Treatments for sperm problems are directed at the underlying causes.
General lifestyle advice and antioxidants:
In cases of sperm abnormalities, men should be advised that measures such as losing weight (if obese), avoiding long hot baths, loose-fitting underwear and eliminating smoking and alcohol may be beneficial for sperm parameters.
Many of these factors are thought to impair sperm production by increasing the level of damaging “oxidative stress” within the spermatogenic tubules. Consequently, there has been extensive interest in the use of antioxidants (e.g. Vitamins C and E and Zinc) for improving sperm quality, although the evidence that they make any marked improvement is inconclusive.
In cases in which hormones such as GnRH, FSH and LH are lacking, they can be replaced using hormonal medications.
In cases of mild sperm defects, artificial insemination or IUI may be beneficial. For more details, see my section on Artificial Insemination.
IVF with ICSI:
In cases in which, sperm is present in the ejaculate but is of very low quality, IVF in combination with Intra Cytoplasmic Sperm Injection (ICSI) is the appropriate treatment. For more information of how to diagnose sperm quality problems see my section on Infertility: Causes, Tests and Treatments. For more information on IVF and ICSI, see my section on IVF/ICSI Treatment.
Surgical sperm retrieval:
In obstructive causes in which there is blockage or absence of tubes leading from the testes, sperm can be surgically retrieved using techniques such as PESA and TESA. When sperm is retrieved surgically in his manner, IVF with ICSI must then be used to fertilise the eggs since such sperm have not gone through the steps required for enabling them to fertilise eggs on their own. See my section on IVF/ICSI treatment for further information. Professor Homer wrote the chapter on how sperm undergo preparation for fertilisation in one of the world’s most popular textbooks of Gynaecology (Gynaecology 4th Edition; Chapter 19).
If spermatogenesis is severely disrupted such as after extensive chemotherapy or in some cases of Klinefelter’s syndrome, it may not be possible to obtain sperm, even with surgical techniques. In such cases, the only other available option is the use of third-party donated sperm. For more information, see my section on Donor Treatment.
Who can help diagnose and treat sperm problems:
An expert in infertility is required to interpret semen analyses and advise on the correct treatments. Prof Homer has extensive expertise in treating male factor infertility and has been accredited by the Australian & New Zealand Royal College in O&G as well as the British Royal College in O&G for performing advanced treatments for male infertility such as surgical interventions for retrieving sperm from the testes.