Male Infertility 男性不孕症

不孕症：夫妻結婚後，每週維持2~3次的頻率性行為，且沒有採取任何避孕的措施，超過一年以上，仍然沒有懷孕稱之為不孕症，若想懷孕生子則必須接受不孕症治療，讓不孕症專科醫師做療程規劃。

Non-genetic Causes of Male Infertility

Penis: Hypospadias, Epispadias, Penile curvature

Testes: Cryptorchidism (undescended testes), Testicular torsion, Testicular atrophy, Varicocele, Traumatic injury

Vas deferens: Congenital absence of the vas deferens, Infection and inflammation of the reproductive tract

Endocrine: Hypogonadism, Hyperprolactinemia

Sexual dysfunction: Ejaculation disorders leading to inability to ejaculate or semen not entering the vagina properly, causing infertility, Erectile dysfunction preventing successful intercourse

Environmental and lifestyle factors: Long-term wearing of overly tight underwear, Excessive heat exposure, Smoking and alcohol consumption. These factors can negatively affect sperm quality and lead to male infertility.

Male Infertility Evaluation Items

General Medical History Review:

Includes assessment of family medical history, reproductive history, sexual activity, medication history, social habits, and occupational background.

Basic Semen Analysis:

Evaluates sperm count, concentration, morphology, and motility to determine the possibility of male infertility.

Advanced Semen Analysis:

Includes the Hyaluronic Binding Assay (HBA) and Sperm DNA Fragmentation Analysis.

• HBA (Hyaluronic Binding Assay):
  This test predicts sperm maturity and fertilization potential. Mature sperm are capable of binding to hyaluronic acid in the matrix surrounding the egg's cumulus cells. When binding occurs, enzymes are secreted from the acrosome of the sperm head, allowing the sperm to penetrate the egg's shell and fertilize it.

• Sperm DNA Fragmentation Analysis:
  If all standard infertility tests are normal but infertility or recurrent miscarriage persists, a sperm DNA fragmentation test may be considered. Using molecular biology techniques, this test identifies potential causes of male infertility. It includes:

  • Y chromosome microdeletion analysis in cases of oligospermia (low sperm count) or azoospermia (no sperm)

  • Sperm DNA fragmentation detection

  • Assessment of mitochondrial membrane potential in sperm

Male Infertility Treatment Methods

Intrauterine Insemination (IUI):

In cases of male infertility, motile sperm are selected from the semen sample, washed, and then inserted into the female partner's uterine cavity at the appropriate time to increase the chances of fertilization.

Intracytoplasmic Sperm Injection (ICSI):

As part of the IVF process, ICSI involves using a microscopic injection needle to directly inject a single sperm into the cytoplasm of an egg to achieve fertilization.

Electroejaculation (EEJ):

For individuals who are unable to ejaculate normally, electroejaculation uses electrical stimulation to induce ejaculation and retrieve sperm.

Microsurgical Testicular/Epididymal Sperm Extraction (micro-TESE/PESA):

In cases of obstructive azoospermia (no sperm due to blockage), sperm may be retrieved directly from the testicles or epididymis through microsurgery.

Sperm Donation (Donor Sperm IVF):

For men diagnosed with azoospermia or who have genetic disorders, donor sperm IVF may be considered as a treatment option.