Reproductive infertility is a relatively common condition. It is estimated that the chances of a fertile couple conceiving is 90% by one year. However, approximately 15% of couples are unable to do so. When infertile couples are evaluated, 20% are found to be caused by male factor alone, with an additional 30% to 40% of cases caused by both male and female factors. Therefore, a male factor is present in 50% of infertile couples. About 25% of infertile couples will conceive via intercourse without treatment.
The goals of evaluating the male are to identify or distinguish between: (1) reversible conditions that may be medically or surgically treated; (2) irreversible conditions that may be managed by assisted insemination or in-vitro fertilization using the male's own sperm; and (3) irreversible conditions that cannot be managed with the male's own sperm and require other alternatives such as donor sperm or adoption.
Evaluation of the infertile male requires obtaining a detailed past medical and surgical history, sexual history, female reproductive history, family history and a physical examination. Further evaluation includes laboratory test to rule out hormone imbalances and other medical conditions, ultrasound and xray studies, and of course, semen analyses.
There are many non-surgical conditions that are causative factors in male infertility. Hormone imbalances and endocrine abnormalities due to disorders of the hypothalamus pituitary gland, thyroid, and adrenal glands which usually do not require surgery and can respond to medical therapy. The diagnosis and treatment of genitourinary tract infections and inflammatory conditions can often times dramatically improve male fertility. Also, many drugs used to treat common medical problems can impair the proper formation and maturation of sperm. Identification and elimination or substitution of these drugs may increase a couple's chances of achieving pregnancy.
Many other services useful in diagnosing and treating male factor infertility are available in the office and Andrology Lab at Urological Associates of Dothan. Semen analyses are done to determine the concentration, motility, viability, and level of maturation of the sperm present in a patient's ejaculate.
Cryopreservation and sperm banking are performed in the office to provide semen for use during intrauterine insemination in the obstetrcians' offices and in-vitro fertilization at remote fertility centers. Cryopreservation and sperm banking is often critical in providing a reserve for man's perm prior to initiating chemotherapy, which can cause male infertility.
The Andrology Lab at Urological Associates also provides on site hormone profiling. Blood tests that evaluate the function of the testes, pituitary gland, hypothalamus, and thyroid are routinely performed.