Male infertility factors can derive from a number of causes and ultimately impact the ability of an otherwise healthy couple to become pregnant. Causes of male infertility can stem from past injury, certain types of illness, hereditary / genetic diseases or lifestyle choices.

The first step in assessing male infertility is typically with a semen analysis and a physical examination. The semen analysis looks at various factors – the number of sperm, the percentage that are moving well (motility), the percentage that are normal in shape (morphology). A semen analysis is best performed after three to five days of abstinence.

Sometimes, blood tests will also be performed to check the hormones associated with sperm production, or to check some genetic factors. These tests will help ascertain what possible procedures could help a couple to become pregnant. There are several treatment options available to overcome challenges such as low sperm mobility, poor morphology, low sperm count or even a lack of sperm.

Bourn Hall Fertility Clinic has a comprehensive range of treatments to help address male infertility.


Urology and andrology health are an important component of men’s overall health and well-being.

Knowing more about your body, how it works, and what diseases can affect you is the first step to a healthier life. Male andrology health disorders are very common and can have a significant effect on a man’s quality of life and relationships.

Andrology services by Bourn Hall

Bourn Hall uses state of the art screening and therapeutic options for optimum male health. We provide professional, confidential, easily accessible, non-judgmental, high quality service by experienced urology and andrology specialists. We also provide a relaxing environment to allow men to frankly discuss their health problems.

•Prostate health

•Diabetic male issues

•Couple’s therapy

•Obesity andrology assessment

•Urinary incontinence


Percutaneous epididymal sperm aspiration or PESA is a surgical sperm retrieval (SSR) procedure where a fine needle is inserted into the epididymis, above the testis, and sperm is then obtained by gentle suction. PESA is usually recommended when male patients do not have any sperm found in their ejaculate, due to a blockage, injury or previous operation.

This procedure is usually preformed prior to starting an IVF cycle where the sperm is frozen and stored for use in conjunction with intra-cytoplasmic sperm injection (ICSI) during your IVF cycle.


If your semen analysis shows that you do not have sperm within your ejaculate, there are different methods of surgically retrieving the sperm, which is sometimes referred to as surgical sperm retrieval (SSR).

Testicular sperm aspiration (TESA) and testicular sperm extraction (TESE) are both methods of SSR where sperm is retrieved from the tissue in a man’s testis. TESA uses gentle suction through a small needle while TESE involves taking a larger tissue sample from an incision. Both procedures are minor day surgeries and should be done before beginning an IVF cycle.


Micro TESE stands for microsurgical sperm retrieval from the testicle and involves an incision in the scrotum through which both testicles can be seen. During this procedure the doctor will examine several areas of the testicles to check for abnormalities and identify the presence of sperm. This procedure is usually applicable if other surgical sperm retrieval (SSR) techniques have been unsuccessful.


Testicular mapping is a minimally invasive procedure during which a fine needle is placed in different areas of the testes to obtain small samples of testicular fluid. This fluid is then examined to find the most favourable areas for sperm to be retrieved from.


A semen analysis is a vital part of any infertility assessment because in almost 50% of couples there is a problem with either the sperm quality or sperm count which may prevent a pregnancy from occurring. Semen analysis evaluates the amount and quality of a man’s semen and sperm including:

  • Motility – movement of the sperm
  • Morphology – percentage of sperm with normal shape
  • Count – the number of sperm present in one sample

In order to obtain the best result with a semen analysis, it is recommended that the sample be provided after abstaining from sexual activity for two to five days.


Vasectomy reversal is a microsurgical operation during which the tubes (vas deferens) that were cut during vasectomy are reconnected in order to allow natural conception. The success of the vasectomy reversal is typically dependent on the amount of time that has passed since the vasectomy.

Patients should be aware that even when the vasectomy reversal is successful and the ability to release sperm in the ejaculate returns, sometimes the sperm is unable to fertilise an egg and IVF may also be required.


A varicoceles is a collection of enlarged veins within the scrotum. It may begin to cause reproductive issues if the valves within the testes cause blood to pool within the scrotum. This pooling of blood affects the circulation and temperature of the testes, leading to decreased motility and poor morphology. As many as 15% of the general population have a varicoceles. If large, it may cause discomfort but often there are no symptoms.

A varicocelectomy is a procedure to remedy enlarged veins. It involves a microsurgical procedure in which swollen veins are tied off while preserving the normal blood vessels. Varicocelectomy is a highly successful procedure and can result in a spontaneous (natural) pregnancy.


A hydrocelectomy or hydrocele repair is a surgical procedure, which can correct the accumulation of peritoneal fluid in the front and sides of the testes.