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What Is The Cause And Treatment For Male Factor Infertility?

Posted on Sat, 6 Dec 2014

Question: Hello Doctor,
My question is regarding severe male factor infertility.
I was diagnosed with Major depression in the year 2012 and i was on medication called Pristiq for around 6 months.
I had erection problems after i stopped the medication and by november 2013 full sexual function including libido etc came back.
We are trying to conceive for the past 9 months,i had gone for semen analysis and while everything like sperm count,color,viscosity,PH etc was in normal range but the motility and morphology were worst.

Count:Around 45 million
Motility:0%
Morphology:1%
Head defects:66%
neck:11%
Tail defects:12%
Round cells:2.3 hpf

I was referred to a Urologist who did physical and hormonal testing and then referred to an IVF specialist.
The RE has said we need to go for IVF+ICSI and its very expensive
My question is,with 0% motility will ICSI still fertilize?
Also what is the cause of zero motility?
Is Round cells normal in semen?
My wife's age is 26 and all her tests and US came out normal.

Answered by Dr. Mahesh Koregol (55 minutes later)

Brief Answer:
Semen analysis

Detailed Answer:
Hi

I read your query and I understand your concerns.

Following is my reply

1. The poor motility and morphology can be due to various reasons but the precise reason cannot be diagnosed.

2. The best solution for this is ICSI by choosing the best available sperm among majority defective sperms.

3. Such a severe morphological alterations are difficult to treat.

4. If finances are problem for ICSI you can opt for choosing donor semen IUI for your wife from the IVF centre.

5. The donor semen IUI is cheap and alternative option for you.

6. Round cells are not normal in semen.

7. Even if 0% motility ICSI can be successfully done. But morphology is concern

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mahesh Koregol (10 minutes later)

Dr XXXXXXX

I Appreciate your Quick Response,
Unfortunately Donor Sperm is not an option for us.

What could be done to treat the round cells?
The urologist and PCP never picked this from the report,i happened to read it yesterday and normal range was 0-2,i thought 2.3 was not a big deal.
Also i thought even a infection cannot cause such bad quality semen.

Its good to know that 0% motility is not a concern in ICSI.
I was told the same by the Reproductive endocrinologist,but it is good to hear from you as well.

If we plan to to do IVF in february 2015,what can i do in the next 3 months to improve my morphology from 1% to 4%.

I read about Acupuncture online,is it worth it?,

i had also taken fertilaid for 1 full month and we still didnt get the BFP,so i thought vitamins are useless.

Also my annual comprehensive metabolic panel was perfect.

Answered by Dr. Mahesh Koregol (1 hour later)

Brief Answer:
Morphology

Detailed Answer:
Hi,

The morphological anormalities ( Like round cells) are difficult to treat. It has to improve by itself as no medicines can do it.

I doubt the accupuncture may not be best option.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mahesh Koregol (13 minutes later)

One last question,

I forgot to mention sperm viability was 50%.

After seeing my stats and my wife's age,do you think ivf/icsi is worth a shot.
I live close to XXXXXXX and the RE is positive.

However since IVF is not covered by insurance,i felt the IVF centre was pushing it too fast,even though that seems to be the only option.

Answered by Dr. Mahesh Koregol (5 minutes later)

Brief Answer: XXXXXXX

Detailed Answer:
Hi,

Sperm viability is fine.

Seeing your reports ICSI is best option.

If you wish cheaper treatment, you can opt for coming to XXXXXXX We can do it at cheaper cost.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar