Male Infertility

Factors that contribute to an increased risk for infertility in men include:

• History of prostatitis or genital infection
• Testicular trauma
• History of early or delayed puberty
• Hernia repair
• Undescended testicles
• Medication
• Cigarette smoking, alcohol, drug use
• Exposure of genitals to high temperatures
• Exposure to toxins
• Testosterone products

Certain medical issues may cause infertility. These include:

• Sperm disorders
• Genetic diseases
• Anatomical abnormalities
• Varicoceles
• Retrograde ejaculation
• Immunologic infertility
• Obstruction of ejaculatory ducts
• Hormonal abnormalities

Diagnostic procedures to determine infertility may include the following:

• Medical history
• Physical exam
• Laboratory tests
• Semen analysis measures the amount of semen produced and the number and quality of sperm.
• Transrectal ultrasound involves a small probe inserted in the rectum and uses sound waves to make an image of your prostate gland.
• Testicular biopsy a surgical procedure that involves removing tissue samples and examining them under a microscope to determine if cancer is present.
• Hormonal profile checks for the presence of pituitary hormones needed to stimulate sperm production.

Male infertility is treated at Brigham and Women’s Hospital with a variety of procedures and surgeries:

• Minor outpatient surgery (varicocelectomy) to repair dilated scrotal veins (varicoceles), correct obstructions, and reverse vasectomies.
• Medication to correct retrograde ejaculation, immunologic infertility and pituitary hormone deficiency.
• Intrauterine insemination (IUI) sperm placed directly into the uterus via a catheter.
• In vitro fertilization (IVF) involves mixing egg cells with sperm cells outside the body to form an embryo. Embryos are then transferred to the mother's uterus.
• Intracytoplasmic sperm injection (ICSI), injection of a single sperm directly into an egg and then, once fertilized, transferred to the partner’s uterus.
• Testicular Sperm Extraction (TESE), a minor outpatient surgical procedure under anesthesia that extracts sperm in men who have no sperm in their ejaculation.
• Hormonal drug therapy can help hormonal imbalances in a small percentage of men.
• Vasectomy reversal restores fertility by reconnecting the ends of the severed sperm duct to the epididymis where sperm matures. The procedure is usually performed under general anesthesia using microsurgery techniques.

Men can take charge of their overall medical and psychological health and adopt better lifestyle choices, a combination that may help improve infertility.

You will receive a thorough diagnostic examination and receive clinically-proven treatment by a board-certified urologist who specializes in male infertility. Male infertility factors can usually be corrected in an outpatient procedure using general anesthesia or intravenous sedation. While postoperative pain is often mild, postoperative recovery and follow up varies.

Brigham and Women’s Hospital practices a multidisciplinary approach to patient care, routinely collaborating with colleagues in other medical specialties. If your urologist discovers that an underlying illness has contributed to your infertility, you will be referred to an appropriate BWH physician for an evaluation.

Go to our online health library to learn more about urology diseases and tests.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.