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Causes of Infertility
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Male Infertility and Sperm Problems
- About 25% of all infertility is caused by a sperm defect and 40-50% of infertility cases have a sperm defect as the main cause, or a contributing cause.
- It can be hard to know whether the sperm problem is the only cause, or just a contributing cause to the fertility problem.
- Part of the problem is that numbers are just numbers. We know that men with low sperm counts can sometimes have children - and some men with normal sperm counts can be infertile.
- If the sperm count or motility is extremely low, we usually assume this is the cause of the fertility issue. If the count or the motility is slightly low, it could be a contributing factor, but the sperm might not be the only fertility issue in the couple. There would often be female fertility problems also.
- What matters is not really how many sperm there are, or how fast the sperm swim - but whether they can fertilize the female partner's eggs. This is really a biochemical issue working at the molecular level. Looking at the little swimmers under the microscope is not necessarily an accurate way to assess their ability to fertilize eggs.
- However, a semen analysis is still the best test that we have to assess male fertility at this time.
ICSI procedure, intracytoplasmic sperm injection is used for many sperm issues
- ICSI needle is inside egg, sperm is being injected in to the egg
- Holding pipette at far left is holding egg steady
- IVF with ICSI is very effective for male infertility - if we have some motile sperm
Pictures showing the ICSI procedure for male infertility