It is a fact that 15% of all couples trying to initiate a pregnancy will have difficulty, even after a year of trying. It is also a fact that a male factor is responsible in 50% of cases. The most common initial test for a man in this situation is a semen analysis which is a test of sperm count, motility and morphology (or shape).
Sometimes it will be discovered that a man actually has no sperm in the ejaculate; this is called azoospermia. Since all the sperm production occurs in the testicles, evaluation is focused on this part of the body. There are three categories of patients with azoospermia:
- No sperm production (often characterized by a problem with spermatogenesis known as "maturation arrest").
- Very little sperm production (This can occur in situations of testicular damage or with "partial maturation arrest").
- Normal sperm production. (This occurs when the testicle is functioning normally, but the out flow is obstructed).
New techniques of sperm retrieval directly from either the epididymis (tubules which receive sperm from the testicle) or from the testicle itself can be used in an in-vitro fertilization setting to fertilize eggs and initiate a pregnancy. Success rates are comparable with standard in-vitro fertilization. The procedure is performed with minimal discomfort in an outpatient surgery setting. This new technique has proven to be a "miracle" for men previously considered unable to father a child.