The Complete Guide to Infertility: From Diagnosis to IVF Success – ARC Summit

In evaluating infertility, it’s essential to consider both partners. For the male, about 30% of infertility cases can be attributed to male factors alone, and roughly 17% involve contributions from both partners. A critical step in male infertility evaluation is semen analysis. We generally ask men to abstain from ejaculation for 2 to 3 days before providing a sample by masturbation. While longer abstinence might increase the volume of semen, it can also result in a higher proportion of non-motile sperm. Ideally, the sample should be fresh but not too recent to get an accurate snapshot of sperm health.

For a man making an appointment, we recommend timing ejaculation appropriately before the visit to optimize the sample’s quality. For instance, if he is scheduled for a Friday, ejaculating on Sunday and Tuesday before the visit is ideal. This routine ensures the semen sample is neither too fresh nor too stale, providing a good representation of sperm health.

In addition, we consider any history of testicular trauma or conditions that might influence sperm health, such as the presence of sperm antibodies. Often, if the initial semen analysis shows abnormalities, we recommend repeating the test after about three months. Sperm production cycles approximately every 75 days, so a second test might reveal whether the initial abnormality was an anomaly or a consistent issue.

In terms of treatment, for men with low sperm counts, we might suggest intrauterine insemination (IUI). During this procedure, a concentrated amount of sperm is placed directly into the uterus, bypassing the cervical environment that could hinder sperm from reaching the egg naturally. This method can significantly enhance the chances of conception, especially when combined with controlled ovarian hyperstimulation, which increases the number of available eggs.

For more severe cases, such as extremely low sperm counts, intracytoplasmic sperm injection (ICSI) is considered. ICSI involves injecting a single sperm directly into an egg, which can be particularly effective when conventional fertilization is unlikely. Once fertilization occurs, the embryo develops and is monitored until it is ready to be transferred to the uterus.

Understanding and addressing both partners’ health is crucial in the comprehensive assessment and treatment of infertility, ensuring that all factors contributing to fertility challenges are appropriately managed.