There are several types of treatments for men when the semen analysis is abnormal.
If the semen analysis is only slightly abnormal a couple can undergo intrauterine inseminations (IUIs).With an insemination, the sperm from the ejaculate are concentrated and washed in the lab so that the very best sperm are collected into small amount of culture media. The sperm are then placed, via a small catheter, into the top of the uterus to improve their chances of fertilizing the egg. When the semen analysis is very abnormal or when inseminations have failed in vitro fertilization (IVF) can be utilized.
With the use of IVF, fertilization rates with even a small amount of abnormal sperm are quite good because the sperm are placed right next to the egg. Alternatively, a procedure called intracytoplasmic sperm injection (ICSI) can be performed in which one sperm is directly injected into one egg. Therefore, fertilization can occur even when there are extremely low numbers of sperm available.
For some men, there is no sperm in the ejaculate, but even for those patients, sperm can sometimes be retrieved from the testicle via a minor surgical procedure. For men who have had vasectomies, they can either opt for a vasectomy reversal or they can proceed directly to IVF with ICSI using sperm harvested from the testicle. These procedures are performed by a urologist specializing in fertility who works in conjunction with the woman’s fertility specialist. However, despite these amazing techniques, some couples prefer not undergo the fertility treatments or can’t afford them. In these settings, donor sperm is a perfectly valid and good option.