The Sperm Story | Texas Fertility Center Blog

Lisa Hansard, M.D.

The Sperm Story

by | February 2, 2012

Infertility is not an issue isolated to the female gender. Boys are invited too!

Infertility is not an issue isolated to the female gender.  Boys are invited too!  In fact, 40% of couples who seek evaluation will have some degree of a sperm problem, and in 25% of cases, the only identified problem is a male factor.

The work-up begins with a semen analysis.

The male collects a semen sample by masturbation after 2 or 3 days of abstinence.  This can be done at home or at the facility’s collection room.  The sample is evaluated for volume, concentration, motility (swimming), and morphology (appearance), as well as for the presence of infection.  If the initial test is abnormal, a second sample for confirmation is typically recommended because any one can have a bad day (or stage fright!).  If the second sample is also abnormal, further evaluation is warranted.

Physical Evaluation of the Male

Typically, the evaluation of the male includes a physical examination to look for anatomic issues that might explain the findings, as well as blood tests to exclude a hormonal abnormality.  If the exam and hormones are normal, treatment recommendations will depend upon the degree of impairment in the sperm parameters.

Causes of Male Infertility

Varicoceles: The most common type of physical problem is the presence of a varicocele.  This is a protrusion of blood vessels into the scrotum, usually on the left side, that may cause dysfunction in sperm formation.  There is significant controversy over whether or not surgical repair of a varicocele results in improvement in fertility.  Most clinicians agree that if the varicocele causes pain, or if the size of the testicle is significantly diminished, repair is warranted.

Hormone imbalances, can often be corrected with medication and will improve semen analysis values in many cases.

Once the sperm production and function has been optimized, or in the absence of an identifiable problem, treatment options can be evaluated.  Based on the total number of motile sperm in an ejaculate, a determination can be made as to whether the sample is sufficient for conception by intercourse, sperm washing with intrauterine insemination (IUI), in vitro fertilization (IVF), or intracytoplasmic sperm injection (ICSI), a micromanipulation technique coupled with IVF.

Tighty Whities or Boxers?

In a nut shell, wearing boxer shorts and avoiding hot tubs will not change sperm that need ICSI, intracytoplasmic sperm injection into sperm that will work by themselves with intercourse .  Bottom line, the more impaired the sperm, the more complex the technology required to achieve success.

For more information on male factor infertility please visit our website at

If you are interested in learning more about the full range of andrology services available, please visit

Tags: , , , , , , , , | Category: Low Sperm Counts, Male Infertility, Semen Analysis |


Lisa Hansard, M.D.

Originally from Lubbock, Texas, Dr. Hansard attended undergraduate college and medical school at Texas A&M University. She completed her residency in Obstetrics & Gynecology at the University of Texas Health Science Center in San Antonio and her fellowship training in Reproductive Endocrinology and Infertility at Duke University Medical Center in Durham, North Carolina. While at Duke, she received the Outstanding Fellow Research Award for her investigation of growth factors and their potential role in embryo implantation. Dr. Hansard is Board Certified in both Obstetrics & Gynecology and Reproductive Endocrinology & Infertility.

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