Tag: Infertility

January 15, 2024

Male Infertility Challenges & Treatments

male fertility

Male infertility is a significant concern that affects a substantial number of couples worldwide. Infertility is generally defined as the inability to conceive after a year of regular unprotected intercourse. While both men and women can contribute to fertility issues, male infertility plays a crucial role in approximately 40-50% of infertility cases. Understanding the challenges and available treatments for male infertility is vital for couples seeking to build their families.

Challenges Of Male Infertility

Several factors contribute to male infertility, ranging from genetic and hormonal issues to lifestyle and environmental factors. One of the primary challenges is the impaired production or function of sperm. Sperm abnormalities, such as low sperm count (oligospermia), poor sperm motility, and abnormal sperm morphology, can significantly reduce fertility. Island Reproductive Services is committed to offering education regarding male infertility challenges and treatments. We have experience testing men for fertility as well as treating men with various medical therapies to help optimize sperm.

Hormonal Imbalances

Hormonal imbalances, particularly disruptions in the production of testosterone and other hormones, can also impact sperm production. These are common sources of problems. Conditions such as varicocele, a swelling of the veins that drain the testicle, can contribute to elevated testicular temperature, affecting sperm production and function. Additionally, genetic factors, such as chromosomal abnormalities or gene mutations, can lead to male infertility.

Lifestyle Factors

Lifestyle factors can play a crucial role in male fertility. Smoking, excessive alcohol consumption, drug use, and obesity have been linked to reduced sperm quality. Environmental factors, including exposure to toxins and pollutants, can also contribute to male infertility.

Diagnostic Approaches

Accurate diagnosis is the first step in addressing male infertility. An evaluation first involves a thorough medical history. Semen analysis is an essential test that assesses the quantity and quality of sperm. Hormone and or genetic testing may also be appropriate once the initial evaluation has been completed. Other diagnostic techniques, like scrotal ultrasound, can provide insights into structural abnormalities leading to male infertility.

Treatments for Male Infertility

Several treatment options are available to address male infertility, depending on the underlying cause. Here are some common approaches. Men with low sperm counts may be placed on medicines such as clomid, letrozole, or hcg. We may recommend to some men that they freeze sperm samples if a long-term problem is anticipated. 

Lifestyle Modifications

Adopting a healthy lifestyle can significantly improve sperm quality. This includes maintaining a balanced diet, regular exercise, avoiding tobacco and excessive alcohol, and managing stress.

Assisted Reproductive Technologies (ART)

In cases where natural conception is challenging, ART procedures can be employed. Intrauterine insemination (IUI) involves placing sperm directly into the uterus, while in vitro fertilization (IVF) with ICSI involves combining sperm and eggs outside the body before implanting the embryo into the uterus.

TESA

TESA involves the surgical extraction of sperm from the testicle. TESA-obtained sperm can then be used in combination with IVF/ICSI to achieve pregnancy. TESA can be used for men with obstruction of sperm release. The procedure can also be used in men without obstruction who do not produce enough sperm through ejaculation to lead to pregnancy. 

Varicocele Repair

Sometimes, the blood vessels surrounding the testicles can be swollen and enlarged. The increased blood flow can affect the sperm quality. Most men with varicoceles do not require surgery, but a subset of men may benefit from the surgical repair of these varicoceles.

Donor Sperm

In cases where the male partner is unable to produce viable sperm, the couple may choose to use donor sperm for fertility treatments.

Vasectomy Reversal

During a vasectomy, the pathway of sperm from the testicle is blocked. However, sperm production continues. The reversal procedure can help re-establish the flow of sperm through the urethra. If successful, this can help achieve pregnancy without the use of IVF

Male infertility poses significant challenges for couples aspiring to start a family. However, with advancements in medical science, many couples can overcome these challenges through a variety of treatment options. At Island Reproductive Services, we are experts in providing the care that your situation requires. For more information or questions regarding male fertility,  check out our website or give us a call at (718) 948-6100. 

October 14, 2023

Genetic Testing In Fertility: Pre-Implantation Genetic Testing (PGT)

genetic testing

The journey to parenthood can be a challenging one, especially for couples who face the burden of genetic disorders or chromosomal abnormalities. Luckily, advancements in medical technology have revolutionized the field of fertility treatment, offering hope to couples struggling with infertility. Among these breakthroughs, genetic testing has emerged as a powerful tool to help ensure healthy pregnancies and the birth of healthy babies. 

Pre-Implantation Genetic Testing

Pre-implantation Genetic Testing (PGT) is a significant technique that involves genetic testing of the embryo for chromosomes and/or specific known genetic disorders. Here at Island Reproductive Services, we are pleased to offer this medical technology to help you start planning your future and achieve your parenting dreams. Some patients are worried that a PGT biopsy may harm the embryo. At Island Reproductive Services, we only biopsy the embryo once cells are “hatching out.” That allows us to avoid going into the embryo to perform the biopsy thus avoiding any potential harm to the embryo.

What Is The PGT Process?

Pre-Implantation Genetic Testing is used to assess the genetic health of embryos before they are implanted in the uterus. The PGT process typically follows these steps:

  1. Ovarian Stimulation and Egg Retrieval: The woman undergoes ovarian stimulation to produce multiple eggs, which are then retrieved.
  2. Fertilization: The retrieved eggs are fertilized with sperm in a laboratory setting, usually through IVF.
  3. Embryo Development: The fertilized eggs develop into embryos over a few days.
  4. Embryo Biopsy: A few cells are carefully removed from each embryo for genetic analysis. This process does not harm the embryo’s overall development since we only biopsy cells as they are extruded out of the embryo..
  5. Genetic Analysis: The extracted cells undergo genetic testing to identify chromosomal abnormalities or specific gene mutations, depending on the type of PGT being performed.
  6. Embryo Selection: Based on the results of the genetic analysis, our doctors choose the embryo that is most suitable for implantation.
  7. Embryo Transfer: The selected embryo is transferred into the woman’s uterus for potential implantation and pregnancy.

What Can Embryos Be Tested For?

Usually, at the blastocyst stage, embryos are genetically tested by removing a few cells from the outside of each embryo. Embryos are frozen, and the cells are sent to a specialized genetic laboratory for analysis. Embryos can be tested for the following:

  1. Chromosomes: Chromosome errors can occur randomly in any egg or sperm. Errors are more likely to occur in eggs and increase with a woman’s age.  Even in women at age 35, approximately 50% of eggs are chromosomally abnormal. Errors can involve an entire chromosome or part of a chromosome.
  2. Structural abnormalities: Some men and women carry chromosome abnormalities that may be passed along to their children. These are usually translocations and often lead to infertility, miscarriages, or an affected child.
  3. Genetic diseases: Some families may have a known genetic disease in family members. A man or a woman may have the disease or may carry an abnormal disease mutation. These include autosomal recessive diseases (both the egg and sperm must carry the mutation to cause the disease in a child), autosomal dominant diseases (if either the egg or sperm carries the mutation, a child has a 50% chance of getting the disease), or X linked (usually passed along from the eggs of a woman who carrier the abnormal mutation).

PGT genetic testing offers numerous benefits to couples seeking to have healthy children. It allows for the identification and selection of embryos with the best chance of successful implantation and development, reducing the risk of miscarriages and genetic disorders.

Work With Island Reproductive Services 

Pre-Implantation Genetic Testing (PGT) represents a remarkable stride in fertility treatment, providing hope to couples grappling with genetic risks and disorders. The ability to screen embryos for specific gene mutations before implantation significantly enhances the chances of healthy pregnancies and births. 
Our team at Island Reproductive Services is here for you through the process. We have resources and information that can help you make decisions. Are you interested in scheduling a consultation with our team? Check out our website or give us a call for more information.