The number one reason for male factor infertility isn't due to the blockage of a passageway - rather, it is low sperm count and motility. IUI is offered to couples where there are small variations in the seminal parameters. When there are severe abnormalities, IVF and ICSI may be considered reasonable alternatives.

TDI is the treatment of infertile couples with male factor infertility issues and the use of donor sperm for artificial insemination.

Varicocele repair is not always necessary. The semen analysis of men with a varicocele may show any or all of the following: an increased number of abnormally shaped sperm; decreased motility; or, a decrease in sperm concentration.

Varicoceles that are only detected using special tests such as ultrasound, doppler studies, and venograms have been proven to result in increased pregnancy rates. There may be slight improvement of sperm morphology (a better count and motility) following a varicocele repair. A lack of research in this area means it is unclear whether having a varicocele repair, even with improved sperm morphology actually improves pregnancy rates.

Sperm Morphology
Sperm Count - number of sperm per cc
Motility - percentage of sperm moving
Sperm Morphology - sperm shape and form

Treatment of a varicocele is focused on tying off or blocking the varicose veins, and includes three options depending on the individual situation:

Open Surgical Approach
Laparoscopic Method
Percutaneous Technique

Open Surgical Approach

• Requires general anaesthetic and a few days off work
• 1 small incision about 3-cm long is made in the lower part of the abdomen
• Varicocele is located
• Veins are carefully separated from tissues and tied

Laparoscopic Method

• Requires general anaesthetic and a few days off work
• 3 small incisions 1-2 cm long each are made in the abdomen
• A laparoscope is passed through one incision for viewing
• Varicocele is located and veins are carefully separated from tissues and tied

Percutaneous Technique

• Requires light sedation, local anaesthesia
• Most men are back to work the day after this procedure
• A small tube is placed through the skin into a large vein in the neck or groin
• The tube is passed through the system of veins to those located around the testicles
• A coil (stainless steel) is released to completely block the enlarged veins from the inside

Some men have an improved semen analysis within 6 to 12 months of repair, and the opportunity to conceive may be increased.

Vasectomy is the leading cause of sperm obstruction. With the use of modern microsurgery; accurate reversal can be achieved in many cases.

This is a microsurgical procedure that can be used to bypass a particular type of block in the epididymis and is successful in up to 60% of cases.

MESA or TESE is used to retrieve sperm cells from the epididymis or from a biopsy of testicular tissue. A single ejaculation of semen may result in only a few hundred sperm that are actually capable reaching a released egg in the fallopian tube. For men who are unable to ejaculate or who produce no sperm at all due to a blockage or testicular disorder, or for those who have had an irreversible vasectomy, MESA or TESE in combination with ICSI makes fertilization possible with just one sperm for one oocyte.