Male Infertility

Approximately 30% cases of infertility are due entirely to a male factor and an additional 30% involves both male and female factors.

 

Approximately 30% cases of infertility are due entirely to a male factor and an additional 30% involves both male and female factors. Male infertility may be attributed to various causes such as sexual dysfunction (erectile dysfunction or hypogonadism), abnormal sperm count, sperm motility and/or morphology, as well as ejaculatory dysfunction. History of undescended testis, certain drugs and surgical or trauma to the lower abdomen or genitalia can increase your risk of infertility. A variety of genetic syndromes such as Klinefelter’s syndrome and hormonal disorders can also be associated with male infertility and have potential health and offspring risks.

When you and your partner have been trying to conceive for more than 18 months and are currently unsuccessful, a visit to your urologist and/or IVF specialist is potentially beneficial. A comprehensive history, physical examination and semen analysis should be conducted first. This is often followed by more specialized tests such as hormonal and genetic tests and scrotal ultrasound if appropriate. Your urologist with subspecialty training in male infertility (Andrology) will direct you in the most appropriate treatment options based on your clinical findings. All attempts should be made to maximise your semen parameters to ensure natural conception prior to IVF treatment.

Professor Chung has published extensively on male infertility (see below) and is the leading surgeon expert in Australia and Asia-Pacific. He is the first urologist in Australia to receive a formal fellowship training in Andrology that is accredited by the Sexual Medicine Society of North America, and the past Chair of the Andrology section for the Urological Society of Australia and New Zealand.

Treatment options for male infertility

Depending on the causative factors for your male infertility, different therapeutic options are available.

 

Depending on the causative factors for your male infertility, different therapeutic options are available.

  1. Microscopic vas reversal (approximation of the tube for sperm passage under microscopic magnification and instruments) following vasectomy
  2. Microsopic varicocele repair (ligation of dilated veins near the testis under microscopic magnification and instruments)
  3. Endoscopic transurethral resection of ejaculatory duct (telescopic resection of blockage in your sperm passage)
  4. MicroTESE (localization and extraction of sperm from the testis under microscopic magnification) and other various sperm retrieval techniques
  5. Other methods to optimise your semen parameters and treat underlying erectile dysfunction, hypogonadism or ejaculatory dysfunction.

Some of the key articles published by Professor Chung on BPH

  • Chung E, Arafa M, Boitrelle F, Kandil H, Renkel R, Saleh S et al. The new 6th edition of the WHO Laboratory Manual for Examination and Processing of Human Semen: Is it a step toward better standard operating procedure? Asian J Androl. 2022;24(2):123-124
  • Calogero AE, Cannarella R, Agarwal A et al (Chung E). The renaissance of male infertility management in the golden age of andrology. World J Mens Health. 2023;41(2):237-254
  • Ghayda RA, Cannarella R, Calogero AE et al. (Chung E). Artificial intelligence in andrology: From semen analysis to image diagnostics. World J Mens Health. 2023. PMID: 37382282
  • Agarwal A, Cannarella R, Saleh R et al (Chung E). Impact of antioxidant therapy on natural pregnancy outcomes and semen parameters in infertile men: A systematic review and meta-analysis of randomized controlled trials. World J Mens Health 2023;41(1):14-48
  • Cannarella R, Shah R, Hamoda TAA et al. (Chung E). Does varicocele repair improve conventional semen parameters? A meta-analytic study of before-after data. World J Mens Health 2023. PMID: 37382284
  • Farkouh A, Agarwal A, Hamoda TAA et al (Chung E). Controversy and consensus on the management of elevated sperm DNA fragmentation in male infertility: A global survey, current guidelines, and expert recommendations. World J Mens Health 2023. PMID: 37118965
  • Agarwal A, Farkouh A, Saleh R et al. (Chung E). Controversy and consensus on indications for sperm DNA fragmentation in male infertility: A global survey, current guidelines, and expert recommendations. World J Mens Health 2023;41(3)575-602
  • Kloping YP, Hidayatullah F, Rahman ZA, Chung E, Hakim L Male reproductive tract involvement and sperm parameters in SARS-CoV-2 patients: A systematic review and meta-analysis. World J Mens Health. 2022;40:e59
  • Shah R, Agarwal A, Kavoussi P et al (Chung E). Consensus and diversity in the management of varicocele for male infertility: Results of a global practice survey and comparison with guidelines and recommendations. World J Mens Health. 2023;41(1):164-197
  • Agarwal A, Gupta S, Sharma RK, et al (Chung E). Post-vasectomy semen analysis: Optimizing laboratory procedures and test interpretation through a clinical audit and global survey of practices. World J Mens Health 2022;40(3):425-441
  • Gupta S, Sharma RK, Agarwal A et al (Chung E). Antisperm antibody testing: A comprehensive review of its role in the management of immunological male infertility and results of a global survey of clinical practices. World J Mens Health 2022
  • Agarwal A, Sharma RK, Gupta S, et al (Chung E). Sperm vitality and ncrozoospermia: Diagnosis, management, and results of a global survey of clinical practice. World J Mens Health. 2022;40(2):228-242
  • Boitrell F, Shah R, Saleh R, Henkel R, Kandil H, Chung E et al. The Sixth Edition of the WHO manual for human semen analysis: A critical review and SWOT analysis. Life (Basel). 2021;11(12):1368
  • Blecher GA, Chung E, Katz D, Shannon K, Bailee J. Onco-testicular sperm extraction (oncoTESE): A contemporary concept review and report of Australian sperm retrieval rates and fertility outcomes. Urology. 2022;160:109-116
  • Agarwal A, Finelli R, Selvam MKP, et al (Chung E). A global survey of reproductive specialists to determine the clinical utility of oxidative stress testing and antioxidant use in male infertility. World J Mens Health. 2021;39(3):470-88
  • Chung E. Chapter: Should a varicocele be repaired before assisted reproductive technology treatment? In: Varicocele and Male Infertility: A Complete Guide. Basingstoke, UK: Springer Nature
  • Agarwal A, Finelli R, Selvam MKP, et al (Chung E). A global survey of reproductive specialists to determine the clinical utility of oxidative stress testing and antioxidant use in male infertility. World J Mens Health. 2021;39(3):470-88
  • Chung E. Varicocele and male infertility: Evidence in the era of assisted reproductive technology. Reprod Syst Sex Disorder 2014; 3:e114
  • Chung E. Andrology- Reproductive years and beyond. Australia Family Physician. 2012;41(10):758-61
  • Chung E and Brock GB. Cryptorchidism and its impact on male infertility: a state of art review of current literature. Can Urol Assoc J. 2011;5(3):210-4
  • Sun Y and Chung E. Chapter: Androgens and Male Fertility: Spermatogenesis and Contraception. In: Androgens: Productions, Functions and Disorders. Hauppauge, NY: Nova Science Publishers, Inc.