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Male Infertility

Reviewed by Joseph Alukal, M.D.

Sometimes overlooked, the male factors leading to infertility should always be investigated when a couple is having difficulty conceiving. NYU Urology Associates offers a personalized approach to the treatment of male infertility. Because no single approach works for everyone, we will work closely with you and your partner to determine the underlying causes of the infertility and to decide upon the most appropriate course of treatment. Our doctors incorporate the latest medical research in their clinical and surgical management of infertility.

More information on male infertility

Causes

The causes of male infertility can be divided into two categories: obstructive and nonobstructive. In obstructive infertility, sperm are physically blocked from exiting the urethra during ejaculation. This may be caused by inherited genetic conditions (such as cystic fibrosis), or by mechanical conditions such as an inflamed epididymis or an obstruction at the level of the prostate. In nonobstructive infertility, the exit of sperm from the body is not blocked, but the seminal fluid leaving the man’s body is not able to fertilize an egg for other reasons. This may be due to a vascular condition such as varicocele (varicose veins in the testicle), a hormonal abnormality or a genetic condition, or it may be the result of a past infection or injury to the testicles.

Diagnosis and treatment

In addition to asking about your medical history and performing a physical exam, we incorporate the following tests to learn more about the causes of each patient’s infertility:

  • Semen analysis. An analysis of the volume, sperm count, sperm motility, sperm shape and other characteristics of a semen sample can provide insight into the causes of infertility.
  • A trans-rectal ultrasound can be used to identify any obstruction at the level of the prostate or urethra.
  • A blood test may be conducted to analyze hormone levels.
  • Genetic testing may be conducted to investigate other genetic abnormalities contributing to infertility.

After determining the factors contributing to male infertility, and taking into account the personal and medical circumstances of you and your partner, we will work with you to determine the best course of treatment.

Surgical treatment. If a duct within the genital system is blocked, surgery may be recommended to remove the blockage. If viable sperm are present, we may be able to extract sperm directly from the testicle itself. If a corresponding condition such as varicocele is present, surgery may be recommended to correct the underlying problem.

Medical treatment. In the case of a hormonal abnormality, we may recommend a course of hormone treatment to restore proper signaling between the brain and the urogenital system.

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More information on male infertility

Related publications by NYU urologists

  • Alukal, Joseph P; Lamb, Dolores J. "Intracytoplasmic sperm injection (ICSI)--what are the risks?" Urologic clinics of North America. 2008; 35: 277
  • Alukal, Joseph P; Lipshultz, Larry I. "Safety of assisted reproduction, assessed by risk of abnormalities in children born after use of in vitro fertilization techniques". Nature clinical practice. Urology. 2008; 5: 140
  • Alukal, Joseph P; Lamb, Dolores J. "Words of wisdom. Re: Persistent motile sperm after ligation band vasectomy [comment]". European urology. 2007; 52: 606
  • Alukal, Joseph P; Zurakowski, David; Atala, Anthony; Bauer, Stuart B; Borer, Joseph G; Cilento, Bartley G Jr; Mandell, James; Peters, Craig A; Paltiel, Harriet J; Retik, Alan B; Diamond, David A. "Testicular hypotrophy does not correlate with grade of adolescent varicocele". Journal of urology. 2005; 174: 2367
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