […] Our team also performs minimally invasive surgery to retrieve sperm, a procedure usually performed in tandem with assisted reproductive techniques such as in vitro fertilization and intracytoplasmic sperm injection (IVF-ICSI).

• #2 What treatment options are available for male infertility? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/menshealth/conditioninfo/treatments

  Treatments for male infertility may be based on the underlying cause of the problem, or in the case of no identified problem, evidence-based treatments that improve fertility may be recommended. […] Medication can treat some issues that affect male fertility, including hormone imbalances and erectile dysfunction. […] Surgery can be effective for repairing blockages in the tubes that transport sperm. […] Surgery can also be used for repair of varicocele. […] Assistive reproductive technologies, such as in vitro fertilization, can be effective if other treatments do not restore fertility.

• #2 Patient education: Treatment of male infertility (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-male-infertility-beyond-the-basics/print

  Patient education: Treatment of male infertility (Beyond the Basics) […] If you and your partner have been trying to get pregnant without success, talk to a health care provider. They can talk with you and run tests to try to determine the cause and whether treatment may be helpful. […] The treatment options for male infertility depends upon the underlying cause. The decision to pursue treatment depends on other factors as well, including personal preferences and cost. […] While there are some situations in which male infertility can be reversed with medication or surgery, in many cases, assisted reproductive technology (ART; for example, in vitro fertilization [IVF] or IVF with intracytoplasmic injection [ICSI]) is the recommended approach. […] Lifestyle changes—Although there is limited evidence that specific lifestyle changes improve fertility, it is reasonable to take steps like avoiding smoking, limiting alcohol intake (to less than 24 ounces of beer, 10 ounces of wine, or 2 ounces of hard alcohol daily), avoiding any marijuana or recreational drugs, eating a healthy diet that contains fresh fruit and vegetables, and maintaining a healthy weight.

• #2 Fertility Pills for Men & Medication Monitoring | University of Utah Health

  https://healthcare.utah.edu/fertility/treatments/male-fertility-drugs

  Male fertility pills can change your hormones and get your fertility back on track. These medications increase your levels of a male sex hormone called testosterone. They also decrease your levels of estradiol (a form of estrogen, a female sex hormone). The following drugs change male hormone levels and boost fertility: […] Clomid helps increase your testosterone to help you produce more sperm. […] Recent studies show that enclomiphene improves testosterone as effectively as Clomid. But enclomiphene has fewer side effects and treats infertility better. […] Boosted levels of reproductive hormones increase your fertility: […] Large-scale studies have found that Clomid and enclomiphene help men who have low testosterone in the following ways: […] Research also showed that the sperm count of up to 10% of men with no sperm increased after three months of taking Clomid.

• #2 Male Infertility Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/436829-treatment

  A limited number of medical treatments are available for improving chances of conception in men with certain causes of infertility. […] A number of patients with hypogonadotropic hypogonadism respond to gonadotropin-releasing hormone (GnRH) therapy or gonadotropin replacement. […] Human chorionic gonadotropin (hCG) is a luteinizing hormone (LH) analogue that may be used alone or in combination with human menopausal gonadotropin (hMG) for Leydig cell stimulation. […] Estrogen modulators can also be of use. […] Clomiphene citrate is a weak estrogen-receptor antagonist that works by blocking the negative feedback inhibition of estrogen on the anterior pituitary, thus increasing the release of FSH and LH. […] Patients with congenital adrenal hyperplasia (CAH) may respond to therapy with glucocorticoids, while those with isolated testosterone deficiency may respond to testosterone replacement.

• #2 Medical treatment of male infertility – Dabaja – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/3512/html

  The use of AIs seems to be effective in restoring LH, FSH, and T levels, improving semen parameters, and re-establishing fertility. […] SERMs, such as clomiphene citrate (CC), tamoxifen, and toremifene, have been widely used in women for the treatment of breast cancer and osteoporosis, their use in the treatment of male hypogonadism and infertility is currently off-label. […] In a recently published meta-analysis that summarized the latest available randomized controlled trials regarding the use of estrogen antagonists (CC or tamoxifen) as empirical medical therapy for idiopathic male infertility with oligo and/or asthenoteratozoospermia, the pooled data showed that estrogen antagonist use was associated with a statistically significant increase in pregnancy rates compared with controls.

• #2 Medical treatment of male infertility – Dabaja – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/3512/html

  The treatment of male infertility in men with pituitary insufficiency is based on the use of gonadotropins, therefore spermatogenesis and T production cannot be induced by pulsatile GnRH. […] Gonadotropins are self-administered subcutaneous injections with dosages ranging between 75-150 IU of FSH or human menopausal gonadotropin (hMG) two to three times weekly plus 1,500-2,500 IU of hCG twice weekly. […] Most studies have shown that gonadotropins induce spermatogenesis in approximately 80% of treated men. […] The pregnancy rate also varies between studies, 38% to 51% of couple who seeks treatment obtain pregnancy. […] For men presenting with infertility and hyperprolactinemia, dopamine agonists are indicated for the treatment of infertility and the pituitary tumor. […] AI treatment of men with idiopathic OAT or azoospermia is an off-label use of this medication.

• #2 Infertility Treatments in Men | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/urology/infertility-female-male/treatments

  There is increasing evidence that lifestyle can have a large impact upon male fertility. For example, weight loss and regular exercise can have a direct, positive effect on hormone levels and sperm production. Quitting smoking, including tobacco and marijuana, can have similar effects. […] Medical therapies can be very effective for men with certain causes of infertility, such as hormonal abnormalities. For men with low testosterone, a number of medications, such as clomiphene citrate, human chorionic gonadotropin (HCG) and anastrozole, can help to boost the bodys natural production of testosterone. […] Testosterone supplementation through gels, injections or other methods can have a negative effect on fertility. These supplements can signal to a mans body that it should stop its own production of testosterone, which can be bad for sperm production. In fact, testosterone supplementation can have such a negative impact on fertility that scientists have studied the possibility of using testosterone as a male contraceptive.

• #2 Male Infertility: Causes, Symptoms, Tests & Treatment

  https://my.clevelandclinic.org/health/diseases/17201-male-infertility

  Infertility is a common problem for many men. […] Fortunately, if you have male infertility, you may be able to have a biological child with your partner. Treatments that can increase your chances of conception are available. […] Yes, many different treatment options can reverse male infertility. Depending on the cause, your treatment may include: […] You may be able to increase the production of healthy sperm by making certain lifestyle changes, including: […] Hormone therapy can regulate hormone levels that are too high or low and affect your sperm quality. […] Surgical treatments may include: […] Assisted reproductive technology (ART) procedures involve removing an egg from your partners ovaries and combining it with your sperm in a lab. […] Just because you have male infertility, it doesnt mean youll never be able to have a biological child. Treatment options are available.

• #2 Low sperm count – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/low-sperm-count/diagnosis-treatment/drc-20374591

  You may learn that you have a low sperm count if you get a healthcare checkup because you’re having trouble getting your partner pregnant. […] This can help guide fertility treatment options for you and your partner. […] Treatments for low sperm count include: […] Surgery. For example, a varicocele can often be fixed with surgery. […] If no sperm are present in the semen, sperm often can be collected directly from the testicles or epididymis. […] Antibiotics can cure an infection of the reproductive tract caused by germs. […] Medicine or counseling can help improve fertility in conditions such as erectile dysfunction or premature ejaculation. […] These treatments can help if you have infertility caused by high or low levels of certain hormones. […] Assisted reproductive technology (ART). Some couples have trouble becoming pregnant despite frequent sex. […] If this happens to you, it’s still possible to have a child. You and your partner can think about using sperm from a donor or adopting a child. […] What treatments are available to raise my sperm count? Which do you recommend?

• #2 10 Ways to Boost Male Fertility and Increase Sperm Count

  https://www.healthline.com/health/boost-male-fertility-sperm-count

  Some evidence indicates that taking antioxidant supplements may help improve male fertility. More specifically, vitamin C supplements may help improve semen quality and partner pregnancy rate. […] Stress has also been linked with a reduction in sperm quality. […] Some research suggests a link between low vitamin D levels and low testosterone levels, which could affect male fertility. […] A 2016 test-tube study involving 40 males showed that adding 40 and 50 g/mL of Tribulus terrestris extract to sperm helped increase motility and fertility. […] A 2020 research review showed that fenugreek supplementation helped significantly improve male testosterone levels. […] Observational studies indicate that low zinc status or deficiency is associated with low testosterone levels, poor sperm quality, and an increased risk of male infertility.

• #2 Male Infertility Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/436829-treatment

  Treatment of hyperprolactinemia is with dopamine antagonists, such as bromocriptine or cabergoline. […] Use of steroids in patients with antisperm antibodies is controversial, with some studies showing improvement in spermatozoal quality and conception rates and others showing no benefit in rates of conception. […] Imipramine or alpha-sympathomimetics, such as pseudoephedrine, may help close the bladder neck to assist in antegrade ejaculation. […] Patients should be encouraged to stop smoking cigarettes and marijuana and to limit environmental exposures to harmful substances and/or conditions. […] Oxidative stress causes suboptimal levels of fertility in men; therefore, the idea of antioxidant supplementation to improve male subfertility has theoretical merit. […] Successful varicocelectomy results in improvement in semen parameters in 60-70% of patients.

• #2 Diagnosis and treatment of infertility in men: AUA/ASRM guideline part II | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/diagnosis-and-treatment-of-infertility-in-men-aua-asrm-guideline-part2/

  Diagnosis and Treatment of Infertility in Men: AUA/ ASRM Guideline Part II (2021) […] Failure to conceive within 12 months of attempted conception is due in whole or in part to the male in approximately one-half of all infertile couples. […] Although many couples can achieve a pregnancy with assisted reproductive technologies (ART), evaluation of the male is important to identify conditions that may be medically important, counsel men regarding future health considerations and to most appropriately direct therapy. […] Most male factor conditions are specifically treatable with medical or surgical therapy, while others may only be managed with donor sperm or adoption. […] Varicocele Repair/Varicocelectomy. […] Surgical varicocelectomy should be considered in men attempting to conceive, who have palpable varicocele(s), infertility, and abnormal semen parameters, except for azoospermic men.

• #2 Male Infertility Treatment – NYC | ColumbiaDoctors

  https://www.columbiadoctors.org/specialties/urology/our-services/sexual-function-and-infertility/treatments/infertility-treatments-men

  Following vasovasostomy sperm appears in the semen in 85% to 97% of men, and about half of couples achieve a pregnancy. […] To help couples achieve pregnancy, doctors sometimes fertilize the egg outside the woman’s body, then place it in the uterus to complete gestation. […] IVF and ICSI are most successful when doctors collect and choose the man’s healthiest sperm.

• #2 Patient education: Treatment of male infertility (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-male-infertility-beyond-the-basics/print

  Hypothalamic or pituitary deficiency—In a small percentage of cases (2 to 5 percent), male infertility is due to problems in the hypothalamus and pituitary gland. In this situation, treatment with human chorionic gonadotropin (hCG) that acts like LH, often in combination with recombinant human follicle-stimulating hormone (rhFSH), is given. […] Treatment with hCG with or without rhFSH is often called „gonadotropin treatment.” […] Varicocele—A varicocele is a dilation of a vein in the scrotum. […] Varicocele can be treated with surgery to cut the veins connected to the varicocele. […] Blockage or abnormality of the reproductive tract—Sometimes, infertility is related to a blockage in the ducts that allow sperm to mix with the semen before ejaculation; this can happen as a result of certain infections.

• #2 Infertility Treatments in Men | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/urology/infertility-female-male/treatments

  For men who do not have any sperm in their ejaculate, sperm extraction may be an appropriate option. During this procedure, a surgical microscope is used to open the testicle and extract sperm, if they are present. These sperm can then be used to fertilize an egg through in vitro fertilization (IVF). […] Men who have had a vasectomy have a blockage that does not allow sperm in the ejaculate. Vasectomy reversal is a good option for these men. Using a surgical microscope, the two ends of the vas deferens are repaired using very small sutures the size of a human hair. If the reversal is successful, men may be able to conceive naturally with their partner. […] For men with this condition, we can perform a microsurgical procedure to ligate the enlarged veins, which can lead to healthier semen and even the possibility of natural conception as soon as three months after the procedure. […] Using a small camera through the urethra, a number of techniques can be used to open the obstruction and restore the path for semen to exit the body.

• #2 Male infertility – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/male-infertility/diagnosis-treatment/drc-20374780

  Diagnosing male infertility problems usually involves: […] Treatments for male infertility include: […] In cases of infertility, it’s recommended that the female partner also be checked. […] Your doctor might recommend additional tests to help identify the cause of your infertility. […] Often, an exact cause of infertility can’t be found. Even if an exact cause isn’t clear, your doctor might be able to recommend treatments or procedures that will lead to conception. […] Surgery. For example, a varicocele can often be surgically corrected or an obstructed vas deferens repaired. […] Assisted reproductive technology (ART). ART treatments involve obtaining sperm through normal ejaculation, surgical extraction or from donor individuals, depending on your specific case and wishes. […] Hormone treatments and medications. Your doctor might recommend hormone replacement or medications in cases where infertility is caused by high or low levels of certain hormones or problems with the way the body uses hormones. […] In rare cases, male fertility problems can’t be treated, and it’s impossible for a man to father a child.

• #2 Patient education: Treatment of male infertility (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-male-infertility-beyond-the-basics/print

  If tests show that the male partner’s semen contains no or few normal sperm, assisted reproductive technologies (ART) can often help. […] In vitro fertilization (IVF)—IVF is a commonly used technique for a variety of infertility problems, including female tubal blockages and unexplained infertility. […] IVF success rates depend upon a number of variables, including the age and health of the female partner, the health of the egg and sperm, and, to some extent, the experience of the infertility center. […] Intracytoplasmic sperm injection (ICSI)—With ICSI, a single sperm from the male partner is injected directly into an egg in the lab. […] Testicular extraction of sperm—If a man’s semen contains no sperm or very few sperm, sperm can sometimes be directly removed from the testicles. […] If sperm can be found and extracted from the testis, the sperm can be used for ICSI.

• #2 Treating Male Infertility

  https://www.webmd.com/men/features/male-infertility-treatments

  These high-tech and expensive male infertility treatments give sperm an artificial boost to get into an egg. ARTs have made conception possible even for men with very low or abnormal sperm. […] Shaban says that by using some combination of ARTs for several months, most couples can expect a pregnancy between 40 to 50% of the time. […] But are there things you can do on your own to maximize your fertility? Yes. […] Ross reminds men that most problems with reproduction do not affect their ability to produce male hormones, their sexual function, or their maleness.

• #2 Patient education: Treatment of male infertility (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-male-infertility-beyond-the-basics/print

  Risks of ART—Most patients who undergo assisted reproductive technologies (ART) have no major complications. […] Sometimes, infertility treatments are not successful, or treatment is not an option. […] Artificial insemination with donor sperm—Some couples may choose artificial insemination of the female partner with donor sperm. […] The use of donor sperm (if the woman is producing eggs) results in overall pregnancy rates that are approximately 50 percent after six cycles of insemination.

• #2 Male Infertility Treatment in Atlanta, GA | ACRM

  https://www.atlantainfertility.com/treatments-services/fertility-testing/male-fertility-testing/male-fertility-treatment/

  The treatment of male factor infertility is dependent on patients specific condition. Sexual dysfunction, for example, is often treated by infertility counseling rather than by „medical” therapies. Most commonly, however, we will be treating male factor infertility with therapies such as inseminations or In Vitro Fertilization. […] Treatment for male factor infertility will depend on how many healthy sperm are produced and released by the patient. […] In order for intrauterine insemination (IUI) to be successful, as a general rule, roughly 3 million healthy, motile sperm must be available. […] Although we usually must have 3-5 million sperm available for IUI success, there are always exceptions to this. […] Using donor sperm may be an option for couples who are dealing with severe cases of male factor infertility.

• #2 Diagnosis and treatment of infertility in men: AUA/ASRM guideline part II | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/diagnosis-and-treatment-of-infertility-in-men-aua-asrm-guideline-part2/

  Varicoceles have long been recognized as a condition that can affect male fertility, where correction of a clinical varicocele can result in substantial improvements in semen parameters and the chance of achieving a pregnancy. […] For men with NOA undergoing sperm retrieval, microdissection testicular sperm extraction (TESE) should be performed. […] Infertility associated with retrograde ejaculation (RE) may be treated with sympathomimetics and alkalinization of urine with or without urethral catheterization, induced ejaculation, or surgical sperm retrieval. […] Male infertility may be managed with ART. […] Clinicians may use aromatase inhibitors (AIs), human chorionic gonadotropin (hCG), selective estrogen receptor modulators (SERMs), or a combination thereof for infertile men with low serum testosterone.

• #2 Infertility in men: assessment and treatment – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/infertility-in-men-assessment-and-treatment

  Spermatogenesis induction is performed using human chorionic gonadotropin (hCG) with or without rFSH or hMG. […] Medical therapy for erectile dysfunction includes two main classes of medicine: phosphodiesterase type-5 inhibitors (PDE5is) and synthetic forms of prostaglandin E1 (PGE-1). […] Medical therapy for oligospermia and non-obstructive azoospermia remains controversial. Treatment with selective estrogen receptor modulators (SERMs), aromatase inhibitors and hCG has been explored in patients with oligospermia and in those with non-obstructive azoospermia prior to testicular sperm extraction. […] Where medical and surgical treatment fail, assisted conception using donor sperm can be considered. […] Surgical sperm retrieval is the mainstay of treatment for obstructive azoospermia with success rates of 100%. It can also be used for non-obstructive azoospermia with significantly lower success rates depending on the underlying diagnosis.

• #2 How Cancer and Cancer Treatment Can Affect Fertility in Men | American Cancer Society

  https://www.cancer.org/cancer/managing-cancer/side-effects/fertility-and-sexual-side-effects/fertility-and-men-with-cancer/how-cancer-treatments-affect-fertility.html

  Some cancers and cancer treatments can cause changes in your body that affect your fertility (your ability to have a child). […] Certain cancers, and some cancer treatments, can cause infertility. […] If you want to have children after cancer treatment, talk to your doctor or cancer care team while you are deciding on treatment. Ask them how treatment might affect your fertility and if there is anything you can do to preserve it. […] It’s best to have these discussions before starting treatment. […] For this reason, sperm banking before a testicle is removed is now recommended for men and boys who want to preserve their fertility. This is called fertility preservation. […] If you have testicular cancer, you will most likely need at least one of your testicles removed. […] If you have this surgery, you won’t be able to make sperm cells, so you won’t be able to father children. Sperm banking before surgery may be an option if you want to father children in the future.

• #2 Fertility Pills for Men & Medication Monitoring | University of Utah Health

  https://healthcare.utah.edu/fertility/treatments/male-fertility-drugs

  Anastrozole reduces low testosterone symptoms such as low energy, reduced muscle mass, low libido, and erectile dysfunction. Men who have a low sperm count or no sperm also produce more sperm while on anastrozole. […] Human chorionic gonadotropin stimulates your testes to make their own testosterone and produce more sperm. […] Research shows that hCG increases the energy, libido, strength, and mood in men with low testosterone. HCG can help you build testosterone no matter what causes your low testosterone levels. […] We check a semen analysis three months after your hormones are at optimal levels. It takes at least three months to see improvement in the sperm counts.

• #2 Male Infertility: Causes, Symptoms, Tests & Treatment

  https://my.clevelandclinic.org/health/diseases/17201-male-infertility

  Male infertility can be very challenging. It affects up to 15% of males in the United States who are attempting to have a biological child. But because of modern technology, many couples have the potential to conceive a biological child. […] Talk to a healthcare provider if your partner cant get pregnant after a year of trying. Lifestyle changes may be able to prevent infertility, and surgeries and procedures can treat the causes.

• #2 Male Infertility – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562258/

  Infertility is usually defined as the inability of a couple to conceive even after 1 year of unprotected, frequent sexual intercourse. The male is solely responsible in about 20% of cases and is a contributing factor in another 30% to 40% of all infertility cases. […] The key purpose for evaluating a male for infertility is to identify the contributing factors, offer treatment for those that are reversible, determine if the patient is a candidate for assisted reproductive techniques, and offer counseling for irreversible and untreatable conditions. […] This activity highlights the etiology and epidemiology of male infertility. The course also reviews the evaluation and management of male infertility as well as the role of the interprofessional team in evaluating and treating patients with this condition.

• #2 Infertility in men: assessment and treatment – The Pharmaceutical Journal

  https://pharmaceutical-journal.com/article/ld/infertility-in-men-assessment-and-treatment

  Management of male infertility should be individualised, taking into account the underlying aetiology, the partner’s age, causes of female factor infertility, cultural and religious beliefs and eligibility for NHS-funded assisted conception treatment. […] The only licensed male medical treatment is for hypogonadotropic hypogonadism. Use of SERMs, AIs and hCG for oligospermia or prior to surgical sperm retrieval for non-obstructive azoospermia is off-license and with limited evidence to support its use.

• #3 Patient education: Treatment of male infertility (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-male-infertility-beyond-the-basics/print

  If tests show that the male partner’s semen contains no or few normal sperm, assisted reproductive technologies (ART) can often help. […] In vitro fertilization (IVF)—IVF is a commonly used technique for a variety of infertility problems, including female tubal blockages and unexplained infertility. […] IVF success rates depend upon a number of variables, including the age and health of the female partner, the health of the egg and sperm, and, to some extent, the experience of the infertility center. […] Intracytoplasmic sperm injection (ICSI)—With ICSI, a single sperm from the male partner is injected directly into an egg in the lab. […] Testicular extraction of sperm—If a man’s semen contains no sperm or very few sperm, sperm can sometimes be directly removed from the testicles. […] If sperm can be found and extracted from the testis, the sperm can be used for ICSI.

• #3 How Cancer and Cancer Treatment Can Affect Fertility in Men | American Cancer Society

  https://www.cancer.org/cancer/managing-cancer/side-effects/fertility-and-sexual-side-effects/fertility-and-men-with-cancer/how-cancer-treatments-affect-fertility.html

  Some cancers and cancer treatments can cause changes in your body that affect your fertility (your ability to have a child). […] Certain cancers, and some cancer treatments, can cause infertility. […] If you want to have children after cancer treatment, talk to your doctor or cancer care team while you are deciding on treatment. Ask them how treatment might affect your fertility and if there is anything you can do to preserve it. […] It’s best to have these discussions before starting treatment. […] For this reason, sperm banking before a testicle is removed is now recommended for men and boys who want to preserve their fertility. This is called fertility preservation. […] If you have testicular cancer, you will most likely need at least one of your testicles removed. […] If you have this surgery, you won’t be able to make sperm cells, so you won’t be able to father children. Sperm banking before surgery may be an option if you want to father children in the future.

• #4 Patient education: Treatment of male infertility (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/treatment-of-male-infertility-beyond-the-basics/print

  If tests show that the male partner’s semen contains no or few normal sperm, assisted reproductive technologies (ART) can often help. […] In vitro fertilization (IVF)—IVF is a commonly used technique for a variety of infertility problems, including female tubal blockages and unexplained infertility. […] IVF success rates depend upon a number of variables, including the age and health of the female partner, the health of the egg and sperm, and, to some extent, the experience of the infertility center. […] Intracytoplasmic sperm injection (ICSI)—With ICSI, a single sperm from the male partner is injected directly into an egg in the lab. […] Testicular extraction of sperm—If a man’s semen contains no sperm or very few sperm, sperm can sometimes be directly removed from the testicles. […] If sperm can be found and extracted from the testis, the sperm can be used for ICSI.

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