Fertility treatments - Evaluations and testing

Urological Exam
This physical exam is instrumental in identifying a wide variety of fertility problems. The urologist starts by assessing the size of the testicles and examines the scrotum and the rectum to evaluate the prostate and seminal vesicles.

The Spermogram
First and foremost, this exam requires that a sperm sample be obtained through masturbation. The spermogram is a basic test used to examine the quality of sperm contained in the ejaculate as well as its consistency. It is also used to determine the number of sperm (count), the proportion of moving sperm (motility), their ability to move forwards (progression) and the number of abnormal sperm (morphology). This examination is performed at the beginning of the fertility treatment during the general work-up.

Hormone Levels
Hormones are complex chemical substances synthesized by an endocrine gland and that circulate in the body's fluids. They trigger or control organs or groups of cells located elsewhere in the body.

FSH or Follicle-Stimulating Hormone is a hormone that stimulates the development and maturation of Graafian follicles in a woman's ovaries and spermatogenesis in men.

Testosterone is a hormone that stimulates the development of male sex characteristics.

Testicular Biopsy
This examination consists of taking a sample, under local anesthesia, of a small fragment of the testicle. The cells from this small fragment are then examined under a microscope.


The various causes of male infertility
The causes of male infertility are numerous and are not always easy to identify. In some cases, infertility can stem from an obstruction in the male genital tract or from a lesion. In other cases, it may be due to low sperm count, poor sperm motility or abnormal shape.

Azoospermia
Azoospermia is defined by the absence of sperm in the ejaculate.

Oligo-astheno-teratospermia (OATS)
OATS is defined as sperm of low concentration, reduced motility and abnormal morphology. This is not a sterility problem but rather a decline in fertility.

Unexplained Infertility
Some couples go through all the recommended fertility examinations and yet, physicians are not able to diagnose the cause or causes of their infertility.


Treatment options and possible solutions

Medical Treatment

Antibiotics to treat an urogenital tract;

Hormones in cases where the testicle is not receiving enough stimulation from the pituitary hormones.

Surgical Correction and Proposed Solutions through Medically Assisted Procreation

Surgical procedure to correct excretory azoospermia. The testicle produces sperm, which is not excreted because of an obstruction somewhere along the path.

Surgical intervention can be attempted so as to cut away the obstructed area and restore continuity between both segments.

Intracytoplasmic Sperm Injection (ICSI): This treatment is only administered to those undergoing in vitro fertilization (IVF). It is indicated in cases of severe male infertility in conditions where abnormal sperm movement and low sperm count make it impossible for sperm to penetrate the egg. Using a sample of the spouse's sperm, the embryologist injects a single sperm captured using a glass needle with a microscopic diameter into each of his partner's eggs. For further information, go to the section "Fertility Treatments".

Percutaneous Epididymal Sperm Aspiration (PESA): This treatment is only administered to those undergoing in vitro fertilization (IVF). Done under local anesthesia, this operation is performed when there is an obstruction of the vas deferens. The procedure most often consists of passing a small needle directly into the epididymis. Making a small incision in the epididymis is sometimes necessary. Sperm is then retrieved and the healthiest ones are used for IVFmicroinjection. For further information, go to "Fertility Treatments" from the Main Menu.

Testicular Sperm Aspiration (TESE): This treatment is only administered to those undergoing in vitro fertilization (IVF) with ICSI. The procedure, performed under local anesthesia, consists of taking a sperm sample directly from the testicles using a very small needle. This technique is used in cases where there is a complete absence of sperm in the ejaculate or epididymis and the testicles still produce sperm. For further information, go to the section "Fertility Treatments".

Insemination with the spouse's sperm (AIS). Go to the section "Fertility Treatments".

Insemination with donor sperm (AID). Go to the section "Fertility Treatments".

In vitro fertilization with the spouse's sperm. Go to the section"Fertility Treatments".

In vitro fertilization through intracytoplasmic sperm injection. Go to the section "Fertility Treatments".

In vitro fertilization using donor sperm. Go to "Fertility Treatments" from the Main Menu.