Male factor issues are responsible for approximately 30% of infertility cases as the only issue. However, they can be a contributing factor in 40-50% of couples suffering from infertility.
The most common problem leading to male infertility is a semen analysis that is abnormal, either because of a low number of sperm or a low percentage of moving and normally shaped sperm. This is usually caused by abnormal sperm production or function, or poor delivery of sperm into the ejaculate from the testicle.
Contributing issues can be general health, hormonal problems, medications or drugs, and even some environmental factors. Therefore, it is important to review with your physician all current medications, drug and alcohol use, recent history of severe illness, history of testicular trauma or injury, and potential environmental exposures.
However, most of the time no clear cause can be identified. There are very few situations where a treatment can be performed to correct the issue; instead treatment typically involves performing procedures that can improve the chance of the sperm fertilizing the egg.
The most common and straightforward treatment is to perform an intrauterine insemination (IUI). An IUI is a minor procedure in which the best sperm from the ejaculate are placed directly into the uterine cavity in order for the most sperm possible to find the egg in the fallopian tubes. An IUI can be performed in conjunction with the female partner during a natural cycle or when the female partner is taking fertility medications.
In cases of severe sperm abnormalities or very low sperm counts, a procedure called intracytoplasmic sperm injection (ICSI) needs to be performed. With ICSI, one sperm is directly injected into an egg. It is always used in conjunction with in vitro fertilization.