Fertility

Treating Severe Cases of Male Infertility


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Summary & Participants

In rare cases of male infertility, a man may be unable to produce or ejaculate any sperm at all. Though this state of affairs may seem bleak, many techniques can be performed to help a couple to have a child of their own. Our panel of experts will discuss the most up-to-date strategies.

Medically Reviewed On: July 21, 2012

Webcast Transcript


MARK POCHAPIN, MD: Hi. Welcome to our show. We're going to talk about infertility. In fact, infertility is a very common problem affecting up to 15% of couples. In women approaching the age of 40 and above, about 25% can have a problem with infertility.

We're going to focus specifically on male infertility problems, known as the male factor infertility. We're going to focus on very severe male infertility, in essence, a zero sperm count.

With me today are two experts in the field. Sitting to my left is Dr. Steven Hirschberg. Dr. Hirschberg is currently the Director of Male Infertility at the Toll Center for Reproductive Sciences and Abington Medical Hospital in Abington, Pennsylvania. He is the male reproductive urologist at the two largest in vitro fertilization programs in the Philadelphia area and works hand-in-hand with 10 reproductive endocrinologists. Welcome.

Sitting next to him is Dr. Lawrence Grunfeld. He's a Clinical Association Professor of Obstetrics and Gynecology at the Mount Sinai School of Medicine in New York, and is associated with the Institute for Reproductive Medicine and Sciences at St. Barnabas in Livingston, New Jersey. He is also a specialist in reproductive endocrinology. Welcome.

When we talk about severe male factor infertility, or in essence, zero sperm count, Larry, what does that mean, and what can be done about that?

LAWRENCE GRUNFELD, MD: It's always a shock for the couple because there is no way that the couple can sense that there is a zero sperm count. Typically, when there is a zero sperm count, the man has a normal sensation for ejaculation. I think it's important here to have the couple understand that there are two components to the semen. There is a liquid component, which they can sense, and then there is the microscopic component which is made in the testicles, which they would have no way of knowing about. So these couples have no way of knowing there is a problem, but when we evaluate the sperm under the microscope, we see normal fluid, but no sperm inside the fluid.

The other subcategory is the dry ejaculate. Sometimes couples present and the husband knows that there is no fluid coming out in the ejaculation. That's a more obvious problem to the couple.

In either one of those cases, the guy has to be sent directly to a urologist with a speciality in male fertility such as Steve.

MARK POCHAPIN, MD: So what happens now? The man comes to you Steve. What can be done?

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