To manage male infertility, urologists at NYU Langone may recommend medications that correct hormonal imbalances. If problems with sperm are causing infertility, your doctor may recommend assisted reproductive techniques, such as intrauterine insemination (IUI) or in vitro fertilization (IVF). These procedures are performed by infertility specialists at the NYU Langone Fertility Center and NYU Langone Reproductive Specialists of New York.
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Medication can improve sperm count in some men with infertility. Your doctor may prescribe an estrogen receptor blocker, such as clomiphene citrate, which stimulates the hypothalamus and pituitary gland in the brain. This generates hormone production and the release of follicle stimulating hormone (FSH) and luteinizing hormone (LH), which can increase sperm production.
This medication is taken by mouth. Your doctor recommends how frequently it should be taken.
Men with low testosterone levels may be prescribed human chorionic gonadotropin to adjust FSH and LH levels and increase sperm production. This medication is injected three times per week for as long as six months. Your doctor uses regular blood tests to monitor testosterone levels, adjusting the medication dosage accordingly. Our experts can teach you and your partner how to administer the medication at home.
Synthetic testosterone is not prescribed, because it can actually decrease sperm count in men.
Your doctor may recommend IUI, which is an assisted reproductive technique that is also known as artificial insemination. This is typically recommended for men with low sperm concentration, which is a reduced number of sperm, or low sperm motility, or movement. It may also be recommended when the source of infertility cannot be determined and the sperm count is normal.
In this procedure, a man produces a semen specimen in a supplied container at home or in private at his doctor’s office. The sperm is then “washed,” so that natural, hormone-like compounds called prostaglandins can be removed. Prostaglandins can cause uterine muscle cramping and can interfere with conception. This procedure produces a high concentration of healthy sperm.
This sperm sample is placed directly into a woman’s uterus just prior to ovulation, when the body releases eggs for fertilization.
Your doctor may recommend IVF, in which eggs retrieved from a woman’s ovaries are fertilized with a man’s sperm to form an embryo that’s implanted in the uterus. If a quality sperm sample cannot be obtained, your doctor may recommend surgical sperm retrieval for in vitro fertilization, or the use of donor sperm.
In surgical sperm retrieval techniques, your doctor may be able to extract quality sperm during an in office procedure. These sperm are then injected into an egg by a trained embryologist in a procedure called intracytoplasmic sperm injection. This procedure is used in men with blockages that prevent sperm from traveling to the urethra and out of the body.
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