Male factor

Infertility is not just a female problem. Between 30%-50% of all infertility is related to the male partner. Male factor infertility refers to issues involving the male partner which may hinder the ability of a couple to become pregnant. The good news is that there are several options available at AFREI for patients suffering from male factor infertility ranging from antioxidant therapy to Intrauterine Insemination (IUI), (a process where several million sperm are introduced into the female partner’s uterus) to Intracytoplasmic Sperm Injection (ICSI), (the injection of a single sperm into a partner’s egg) or testicular sperm extraction. Even in severe cases of male factor infertility most men can father their own genetic offspring. A patient who had completely immotile sperm was even able to have his own genetic offspring with the expertise of the staff at AFREI. Read the article from “The Journal of Assisted Reproduction and Genetics” here.

The first step in the evaluation for male factor infertility is a semen analysis. This will evaluate several factors which can contribute to infertility including sperm count, sperm motility, sperm appearance, and the presence of anti-sperm antibodies. Following the initial analysis other tests may be recommended which can include sperm function tests to see if the sperm are functioning properly; hormone tests to evaluate if a reduced sperm count is due to a hormone imbalance or a blockage; or genetic tests to look for deeper underlying issues.

Here’s a brief look at some of the many services we provide our male patients:

  • 24-hour motility testing
  • Anti-sperm antibody testing
  • Routine semen analysis
  • Semen washing for intrauterine insemination (IUI)
  • Sperm Banking for cryopreservation
  • TESE – testicular sperm extraction and sperm banking for cancer patients


TESE or testicular sperm extraction refers to a surgical procedure designed to extract sperm directly from the testes for use in an IVF cycle. TESE is most often performed in individuals with no sperm in their ejaculate due to poor sperm production. TESE is also performed in individuals with a blockage in the epididymis or vas deferen or in men who have had a vasectomy or failed vasectomy reversal.

TESE takes approximately 30 minutes to perform. It is performed under local, regional or general anesthesia. The patient can return to desk work as early as 1 day after surgery. However, strenuous physical activity may be limited for as much as a month (usually less).

Sperm retrieved from a TESE procedure are used in a procedure called ICSI or intracytoplasmic sperm injection. In this procedure, eggs from the female partner are retrieved on the morning of the TESE procedure. The sperm retrieved in TESE are then injected directly into the mature eggs within approximately six hours of retrieval.

This technique would also be applicable for patients with:

  • Congenital absence of the vas deferens
  • Previous infection with resultant occlusion of the epididymis
  • Ejaculatory dysfunction due to multiple sclerosis or diabetes