Fertility Problems: Treatment for Males

To help improve sperm production, your provider may advise:

• Making lifestyle changes. Some healthy changes may help improve sperm production. You may be guided in healthy eating. You may need to quit smoking. And you may need to reduce your alcohol intake. It often takes time for sperm quality to improve. This is because it takes almost 3 months for sperm to mature.
• Correcting hormone problems. Medicines may be used to adjust hormone levels. They can help boost sperm production. They may be taken for several months, or until pregnancy happens.

You may need treatment for:

• An infection. An infection in the reproductive tract can cause inflammation or other problems that block the path of sperm. It's most often treated with antibiotic medicine.
• Retrograde ejaculation. This is a condition that causes semen to travel into the bladder. In some cases, this can be treated with medicine. If not, sperm can be recovered from the urine and used in a lab to fertilize an egg.

Some fertility problems may be treated with surgery. These include:

• Duct blockage. A blockage can prevent sperm from coming out in the semen. A blockage may be caused by scarring or infection. It may be caused by a previous surgery. Surgery can be done to fix the blockage.
• Varicoceles. These are enlarged veins. They can happen in the scrotum. They let blood pool around the testicles. This is not a serious health risk. But the pooling blood raises heat in the testicles. This may decrease sperm production. To fix the problem, the veins can be closed off with surgery. Other veins will then handle the blood flow. Treating varicoceles doesn’t guarantee better fertility.
• Vasectomy reversal. This is known as a vasovasostomy. It’s a surgery to reconnect the vas deferens. This lets sperm move from the testicles to the penis. The shorter the time between a vasectomy and the reversal, the better the results. But even when the surgery goes well, it's not a guarantee that fertility will be restored.

Some treatments are only used as part of assisted reproduction. This is when a pregnancy is created with the help of a lab. One example is in vitro fertilization (IVF). Ask your provider to learn more about ART if needed. These are the most common procedures:

Sperm washing. This is a method for concentrating sperm. First, a semen sample is collected. Active sperm are then carefully separated from the semen in a lab. The concentrated sperm can then be used to fertilize an egg.

Sperm retrieval. This is done when there are no sperm in the semen. This can be due to blockages or other problems. There are several methods for retrieving sperm:

• MESA. This is microepididymal sperm aspiration. It’s done by making an incision in the scrotum to retrieve sperm from the epididymis.
• TESE. This is testicular sperm extraction. It’s done by removing a small amount of tissue from the testicles to retrieve sperm.
• PESA. This is percutaneous epididymal sperm aspiration. It uses a needle to retrieve sperm from the epididymis.

Talk with your healthcare provider to learn which options may work best for you. They will tell you what to expect for your situation.