Of the various factors that contribute to cases of male infertility, one of the most pervasive is that of low sperm count, a condition wherein a man produces semen that contains fewer than 15 million sperm per milliliter. In addition to having a lower-than-average amount of sperm within the semen, a man with low sperm count may also have sperm with low motility — a condition characterized by sperm that move in a forward progression at a pace slower than 25 micrometers per second. The scarcity of sperm combined with the existent sperm’s inability to move effectively toward an egg often contributes to difficulty conceiving.
Though the primary sign that a man may be affected by low sperm count or poor motility is his inability to conceive a child with a partner, issues like erectile dysfunction, testicle pain, or signs of hormonal abnormalities may also be indicators. While some cases of low sperm count and motility can be attributed to unhealthy lifestyle choices or exposure to hazardous chemicals, heat, and radiation, other cases caused by genetics or medical issues are not always as easily treated. Though only a medical professional can determine the best option for patients with infertility, the following three assisted reproductive technology (ART) procedures are some of the most commonly used for men who have been diagnosed with low sperm count and/or motility.
1. In vitro fertilization (IVF)
IVF is both the most commonly used and the most statistically effective form of ART, according to data presented by the Centers for Disease Control and Prevention (CDC). To facilitate the IVF procedure, the doctor retrieves eggs from the female partner via minor surgery. The male partner then produces a sperm sample, which is processed to isolate sperm from seminal fluids and then quickly mixed together with the female partner’s eggs in a laboratory dish. This direct intermingling of eggs and sperm makes the fertilization process easier for sperm that have poor motility or are few in number. The eggs are then routinely examined by medical professionals to identify those experiencing cell division, which signals fertilization and the development of an embryo.
Once the embryos have been given time to develop (an average of three to five days), the healthiest embryos are selected for transfer to the female partner’s uterus via catheter. If the IVF procedure is successful, one or more of the healthy embryos implant themselves into the wall of the uterus. The cost of the average IVF procedure tends to be somewhere between $10,000 to $15,000, not including the cost of any medications that may be issued to the couple in order to produce a higher number of eggs or healthier semen. According to the American Pregnancy Association, the live birth rate for couples who undergo IVF in which the female partner is under the age of 35 is approximately 41 percent to 43 percent.
2. Intrauterine insemination (IUI)
Also known as artificial insemination, IUI is often the first approach that couples struggling with infertility take when attempting to conceive a child, including couples in which the male partner is affected by low sperm count. Though IUI may not be a viable option for all couples, the price of one IUI treatment may cost between $895 and $3,000 — significantly less than IVF. Fertility specialists tend to recommend that men with extremely low sperm count and motility avoid using IUI as a method of conception, as it is unlikely to be successful unless a man’s sample has at least 5 million motile cells or more after it has been processed.
To perform the procedure, a fertility specialist will typically prescribe medications to the female partner that stimulate the development and release of multiple eggs during her cycle. The male partner then abstains from ejaculation for between two and five days prior to the date of the insemination, which is scheduled to take place during the female partner’s ovulation period. On the day of the procedure, the male partner produces a sperm sample that is then processed by medical scientists in a laboratory before it is placed directly into the cervix or uterine cavity of the female partner via catheter. The placement of a concentrated sperm sample directly into the cervix or uterine cavity makes it more likely that the male partner’s viable sperm encounter and fertilize the egg or eggs of the female partner, increasing the likelihood of conception.
3. Intracytoplasmic sperm injection (ICSI)
The intracytoplasmic sperm injection procedure is a form of ART recommended for men affected by extremely low sperm count or motility. ICSI is a companion procedure to IVF, though not every couple who undergoes IVF will need ICSI as well to conceive. The cost of ICSI usually adds an additional $1,400 to $2,000 to the cost of IVF.
ICSI is performed in the laboratory after samples of eggs and sperm have been procured. Rather than mix the two samples in the laboratory dish to allow fertilization to occur naturally as the cells interact, medical scientists instead use a microscopic needle to inject a single sperm into each retrieved egg. This procedure completely mitigates the need for sperm with poor motility to travel within the dish to fertilize the eggs and instead facilitates the fertilization process directly. Healthy embryos that occur as a result of this procedure are then transferred to the female’s uterus and the IVF process continues as it otherwise would. Though an IVF procedure does carry a slightly higher risk that a child is born with a birth defect compared to natural conception, the ICSI procedure does not carry any additional risks other than those already associated with IVF. The standard rate of fertilization in ICSI procedures is between 50 percent and 80 percent, as direct injection of a sperm into an egg does not guarantee that fertilization will occur.
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