Treatment for infertility should first address any underlying medical condition that may be contributing to fertility problems. Drug therapy may be used to treat hypogonadism and other hormonally related conditions. Surgery is used to repair varicoceles and correct any obstructions in the reproductive tract.
If fertility issues remain unresolved, intrauterine insemination (also called artificial insemination) and assisted reproductive technologies such as in vitro fertilization should be considered. Intracytoplasmic sperm injection is commonly used in combination with in vitro fertilization in cases of male factor infertility. [See "Assisted Reproductive Technologies "section.] The couple can also discuss with a fertility specialist other options such as donor sperm or eggs.
Choosing a good fertility clinic is important. Those offering assisted reproductive techniques are not always regulated by the government, and abuses have been reported, including lack of informed consent, unauthorized use of embryos, and failure to routinely screen donors for disease.
The clinic should always provide the following information:
Adolescents and adult men undergoing cancer treatments who may want to father children in the future should consider banking and freezing their sperm for later use in assisted reproductive therapies. This technique is called sperm cryopreservation. Sperm cryopreservation is recommended by the American Society of Clinical Oncology as the method with the highest likelihood of success for male cancer survivors. However, these banking methods are not appropriate for pre-adolescent boys being treated for childhood cancers such as leukemia. Researchers are investigating ways that stem cell transplantation may someday help these children regain their fertility while avoiding leukemia relapse.
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Levine BA, Grifo JA. Intrauterine insemination and male subfertility. Urol Clin North Am. 2008 May;35(2):271-6.
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Van Peperstraten A, Proctor ML, Johnson NP, Philipson G. Techniques for surgical retrieval of sperm prior to intra-cytoplasmic sperm injection (ICSI) for azoospermia. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD002807.
Zhu JL, Basso O, Obel C, Bille C, Olsen J. Infertility, infertility treatment, and congenital malformations: Danish national birth cohort. BMJ. 2006 Sep 30;333(7570):679. Epub 2006 Aug 7.
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