Male Infertility –
Sperm Quantity
And Quality

Although only one sperm is needed for conception, millions are released during intercourse to increase the chance of pregnancy. A fertile male ejaculates at least 2 milliliters of semen with the right consistency to transport at least 40 million sperm toward the waiting egg(s). Of these, at least 50% should be moving vigorously through the liquid, 2% must be moving forward and at least 4% should have a normal shape – an elliptical head and tail to provide the thrust they need.

Poor sperm count and quality are indicators of male-related infertility. If a semen sample includes too many white blood cells, bacteria, sexually transmitted diseases or infection, any of these issues may contribute to the problem. Males exposed to DES (diethylstilbestrol), a synthetic hormone taken by pregnant women in the 1960s and 1970s, may have anatomical abnormalities and problems with sperm count, movement and shape.

Treatment Options For Low Sperm Motility, Poor Sperm Count Or Quality

• Medication – antibiotics may be prescribed to treat infection affecting sperm quality. Hormonal treatments such as clomiphene citrate, letrozole or aromatase inhibitors like Arimidex may be helpful. These should only be given under the supervision of a urologist or medical endocrinologist. Testosterone should NOT be taken as this can cause complete cessation of sperm production.
• Surgery – microsurgical epididymal sperm aspiration (MESA and TESA) are surgical techniques recommended when there are few or no sperm in the ejaculate as a result of vasectomy, congenital absence of the vas deferens or epididymis, prior failed surgery or epididymal scarring from infection. Tissue is collected from the testes and processed in the laboratory to remove healthy sperm for use with intracytoplasmic sperm injection (ICSI). Used with in vitro fertilization (IVF), ICSI involves injection of a single sperm into the core of an egg.