We recognize that a successful pregnancy starts with both healthy eggs and sperm. When infertility issues are encountered and there is a male partner involved, it is critical that he be thoroughly assessed. Approximately 30 percent of all cases of infertility are the result of male factors, including the following:

Low or Absent Sperm Production
Without proper numbers of healthy sperm, the chance of fertilization is decreased.
Erectile Dysfunction
The inability to achieve an erection, and/or dissatisfaction with the size, rigidity, and/or duration of erections can be a barrier to conception.
Abnormal Sperm Function
Sperm must have proper motility and the ability to penetrate the egg.
Varicocele
This is a condition in which varicose veins develop around the testes. It is a very common cause of male factor infertility and is usually treatable and reversible with surgery.
Lifestyle
Use of recreational drugs (i.e., marijuana, cocaine), heavy alcohol use, cigarette smoking, certain medications, and excessive heat to the genital area (like hot tubs) can affect sperm quality and function.
Hormonal Disorders
Improper male hormone or endocrine function can affect sperm production and fertilization ability.
Chromosomal Defects
Certain chromosomal abnormalities are associated with male infertility.
Birth Defects
Abnormalities in a man’s reproductive system can occur during fetal development.
Immunological Problems
A man may have antisperm antibodies (immune or protective proteins), which attack and destroy sperm after a vasectomy.

A semen analysis evaluates characteristics of the semen and the sperm contained within it. The sperm is analyzed for count (how many are produced), motility (how well they “swim”), and morphology (their size and shape). Male partners may be asked to undergo a semen analysis as preliminary testing before infertility treatment is initiated. Sperm parameters can fluctuate, so additional semen analyses may be needed to confirm the initial assessment.

If our physicians discover that male factors are affecting one’s fertility, CWRC offers the following procedures:

Treatment Options

Intracytoplasmic sperm injection (ICSI)
Most problems involving male factor infertility can successfully be resolved by the use of ICSI. ICSI is used in conjunction with IVF and is a procedure in which the sperm is directly injected into the egg in a laboratory setting. The fertilized egg then remains in laboratory for one to five days, after which it is implanted into the woman’s uterus. ICSI can potentially eliminate barriers to fertilization such as low sperm count, less mobile sperm or a reproductive tract blockage.
Testicular Sperm Extraction or Aspiration (TESE/TESA)
Testicular sperm extraction (TESE) is the process of removing a small portion of tissue from the testicle in the hopes of extracting viable sperm cells for ICSI. With testicular sperm aspiration (TESA), the tissue and extracted sperm are aspirated from the testicle.  Performed under anesthesia and coordinated with a urologist,  the TESE or TESA process is recommended to men who are unable to produce sperm by ejaculation as a result of primary testicular failure, congenital absence of the vas deferens or non-reconstructed vasectomy. A diagnostic TESE or TESA may be performed prior to the IVF cycle to evaluate the number and quality of testicular sperm.
Further Evaluation
One of the many advantages of being the fertility practice of Columbia University Medical Center is the wealth of additional medical and interdisciplinary expertise available. This affords our patients the benefit of collaboration among top-notch specialists when necessary. For cases where a more comprehensive assessment of the male partner is needed, we are pleased to have urology services on-site for continuity of care. Dr. Peter Stahl, Director of Male Reproductive & Sexual Medicine, is available to see patients at multiple locations, including CWRC. For an appointment, please call (212) 305-8511. For more information about his practice, please visit his website.