Causes of Infertility
in Men

1. Poor sperm quality
2. Ejaculatory duct obstruction
3. Absence of sperm in the semen (azoospermia)
4. Genetic diseases
5. Malignant diseases

1. Poor sperm quality

In order to fertilize an oocyte, it takes millions of motile sperm (spermiogram/semen analysis). However, only a few of them actually reach the fallopian tube. In order for fertilization to occur, the oocyte in the uterine tube must be surrounded by several hundred sperm cells. If motile spermatozoa are not present in the tube in sufficient numbers, fertilization cannot take place. In most cases, the cause of this can be found not only in a hormone deficiency. In the majority of cases, disorders that affect the testes themselves are responsible for the problems. Such disturbances are usually difficult to treat. Special examinations are needed for further clarification. Attempts can be made, through the regular supply of certain micronutrients, vitamins or hormones, to increase the number and/or quality of sperm.

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2. Ejaculatory duct obstruction

Blockage in seminal ducts can be linked to inherited diseases (cystic fibrosis / mucoviscidosis) or result from inflammation, previous surgery / male sterilization (vasectomy) or traumas (injuries). Surgical sperm retrieval techniques, such as TESA / TESE may be used to extract the spermatozoa required for IVF directly from the testicles. One of the pioneers in this field, Dr. Pierre Vanderzwalmen, has been part of the team at Next Fertility IVF Prof. Zech for over 25 years. It is partly thanks to him and his great commitment that today children can be conceived through the use of testicular sperm after being processed in the laboratory (worldwide first successful TESE in 1993).

3. Absence of sperm in the semen (azoospermia)

Due to malignant diseases requiring the surgical removal of part of the testes as well as subsequent chemotherapy/radiotherapy, sperm production may be permanently impaired. Here, precautionary sperm banking can help ensure the possibility of conception in the future. Impaired sperm production (spermatogenesis) can occur spontaneously or be associated with genetic disorders. In some cases, the problem can only be overcome by means of donor sperm.. Sometimes it may also be possible to extract sperm from a tissue sample obtained by testicular biopsy.

4. Genetic diseases

Genetic disorders in humans may result in serious diseases and may also have an adverse effect on fertility, leading for instance to reproductive impairment, miscarriage etc. Particularly for those couples who had to face a number of setbacks in the past, and who are now willing to use assisted reproductive technology (ART) to address their infertility issues, the linking of reproductive medicine and genetics might be a real blessing (Learn more).

5. Malignant diseases

Patients suffering from malignant diseases need therapies that are tailored to their individual situation. This may include, for instance, radical surgery and/or chemotherapy and/or radiation. Any such treatment can result in permanent infertility, since the testicles may irretrievably lose their ability to produce adequate sperm. In order to preserve male fertility, testicular tissue or ejaculate sperm can be frozen (cryopreserved) for future use (along with the partner's eggs) in IVF/ICSI/IMSI treatment. For many years now, we, at our IVF centers have concerned ourselves intensively with the subject of freezing techniques (see "cryopreservation").