Childlessness due to physical problems in men

1. Poor sperm test

Many millions of motile sperm cells (semen analysis/spermiogram) are necessary for the successful fertilization of an oocyte. However, only a few of them will actually reach the fallopian tube. Within the fallopian tube the oocyte has to be surrounded by several hundreds of sperm cells for fertilization. Too few mobile sperms will result in a failure of fertilization.

It is rare that abnormalities in semen are only caused by hormonal imbalance, but more frequently by a defect in the testicles themselves, which are more difficult to treat. The diagnosis requires special tests.

You could try to increase the number and improve the quality of your sperm cells by taking vital substances and vitamins (e.g. Feritlovit M) or hormones.

The blockage of the vas deferens can be caused by genetic diseases (cystic fibrosis), inflammations, trauma from previous surgeries / sterilization (vasectomy) or injury.

In these cases enough sperm can be extracted from the testes by the TESA /TESE procedure. Our long-standing colleague, Dr. Pierre Vanderzwalmen, is one of the pioneers in this field. Among other findings, it is due to him that sperm retrieved directly from the testicles (first successful TESE in 1993) could be prepared in laboratory and subsequently used for fertilization.

Particularly when couples know that they are carriers of genetic disorders (e.g. down-syndrome, cystic fibrosis, thalassemia or a family history of cancer) or if they have already given birth to a child suffering from a genetically-caused disease (maybe by spontaneous mutation) or when they have suffered multiple miscarriages, or if there is a case of mental disability within the family or if the partners are blood relatives the pre-implantation genetic diagnosis may help, in many cases, to prevent the passing from parents to offspring.

Genetic diseases, such as cystic fibrosis, require techniques such as TESA / TESE to harvest sperm, because in patients diagnosed with cystic fibrosis the vas deferens are usually absent.

In these cases, it could be sensible to perform a preimplantation genetic diagnosis on the embryos. We will be glad to offer you advice!

Malignant diseases that have been treated by partially removing the testicles and subsequent chemotherapy / radiation may often cause sperm production to stop completely. Preventive sperm cryopreservation may help to subsequently realize the fertilization of egg cells.

The absence of spermatogenesis may occur spontaneously or can be due to genetic diseases. In that case, sperm donation should be considered. In certain cases, sperm can be found in the testes after prior biopsy (TESE). In some of these cases, it may be appropriate to perform a preimplantation genetic diagnosis on the embryos to prevent passing a genetic disease to a child.

Patients suffering from malignant diseases need individually adjusted therapeutic treatment, e.g. radical surgeries and/or chemotherapy, radiation etc.. All these treatments may lead to irreversible infertility in men, for they interfere with sperm production in the testes.

There are different procedures to preserve fertility such as cryopreservation of testicular tissue or sperm after ejaculation. If in the future you desire to father a child, your partner’s egg cells can be fertilized by means of the IVF/ICSI/IMSI procedure.

Our institute has been working for many years with the techniques of cryopreservation. Our long-standing colleague, Dr. Pierre Vanderzwalmen, is one of the pioneers in this field, too.