Fertility (infertility, subfertility)

Male fertility disorders (infertility, subfertility)
For 60% – 70% of cases of loss of male fertility, no cause can be identified (idiopathic infertility). For this reason, therapy is not always simple, and not always possible.

Causes may include:
  • Hormone disorders (malfunctioning of the thyroid gland, prolactinoma, disorders of the pituitary gland)
  • Earlier maldescended testicles (cryptorchidism)
  • Testicular varicose veins
  • Genetic factors
  • Earlier radiotherapy and/or chemotherapy for tumour disorders
  • Nicotine or alcohol abuse
  • Hormone abuse (e.g. doping or anabolic steroids)
Possible therapies and chances of improvement depend on the cause.

Where no improvement of sperm quality can be achieved, various forms of “assisted / artificial” fertilisation are possible.

Insemination: The man’s sperm is specially treated (e.g. by “swim-up” technique), and inserted into the partner’s womb at the optimal moment, as ascertained by observation of her hormone levels.

In vitro fertilisation (IVF): After hormonal stimulation of the woman, a brief intervention enables egg cells to be extracted from the ovaries. The cells are brought together with the man’s sperm outside the body (in vitro = in glass fertilisation). The resulting embryos are then transferred back into the woman’s womb.

Micro-injection (ICSI = intra-cytoplasmic sperm injection): Initial procedure as for IVF; followed, however, by micro-injection of the sperm cells directly into the extracted egg cells. In the event of successful fertilisation, embryo transfer to the woman’s womb.

TESE (Testicular sperm extraction): If no sperm cells can be identified in the male ejaculate (azoospermia), it may be possible for sperm cells to be obtained from the testes by surgical extraction of tissue, and for these cells to be used for ICSI.
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