Male causes

Male factor infertility is a sensitive issue that is often ignored. Many men are not offered the explanation as to the cause of their condition, and are not made aware of their options for treatment.

We are the only private service in the Birmingham area with a dedicated Male Factor Clinic run jointly by a Fertility Consultant and a Consultant Urologist, both with special expertise in the management of male infertility.

Male infertility can be due to a low sperm count, poor sperm motility, low number of normal sperm or even no sperm whatsoever (azoospermia). Sperm counts do vary significantly, so it is important to repeat the sperm sample, if it is abnormal before reaching a diagnosis.

No sperm (azoospermia)

There are two types of conditions which result in no sperm being in the ejaculate. Either no sperm is being produced by the testis, or whilst sperm is produced, there is a blockage stopping the sperm.
In some men the sperm passes into the bladder at ejaculation rather than out (retrograde ejaculation).
Other causes include hormonal imbalances, chromosome abnormalities (variations in the way the genetic material is arranged), and a special type of carrier status for Cystic Fibrosis.
Depending on the cause, treatment is either by treating the cause such as removing an obstruction or hormone treatment, or by retrieving sperm for use in IVF techniques . Obtaining sperm from the testis is done by a simple procedure under local or general anaesthetic. Such sperm is then used for a special form of test-tube baby treatment, called ICSI (intracytoplasmic sperm injection). In ICSI a single sperm is injected into the egg to fertilise it and make an embryo.

Severe sperm problems

This is where there is sperm in the ejaculate, but it is of very low count/ very slow or of poor quality. In such circumstances, we check for chromosome abnormalities, and occasionally hormone imbalances. Treatment is with a special form of test-tube baby treatment, called ICSI (intracytoplasmic sperm injection).

Mild - moderate sperm problems

Treatment is either with IVF (in vitro fertilisation) or artificial insemination (AI), depending on the severity of the problem. In AI the sperm are prepared in special way and injected into the womb of the female partner at time of ovulation.

Other special conditions

Varicocele: This is where the veins around the testis are increased in size and engorged. They can be felt on examination and may lead to groin/testicular discomfort and pain. Varicocele are more common in men with infertility, but currently there is controversy about whether treating them would lead to improvement in fertility. The various options and their risks and benefits will be fully discussed with you.

Impotence: This can be due to hormonal imbalance, as well as life-style causes. There are a number of treatment options.

DNA damage: The Birmingham Fertility and Gynaecology Centre is the first clinic in Birmingham to offer this important test which is able to detect the level of DNA (genetic material) damage in the sperm.

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