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Male Factor Infertility

What Causes Male Factor Infertility?

Testing for male factor infertility is often the first step for many patients who suspect that they are infertile. Male factor infertility can be caused by several factors, such as low sperm production, sperm that have a low rate of motility (movement), low percentage of normally shaped sperm, and even potential blockages that prevent the sperm from being properly ejaculated. GIVF Fertility offers semen analysis and specialized sperm function testing to establish the health of the sperm and semen.

If the patient does have male factor infertility, the GIVF Fertility specialists will work closely with our patients to provide a variety of options to help them achieve their goal of parenthood, including intrauterine insemination (IUI), or intracytoplasmic sperm injection (ICSI), non-surgical sperm aspiration (NSA), collaborating with urologists for sperm retrievals, and use of donor sperm through our in-house sperm bank, Fairfax Cryobank.

Why GIVF Fertility for ICSI?

GIVF Fertility achieved the first ICSI pregnancy in the United States, and since then, the procedure has become the standard of care for male factor infertility. The American Society for Reproductive Medicine considers it a safe, effective procedure that has helped thousands of patients becomes parents.

What Is Intracytoplasmic Sperm Injection (ICSI)?

Intracytoplasmic sperm injection is the direct injection of sperm into eggs obtained for in vitro fertilization (IVF). ICSI frequently permits the establishment of pregnancy in even the most difficult types of male infertility, including patients who have fewer than 100 sperm in a semen sample. For patients with no sperm at all in their semen, sperm can be obtained directly from the testis with non-surgical sperm aspiration at our office or a sperm retrieval procedure by a urologist. Testicular sperm can be used for fertilization by utilizing ICSI to directly inject the sperm into the eggs.

What Is the ICSI Process?

There are four steps in the ICSI process. A glass pipette holds the egg in place during the injection, and then a single sperm is picked up in a micro-needle. The needle is then gently pushed through the shell of the egg into the cytoplasm. The ICSI process is complete when the sperm is deposited deep inside the egg and the needle is withdrawn.

The difference between IVF and ICSI is in how the sperm meets the egg. With traditional/conventional IVF, the sperm is put into the petri dish that the eggs are in and fertilization takes place in the dish the same way it would in the fallopian tubes. Millions of sperm compete to fertilize each egg. With ICSI, an individual sperm is injected into a single egg.

When Should I Consider Intracytoplasmic Sperm Injection?

ICSI is used when there is a medical concern about the sperm. The likelihood of fertilization is maximized if sperm is injected directly into the egg. ICSI does not guarantee that fertilization takes place, but it does ensure that sperm meets egg. Your doctor will advise you if ICSI is recommended for you based on the results of your semen testing and other medical factors.

What Is Non-Surgical Sperm Aspiration (NSA)?

Non-surgical sperm aspiration (NSA) at GIVF Fertility is a quick, office-based procedure performed in our clinic under sedation. A tiny needle is used to extract sperm directly from the testis. While the ejaculate normally contains 100 to 300 million sperm, with NSA, as few as 100-200 sperm by NSA has been enough to achieve pregnancy when combined with ICSI.

Who Should Consider Non-Surgical Sperm Aspiration?

NSA may be recommended for patients who:

  • Have had vasectomies and later decide that they want to have children.
  • Have no sperm in their semen due to blocked ducts (other than vasectomy).
  • Have difficulty ejaculating (due to a variety of reasons, including medical causes such as spinal cord injury).

While it is possible to reverse a vasectomy by having bypass surgery, the operation is frequently unsuccessful. Additionally, sperm quality after vasectomy reversal is often reduced, and ICSI is required even if sperm appear in the ejaculate. For many men, NSA eliminates the need for vasectomy reversal surgery.

Your GIVF Fertility reproductive endocrinologist will discuss with you all options for obtaining sperm, including seeing a urologist who could perform other sperm extraction procedures.

Non-surgical aspiration does not require hospitalization, and recovery takes only days. If you are interested in NSA or other fertility options, contact us to schedule a consultation.

When Should I Consider Using Donor Sperm?

For patients experiencing male factor infertility, access to third-party reproductive services such as donor sperm can greatly improve their chances of becoming parents. If the patient and their reproductive endocrinologist decide that ICSI and sperm aspiration are not the best choice for them, donor sperm is often an appropriate option.

Thousands of parents from around the world have benefitted from frozen donor sperm made possible by advances in cryopreservation, thorough donor screenings, and knowledgeable embryologists. GIVF Fertility offers patients the benefits of our in-house donor sperm bank, Fairfax Cryobank, which is one of the largest and most trusted sperm banks in the world.

If you are interested in viewing potential sperm donors, visit the Fairfax Cryobank donor search directory for hundreds of healthy, FDA-approved donors to best match your family.

If you or someone you know, is interested in becoming a sperm donor fill out the application on

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