Infertility in Men

As with female reproduction, male reproduction is hormonally driven, requiring a normally functioning hypothalamus and pituitary gland. As in women, gonadotropin releasing hormone, or GnRH, is released in a pulsatile fashion, stimulating the release of follicle stimulating hormone (FSH) and leutinizing hormone (LH). In men, LH primarily stimulates testosterone production, while FSH stimulates the production of sperm. The testes must be capable of response to this hormonal stimulus. In addition, there must be an intact ductal system to transport sperm to the urethra.

The male external genitals consist of the scrotum, which houses the testes and associated ductal systems (the epididymis and vas deferens), and the penis. The testes are covered by a tough fibrous layer called the tunica albuginea, which divides the testes into lobules. Each of the 200 to 300 lobules contains one to three long and tightly coiled seminiferous tubules, within which sperm production occurs.

In contrast to female eggs, sperm are continually produced throughout a man's lifetime. During spermatogenesis and transport through the male reproductive tract, the male spermatozoa are transformed into a highly specialized cell with its own motility and enzymatic capacity to penetrate the egg. Epididymal function must be normal and the accessory glands must be functional to produce normal seminal plasma. An intact nervous system is also required to permit penile erection and normal ejaculation.

Our approach to infertility in men

UCSF is a leader in reproductive health, achieving consistently high pregnancy rates, and we offer a comprehensive array of evaluation and treatment options for men with fertility concerns. We recognize that the process of resolving infertility can be difficult, and we are committed to caring for each patient with knowledge, understanding and respect.

Treatment for male infertility depends on the underlying condition. Anatomical problems can often be addressed effectively with surgery. Medications can be used to treat certain disorders or to enhance sperm production. If neither surgical nor medical therapy is appropriate, we offer the latest assisted reproductive technologies. These include sperm extraction procedures and intracytoplasmic sperm injection, a revolutionary technique developed at UCSF that has helped many couples with male fertility problems achieve pregnancy.