Approximately 40% percent of all infertility (the inability to initiate a pregnancy after one year of unprotected intercourse) is caused by a male factor.
It is the sole cause of infertility in about 20-25% of infertile couples, and in about another 20% of couples, male factor contributes to diminished fertility. Male infertility has many causes, which may be classified into three groups: (a) pre-testicular, (b) testicular, and (c) post-testicular. Examples of these include:
- endocrine disorders
- deficient sperm production
- injury to the testicle
- undescended testes on one or both sides
- childhood german measles infection
- blockage of the sperm delivery routes
- anti-sperm antibodies and varicose veins around the testicle (varicocele)
Sperm Retrieval Procedures
Dr Pasquale Patrizio, MD, MBE, HCLD, a leader in both male and female infertility.
The Yale Fertility Center is one of very few centers in the country that has a Reproductive Specialist with dual training in both male and female infertility. Dr Pasquale Patrizio has over 20 years of experience in male and female infertility. Dr Patrizio was also the co-pioneer of several sperm retrieval procedures and performs PESA’s and TESE’s in our office. At most fertility centers, sperm retrievals must be timed and coordinated with an off-site urologist to perform the procedure. At Yale, we are not forced to fragment our patient’s care and are able to treat couples with male factor infertility as a whole.
Percutaneous Epididymal Sperm Aspiration (PESA) is a procedure to harvest sperm from the Epididymis and use them for ICSI (Intra Cytoplasmic Sperm Injection). Procedures are performed at our New Haven office under conscious sedation. Candidates for PESA are men with:
- Congenital absence of the Vas deferens (common in men with Cystic Fibrosis)
- Failed Vasectomy Reversal Inflammatory obstruction of the Vas Deferens due to infections
- Ejaculatory duct obstruction
- History of retroperitoneal lymph node dissection for prostate cancer
Testicular Sperm Extraction is a procedure where a small incision is made and testicular tissue is biopsied for the presence of sperm. Embryologists thoroughly search the tissue for viable sperm to be used for ICSI. Procedures are performed at our New Haven office under conscious sedation. Candidates for TESE are:
- Men with no sperm in the ejaculate (azoospermia) and with blockage of ejaculate (idiopathic, spinal cord injuries, post chemotherapy, Klinefelter’s)
- Men with a failed PESA