Session 1: Primary investigation of the infertile couple

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2. Male infertility evaluation and worries !

Male infertility can primarily be classified as obstructive and non-obstructive infertility. More infrequent are retrograde ejaculation, sexual dysfunction, and congenital abnormalities. Obstructive disorders which are caused by a former vasectomy must be attempted re-anastomosed prior to other treatment. Non-obstructive disorders are often detected because of impaired sperm quality from a slightly reduced sperm count and morphology to no sperm cells at all in the ejaculate. Patients who lack spermatic cords or have less than 1 mill. sperm cells per ml in the ejaculate must be evaluated genetically prior to treatment where own sperm cells will be used. Therefore these flow-charts.

Patients with male infertility are treated after flow-chart: Click here

Treatment of severe male infertility in an IVF clinic: Click here

Genetics and cancer risks at male infertility:

The below stated guidelines are due to the fact that many men with a severely reduced sperm count have micro-deletions on the Y-chromosome or chromosome aberrations. Furthermore, these men have a considerable risk of developing testicle cancer, as compared to normospermatic men. It is today possible to evaluate for this diagnosis by ultrasound scan of the testes, as this will disclose a possible preliminary stage of carcinoma in situ. Men with cystic fibrosis deletions might also have a congenital absent vas deferens (CAVD) as the only symptom, whereas their children can get the disease. Now, where it is possible via ICSI (Intra Cytoplasmatic Sperm Injection) to treat almost all men with reduced or lacking spermatogenesis, there are great worries about the increased genetic risk these parents expose their offspring to. Therefore this genetic evaluation of the man.

Genetic evaluation program for all men referred for ICSI due to oligozoospermia: Click here

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