Male Infertility

Male infertility can often be the cause of a couple's inability to conceive. The Emory Reproductive Center includes a complete evaluation of both the male and female as an initial part of the infertility investigation process. Akanksha Mehta, MD, from Emory’s Department of Urology, is available to see male patients concerned with fertility issues in the Emory Reproductive Center.

Male infertility can be caused by hereditary factors, by injury or even by stress. An evaluation of the man's medical history is critical to achieving a better understanding. Semen analysis has been a proven method of testing for male infertility for many years and is also part of the evaluation.

The semen analysis, along with other lab tests including blood work, can uncover the underlying reasons for male infertility. Emory offers the latest, innovative treatments to address male infertility problems, some of which are described below.

Male Infertility Conditions

The complete absence of sperm in the ejaculate is called azoospermia. Azoospermia can be the result of a physical obstruction or abnormal development of the ducts leading from the testicles to the urethra. There are two basic forms of azoospermia.

  • Obstructive Azoospermia: Generally, there is a normal level of sperm production in the testis but the sperm cannot be transported to the urethra at the time of ejaculation.
  • Non-obstructive Azoospermia: This occurs when the dysfunction in the testis leads to such a low level of sperm production that no sperm appear in the ejaculate. Patients with this condition are evaluated by an urologist to determine the cause.

Treatment for Azoospermia

  • Epididymal Sperm Aspiration: Used in cases of obstructive azoospermia in which there is a normal level of sperm production in the testicle. Recovery of sperm from the epididymus can be performed by percutaneous aspiration or by micro-surgical aspiration.
  • Percutaneous Aspiration: Performed by inserting a small gauge needle under the skin of the scrotum and into the epididymus. This is performed with a local anesthetic to minimize discomfort. There are little or no after effects and no special recovery is required.
  • Microsurgical Sperm Aspiration: Performed under general anesthesia. The epididymus is surgically exposed and individual tubules of the epididymus are opened to recover sperm and then sutured closed. This is performed in an attempt to maintain the integrity of the epididymus in case the patient may wish have the obstruction surgically corrected. Microsurgical sperm aspiration is sometimes in conjunction with vasectomy reversal, as a back up in case the reversal is not successful.
  • Testicular Sperm Aspiration: Sperm is obtained by removal of a small sample of testicular tissue. This is typically performed in an exam room and requires only local anesthetic. The tissue is transported to the IVF laboratory where it is mechanically disrupted to release sperm from the tissue. This allows the sperm recovery to be performed at the patient's convenience. The Emory Reproductive Center works in collaboration with a number of area urologists to provide sperm extraction and freezing services as well as the use of epididymal or testicular sperm in IVF cases.
  • Therapeutic Donor Insemination: Insemination using donor sperm is a common and effective treatment for overcoming male infertility. Emory can help you chose a commercial sperm bank and provide short term storage of your donor specimen. Patients who wish to explore this option should schedule a new patient consultation appointment with one of our physicians.

Attend a free fertility seminar.