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Male Infertility Treatments

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A vast majority of the talk surrounding infertility surrounds female treatments. Male factor infertility does indeed play a role in a significant number of the cases I see. Thankfully, with today’s reproductive medicine, even men with the most severe infertility cases (i.e., men who have undergone chemotherapy and have scant amounts of sperm), can have biological children thanks to techniques such as IVF-ICSI with either Microsurgical Epididymal Sperm Aspiration (MESA) or Testicular Sperm Extraction (TESE). (Be advised that these procedures may also be utilized in instances where a man has undergone a vasectomy.)

With a MESA procedure, under local anesthesia and general sedation, an incision is made in the scrotum, exposing the epididymus, the tubules immediately adjacent to the testicles that collect the sperm. Using an operating microscope, an incision is made into these tubules and sperm is aspirated. Although millions of motile sperm can often be collected, this sperm has not acquired the ability to penetrate an egg and must be injected into eggs via the IVF-ICSI technique. The advantage of MESA over TESE for men with obstructive azoospermia is that sperm collected in this manner can usually be frozen, and even if his partner has to undergo more than one IVF procedure, the MESA should provide adequate sperm for all subsequent IVF procedures.
A TESE or testicular sperm extraction is a procedure that involves directly aspirating the sperm from the testes or obtaining sperm from a testicular biopsy. It is usually performed under local anesthesia block and can be done as an office surgical procedure. The disadvantage is that in many cases, testicular sperm is much more scarce and therefore difficult to freeze. Usually, there is only enough sperm recovered for one IVF case and if further IVF attempts are needed, the TESE procedure needs to be repeated.


ICSI or intracytoplasmic sperm injection is a new procedure that allows couples with sperm problems to have IVF treatment. Developed in Belgium in 1992, ICSI is the process of injecting a single sperm into an egg. It is a remarkable procedure since it allows men with only very few sperm to have a chance of having their own children.

If you or someone you know has questions about these male factor infertility treatments or wants to know the way of getting started with them, please drop me a line. I’d love to hear from you!
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About the Author

Dr. Herbert is a fertility expert and an innovator in the field.

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