Sharon Perkins - Dad's Guide to Pregnancy For Dummies

The most common cause of a low sperm count is a varicocele, an abnormality in the vein in your scrotum that drains the testicles. Varicoceles can cause decreased fertility in the following ways:

Increasing temperature in the testes

Decreasing blood flow around the testicles

Slowing sperm production and motility

Varicoceles are treatable in the following ways:

Surgery: An outpatient procedure during which an incision is made just above the groin and the swollen vein is “tied off.” Recovery takes seven to ten days and requires minimal activity and no heavy lifting. Risks are minimal and include infection, nerve injury, and the collection of fluid around the testicles.

Radiographic embolization: Also an outpatient procedure, this requires the insertion of a catheter through the femoral vein in the groin. Dye is injected to show where the problem is located and, when isolated, it’s blocked so blood flow to that vein stops.

Other less common male-fertility issues include the following:

Hormone imbalances: Medications to adjust hormone levels may improve sperm quantity.

Chromosomal abnormalities: One such problem is sperm that lack part of the Y chromosome, which is the male chromosome. In vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), where the best-looking sperm are injected directly into your partner’s egg in the lab, can help overcome abnormal sperm issues. (See the following section for more info.)

History of cancer: Having treatment for cancer, including lymphoma and testicular cancer, can kill or damage sperm. Many men freeze sperm before undergoing cancer treatment for this reason.

Various diseases: Diabetes, sickle cell disease, and kidney and liver diseases can cause problems. Treatment depends on your individual issues.

Even if your ejaculate has no sperm at all, a procedure called a sperm aspiration in conjunction with an IVF cycle may be able to remove sperm directly from the testicles.

Researchers are always looking for the next big thing in treating infertility. Many of the most recent research has centered around eggs, namely freezing them and producing them.

Freezing sperm is old hat in the infertility world. Embryos can also be quite successfully frozen and thawed years later. Eggs, however, have had less success in the freezing department because they contain more water than embryos or sperm. Enter vitrification, a kind of “flash freezing” technique many fertility clinics now use to preserve eggs for later use.

Although egg freezing doesn’t have a lot of application for most couples, it can be a valuable technique if your partner has to undergo treatments that could seriously damage her ovaries or if a disease such as endometriosis is destroying her ovaries.

If you’re not quite ready for parenthood but your partner is feeling the effects of the ever-advancing biological clock, egg freezing can buy you the time you need to travel the world, advance your careers, or climb Mt. Everest before settling down to parenthood.

Even though some fertility clinics claim high success rates freezing eggs, the proof is in the pudding, so to speak. You won’t necessarily know whether it worked until you actually try to use frozen eggs, perhaps years later, when it’s too late to go back for more. In most cases, fertilizing the eggs and freezing them as embryos has a better chance of success down the road.

Research that’s still in preliminary stages may find a way to make ovaries produce eggs in women who are in premature ovarian failure (POF), a condition where menopause that occurs early (before age 40) results in a shutdown of egg production.

Researchers have removed the ovaries in women experiencing POF, cut the ovary into sections, and then treated them with drugs to block a protein that prevents egg follicles from growing normally. The ovary fragments are transplanted back near their original site, where the egg follicles then begin to grow. This technique could eventually help women whose reproductive days are cut abnormally short.

Deciding what steps you’re willing to take to get pregnant is easier after you have a better understanding of the infertility issues you and your partner face. Most infertility treatments can be quite expensive, so check with your insurance company to see what it covers.

Making decisions on infertility treatments based on finances seems heartless, but if your insurance doesn’t cover a treatment or medicines, you could be looking at bills in the thousands of dollars.

The most common procedures to aid in pregnancy are the following:

Intrauterine insemination (IUI): A lab tech takes your sperm sample, pulls out the best of the best, and adds it to a saline solution, which is then inserted past your partner’s cervix. This gives the sperm a far shorter distance to travel and a greater chance for success.

In vitro fertilization (IVF): Sperm meets egg in a lab, and then the fertilized embryo is placed into the womb. Fertilization can take place by either placing a concentrated semen sample in a dish with the egg or via intracytoplasmic sperm injection, or ICSI. In ICSI, a single sperm is injected directly into a mature egg. Even with ICSI, fertilization may not occur, because the egg or sperm may be chromosomally abnormal, which in some cases isn’t evident just by looking at them.

Try not to make too many long-term decisions about how far you’re willing to go because undergoing fertility treatments is like riding a roller coaster — after you’re on, it’s harder to get off. Especially when it feels like your baby could be just around the next corner. Make decisions month to month and procedure to procedure to avoid stress and allow for an open, ever-changing dialogue with your partner.

Deciding to try to have a baby is a very big, very exciting step for most couples, and increasingly it’s something many people choose to share with a select group of friends and family members. News of an expanding family is usually met with joy, cheers, and even a few inappropriate jokes about your sex life. But although sharing good news is fun, you also need to be prepared for people in the know to ask nosy questions and offer unwanted advice — all of which becomes less fun if it takes longer than expected to conceive.

Sharing the news means you’re turning your quest to have a baby into a mini-reality show that your loved ones are going to closely follow. Having a well of support during this time can be great, but having your mom and dad hinting for info every time you talk on the phone can also feel intrusive.