Our andrology staff is highly experienced technicians and co-directed by Sergio Oehninger, MD, PhD, and Mahmood Morshedi, PhD, HCLD, internationally known experts in andrology. We employ the Kruger Strict Criteria approved by the World Health Organization when evaluating semen. The following characteristics are assessed:
- Semen volume – the amount of fluid that makes up the semen
- Sperm count – the number of sperm present in a standard volume. A normal sample contains more than 20 million sperm per millilitre.
- Motility – the percent of sperm moving when the semen is examined under the microscope. Normal is defined as >50% motile.
- Progression – the forward movement of sperm cells
- Viability – the percent of live sperm
- Sperm morphology or shape
- Additional semen contents, such as white blood cells, are an indication of infection. Less than five white blood cells per high power field are considered normal.
In moderate to severe male factor infertility, IVF using the partner’s sperm is the treatment of choice. Recent advances in assisted reproductive technologies, such as intracytoplasmic sperm injection (ICSI), enable men with moderate to severe male factor infertility to father a child.
In ICSI, a single sperm is injected into the egg. The sperm can be obtained from the ejaculate or areas of the male reproductive tract, such as the testes. It is possible for a man with no sperm in his ejaculate to father a child.
Sperm production requires 90 days; an analysis done today reflects the state of “sperm development” three months prior. Unfortunately, in most cases, no scientifically proven medication will significantly increase sperm quantity or quality unless there is a specific organ disease that can be treated. Medications, such as Clomid and FSH, have been tried, but they must be administered for at least three months and are very expensive. Even so, improvement in sperm count is marginal.
Intrauterine insemination (IUI) with specially prepared sperm is often effective in treating mild male infertility. In this procedure, the sperm are obtained by masturbation, then washed, concentrated, and placed in the female’s uterus via a small catheter.