Anything that blocks the pathways in which the sperm travel — like scar tissue that formed as a result of previous surgery or from an infection — is an obstructive problem and may cause male factor infertility.
Varicose veins that develop in the testes may also interfere with sperm production. Some structural defects may be congenital (present at birth).
Diagnostic testing for obstructive problems
The “fructose test” can help your doctor evaluate an obstructive problem or a blockage of the seminal vesicles — the duct that connects the seminal vesicles to your ejaculatory duct. If there isn’t fructose in your semen, there may be an obstructive problem. At Shady Grove Fertility, we prefer performing ultrasounds rather than fructose testing because an ultrasound provides greater accuracy.
Treatment for obstructive problems
If your doctor diagnoses a structural problem, surgery may be an option. Quite often, the reason for male factor infertility is unknown, so your doctor may speak with you about other options, such as intrauterine insemination (IUI), in vitro fertilization (IVF), and other similar procedures.
IVF with intracytoplasmic sperm injection (ICSI) has become a revolutionary procedure for patients with male factor infertility, as embryologists only need to isolate a single healthy sperm to fertilize the egg.
Your physician may recommend ICSI as part of your IVF procedure to treat many causes of infertility, especially when there is a problem with the sperm, such as low motility (movement) or a low sperm count. ICSI is especially useful in cases where the sperm cannot penetrate the egg or if the sperm are abnormally shaped.