TREATMENT

Can male infertility be treated?

The results of medical tests help doctors decide whether the male infertility problem can be treated.

• Treatable conditions
  One in eight infertile men have a treatable condition that can be overcome, so that couples can become pregnant naturally.
• Untreatable subfertility
  Three quarters of infertile men have sperm present in the semen, but lower numbers than normal.  The problem causing the poor production or function of their sperm cannot be cured.  These men are often defined as subfertile as pregnancies may happen but at lower rates than usual.  On average, more months of trying are needed for conception to happen, but it still may never happen.  Assisted reproduction or in vitro fertilisation (IVF) can help some of these men to become fathers.
• Untreatable male sterility
  About one in nine infertile men have no sperm in their semen or in their testis and cannot be treated.  Sperm producing cells in the testes either did not develop or have been irreversibly destroyed.  Adoption or donor insemination are the only possibilities for couples in this group who wish to have a family.

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How is the best treatment decided?

By reviewing all the results of physical examinations and the laboratory tests, a doctor can usually work out if difficulties in becoming pregnant are due to a problem with the male partner and if the condition is treatable.  Possible treatments may then be explained.

Doctors will also discuss the chances of becoming pregnant naturally, when certain male infertility problems exist.  Many subfertile men, whose sperm production is poor or low, can father children naturally.

As for any medical intervention, there may be risks associated with the type of treatment. It is important to discuss the risks of treatment with your doctor when discussing your treatment options to make the best decision as to your treatment.

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Deciding on the right treatment

Your doctor should give you an indication of the likelihood of you and your partner achieving a pregnancy without medical intervention and then should provide you with an indication of the likely success of the treatment that is being suggested. 
 
It is important to realize that you and your partner have the final decision.

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What causes of male infertility can be treated?

In some cases, the cause of the male infertility problem can be treated and a couple can try and achieve a pregnancy naturally.  Treatable causes of male infertility include:

• Hormone problems;
• Blockages of sperm transport
  for example, vasectomy;
• Sperm antibodies;
• Some sexual problems
  for example, problems with getting and maintaining an erection;
• Some reversible conditions
  for example, use of anabolic steroids.

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When is male infertility completely untreatable?

About one in nine infertile men have no sperm in their semen (azoospermia) or in the testes, because the sperm producing cells in the testes either did not develop or have been permanently destroyed.  It may be caused by chromosomal or genetic disorders, inflammation of the testes or certain drugs.  It may also be due to failure of the testes to descend into the scrotum during childhood (undescended testes).

The only options for such couples who want to have a family is to consider adoption or donor insemination.

More information: Having a Family

Some men with failure of sperm production do not produce normal amounts of the male sex hormone, testosterone, and their general health and sexual performance is improved through testosterone replacement therapy.

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Can natural therapies improve sperm production?

There have been many natural products marketed to improve unexplained sperm production problems, such as vitamin and zinc supplements, antibiotics (even when no infection is present), hormone injections and various other natural tonics.  At this stage, there is no medical evidence that such treatments improve the chance of having a child but equally they are unlikely to do any harm.

Men should talk with their doctor when thinking about taking natural products to help improve their sperm production problem.

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When is assisted reproduction (such as IVF) an option?

In some cases, doctors recommend that couples seek assisted reproductive technologies (such as IVF) to become pregnant.  It is important to realise that with all medical treatments, including IVF, there are some risks.  Even when the fertility problem relates only to the man, IVF procedures place the female partner at risk of side-effects and complications.  Deciding on treatment needs careful thought and discussion with the doctor.

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