Treatment Options for Male Infertility: From Medication to IVF & ICSI

When couples face fertility struggles, it's easy to assume the problem lies with the woman. But truthfully, male infertility is just as common. The good news is that there are more treatment options today than ever before, and many of them work.

From medications that nudge the body toward better sperm production to high-tech solutions like ICSI, male infertility isn’t the mystery it once was. Whether it’s a hormonal hiccup, a physical blockage, or a genetic issue, there’s often a clear path forward. This article will walk you through the main treatments for infertility so you can approach the process informed and empowered.

Medications & Lifestyle Changes for Sperm Health

Before moving toward infertility treatments, fertility doctors first prescribe lifestyle adjustments and then medications, especially if the issue isn’t severe.

Lifestyle Changes

No one loves being told to "just live healthier," but when it comes to sperm, the connection is real. Diet, exercise, sleep, alcohol, drugs, and stress all affect sperm quality more than most people realize. 

Here are some changes that can make a difference:

• Eat a diet rich in antioxidants, such as leafy greens, berries, nuts, and fish
• Sleep at least 7 hours a night
• Avoid tobacco and cut back on alcohol
• Avoid tight-fitting clothes as too much heat can damage sperm.
• Get regular exercise.

Even these small shifts can have a measurable impact within 2–3 months, which is the average time it takes for sperm to regenerate.

Hormonal Treatments

Sometimes, the body just needs a little encouragement. If a man’s infertility is due to hormonal imbalances like low testosterone or elevated prolactin, medications can correct those issues.

Clomiphene citrate, hCG injections, or gonadotropins may be prescribed to stimulate natural sperm production. However, hormonal testing must be done first to determine exactly what’s going on.

Antibiotics and Anti-Inflammatories

If there’s evidence of infection or inflammation in the reproductive tract, antibiotics can help. Reducing inflammation in the prostate or epididymis can improve sperm health over time.

Surgical Treatments

Sometimes medication isn’t enough. If there’s a physical blockage or anatomical abnormality standing in the way of fertility, surgical techniques may be required. Thankfully, many of these procedures are minimally invasive and highly effective.

Varicocele Repair

A varicocele is essentially a varicose vein in the scrotum. It may not sound like a big deal, but it can raise scrotal temperature and interfere with sperm production.

Varicocele repair, either through open surgery, laparoscopic methods, or embolization, can significantly improve sperm count and motility for many men. Some studies even suggest pregnancy rates improve post-repair, especially in younger men with otherwise unexplained infertility.

Sperm Retrieval Procedures

For men who don’t have sperm in their ejaculate (a condition called azoospermia), all hope isn’t lost. Several methods exist to retrieve sperm directly from the testicles or epididymis, often under local or general anesthesia. These methods include the following. 

TESE (Testicular Sperm Extraction)

This involves removing a small piece of testicular tissue and extracting sperm cells from it. It’s commonly used when sperm production is happening, but the sperm just isn’t making it into the semen.

Micro-TESE

This is a more advanced version of TESE. Here, a surgical microscope is used to locate the healthiest areas of sperm-producing tissue, increasing the chances of finding usable sperm, especially in men with severely impaired sperm production.

PESA (Percutaneous Epididymal Sperm Aspiration)

This less invasive procedure retrieves sperm through a needle inserted into the epididymis, where mature sperm is stored.

MESA (Microsurgical Epididymal Sperm Aspiration)

This version uses a microscope to improve precision and reduce damage. It’s typically done when PESA isn’t successful or when a more controlled approach is preferred.

Each of these techniques has its pros and cons, and the best option depends on the root cause of infertility, overall health, and fertility goals.

IUI & IVF for Male Factor Infertility

If sperm counts are low but not zero, assisted reproductive technologies like intrauterine insemination (IUI) and in vitro fertilization (IVF) might be on the table.

Intrauterine Insemination (IUI) 

This is one of the less invasive fertility treatments and is often a first choice when mild male factor infertility is diagnosed. During IUI, washed and concentrated sperm is inserted directly into the woman’s uterus around the time of ovulation. This gives the sperm a head start by bypassing the cervix and cutting down the distance to the egg.

It’s simple, relatively low-cost, and can work well in cases of slightly low sperm count or motility.

In Vitro Fertilization (IVF)

When sperm issues are more pronounced, IVF is often the next step. In this process, eggs are retrieved from the woman’s ovaries and fertilized with sperm in a lab. The resulting embryos are then transferred to the uterus.

For many couples dealing with male infertility, IVF offers a real shot at pregnancy, even when sperm quality is far from ideal.

How Intracytoplasmic Sperm Injection (ICSI) Works

In some cases, even in an IVF setting, the sperm need a bit more help. That’s where ICSI comes in. 

With ICSI, a single sperm is carefully selected and injected directly into an egg using a tiny needle. This bypasses the entire fertilization process that typically relies on sperm motility and morphology. As long as you’ve got one good sperm and one viable egg, you’ve got a shot.

ICSI is often used in cases of:

• Extremely low sperm count
• Poor sperm motility or morphology
• Previous failed IVF attempts
• Sperm retrieved through TESE or other surgical methods

The fertilization rates with ICSI are remarkably high, and while it's not a guarantee of pregnancy, it significantly boosts the chances for couples dealing with male factor infertility.

Choosing The Right Treatment Path at Ivy Fertility

Now, here’s the part where personalized care makes all the difference. Male infertility isn’t a one-size-fits-all. That’s why choosing a fertility clinic that understands male reproductive health is so crucial.

At Pacific Northwest Fertility, the treatment journey begins with a thorough evaluation using different techniques, including a semen analysis, hormonal testing, and, if necessary, genetic screening. Based on these results, a tailored treatment plan is created. 

Whether it’s starting with lifestyle changes or jumping into advanced procedures like ICSI, the focus stays on finding the most effective, least invasive path to success.

Patient education, compassionate care, and access to cutting-edge technologies are what set Ivy Fertility apart.

FAQs

Can male infertility be treated?

Yes, male infertility can be treated using different methods, including IVF, IUI, and a change in lifestyle choices. 

Who needs a sperm retrieval procedure?

Sperm retrieval is typically used for men who have azoospermia (no sperm in their ejaculate), previously undergone a vasectomy, genetic conditions that block sperm transport, and ejaculatory dysfunction or obstructions in the vas deferens.

What are the different types of sperm retrieval procedures?

Different types of sperm retrieval procedures include:

• TESE (Testicular Sperm Extraction): Involves removing sperm from a biopsy of testicular tissue
• Micro-TESE: Uses a microscope to find areas in the testicle with active sperm production.
• PESA (Percutaneous Epididymal Sperm Aspiration): Uses a needle to draw sperm from the epididymis.
• MESA (Microsurgical Epididymal Sperm Aspiration): A more precise version of PESA, usually done in a surgical setting.

Each method has different use cases, and your fertility specialist will recommend what’s best based on your specific condition.TESE (Testicular Sperm Extraction): Directly removes sperm from testicular tissue.

Is sperm retrieval painful?

No. These procedures are performed under local or general anesthesia, so discomfort is minimal.

Can retrieved sperm be used for IVF?

Absolutely. In fact, sperm retrieved through surgical methods is often used in combination with IVF or ICSI. Since these sperm haven’t traveled through the reproductive tract, they need assistance reaching and fertilizing the egg.

What is the success rate of sperm retrieval procedures?

Success rates depend on the method and the underlying cause of infertility. For many men, the success rate of retrieving usable sperm ranges from 50% to 90%. Micro-TESE tends to offer the highest success in difficult cases.