In about 10 to 15 percent of cases of male infertility involving no blockage and no sperm, genetic testing will reveal a missing sex chromosome. The condition is called “micro Y deletion,” for a missing piece of the Y—male—chromosome. A new technique that involves removing tiny pieces of testicle tissue containing minute amounts of sperm has made it possible for half of these men to overcome infertility and father a child.
Male Infertility Cause: Sperm Antibodies
In some cases, a man’s own body will produce antibodies that severely weaken his sperm, making it difficult for them to move and penetrate an egg. Identifying the reason for the antibodies helps determine which type of fertility treatment to pursue. If the doctor finds that an infection of the epididymis or prostate is responsible, antibiotic medication can often clear things up. If one of the reproductive ducts is damaged from an injury, surgical reconstruction might be able to correct the problem and restore fertility. And when it’s impossible to pinpoint the cause for the anti-sperm antibodies, steroid drugs can be used to stop the body from rejecting sperm.
Male Infertility Cause: Hormonal Irregularities
In some cases, infertility in men can be attributed to a lack of male hormones. Hypogonadism is a condition in which the testicles produce very little or no testosterone because the pituitary hormones that drive the testicles are missing. Without adequate levels of the hormone, a male can’t start puberty, which signals the onset of sperm production. Treatment for hypogonadism involves drug therapy to jumpstart testosterone production, including regular doses of medications such as human chorionic gonadotropin (hCG). It takes approximately six months to two years to complete the cycle of drug therapy and improve fertility.
When Infertility Can’t be Fixed
Kevin Garton, 40, of Vienna, Virginia, was born with a defect that left him with undescended testicles. He had surgery in the third grade to correct the condition. But by then it was too late and the damage to his genitals had left him unable to produce sperm. (When the defect is corrected within a year or so of birth, fertility is usually not seriously impaired.) “We chose to go down the anonymous sperm donor route,” says Garton, who’s now the proud father of three children, ages 8, 6 and 1. “For my wife and I it just became a natural, beautiful, and normal way to do things.” For more information on sperm donor banks, check out www.fertilityplus.org.
Recent advances in microsurgery mean that now many men like Kevin Garton can be helped to be fathers. “Using testicular sperm extraction with microdissection, we can find sperm in 60 percent of men with zero sperm counts and a history of undescended testes,” says Dr. Goldstein. “And with each ICSI and IVF try, 40 percent of these men can help their partners achieve a pregnancy.”
Thanks to genetic and hormone research, advancements in microsurgery, and new techniques such as ICSI , most men dealing with infertility today can ultimately be helped to become fathers.