Infertility is a medical condition that can affect both men and women. It is defined as the inability to conceive after one year of regular unprotected intercourse.

Infertility affects around 15% of couples worldwide – some 48.5 million couples. Impaired male reproductive function has been identified as the cause of childlessness in 20–30% of cases.

Infertility carries a considerable psychosocial burden for men, and the condition is becoming more common over the years. Assisted reproductive technologies such as IVF and ICSI succeed in only 50% of cases. This is why the search for new, more effective fertility treatments is so active today – and cell therapy is one of the most promising technologies in the field.

Types of male infertility

There are two types of male infertility: primary and secondary. Primary infertility refers to a man who has never fathered a child. Secondary infertility is diagnosed when a man was previously fertile (able to conceive a child) but no longer is. The most common cause of secondary infertility is varicocele – enlarged veins in the scrotum.

Causes and signs of male infertility

The main causes of impaired male fertility are:

  • a low sperm count, reduced sperm motility or abnormal sperm morphology;
  • a complete absence of sperm (azoospermia);
  • infection or inflammation of the testicles;
  • an undescended testicle or other congenital defects of the reproductive system;
  • ejaculation disorders;
  • cancer treatment (chemotherapy or radiotherapy);
  • genetic conditions and hormonal disorders.

Certain medications can also lead to male infertility. These include chemotherapy drugs, anabolic steroids and anti-inflammatory drugs used to treat conditions such as Crohn’s disease.

Factors that increase a man’s likelihood of developing infertility include:

  • smoking;
  • alcohol misuse;
  • drug use;
  • a sedentary lifestyle;
  • high levels of stress;
  • obesity.

As a rule, the main (and sometimes the only) sign of male infertility is the inability to conceive. In some cases, however, other symptoms are present:

  • problems with ejaculation or erection;
  • reduced libido;
  • pain, swelling or a lump in the testicular area;
  • hormonal disorders, which may show as abnormal breast growth (gynaecomastia) or loss of facial or body hair.

If these signs occur together with an inability to conceive, a diagnostic assessment is advisable – ideally at one of Switzerland’s leading specialist clinics. CorSwiss will advise you on any questions you may have and select the best clinic for your fertility assessment.

Diagnosing male infertility at Swiss clinics

The two main methods of assessing male fertility are a blood test for hormones and a semen analysis, which determines the count, motility and morphology (shape and size) of the sperm. The doctor may also recommend an ultrasound scan to assess the reproductive organs. In some cases, a testicular biopsy – the removal of a small sample of tissue for histological analysis – is performed to establish the cause of infertility.

Diagnosis begins with a medical examination and a detailed medical history. The patient then undergoes a series of tests, including:

  • Semen analysis. This assesses the count, motility and morphological characteristics of the sperm.
  • Hormone tests. These determine the levels of testosterone and other hormones that influence male reproductive function.
  • Pelvic ultrasound. This assesses the testicles, epididymides and other organs of the reproductive system.

Treating male infertility at Swiss clinics

Switzerland is one of the world leaders in fertility treatment. Its highly qualified specialists work with advanced technologies and treatment methods.

Treatment of male infertility depends on its cause. In some cases it can be fairly conservative – for example, when the cause is varicocele. In others, surgery or assisted reproductive technologies (ART) may be required.

Assisted reproductive technologies

ART are fertility treatments that help achieve pregnancy by fertilising the egg in the laboratory. The most common ART methods are:

  • In vitro fertilisation (IVF). The egg is fertilised by a sperm outside the woman’s body.
  • Intracytoplasmic sperm injection (ICSI). A form of IVF in which a sperm is injected directly into the egg.
  • Embryo transfer (ET). The embryos are transferred into the woman’s uterus.

The latest stem cell treatments for male infertility

  • Because assisted reproductive technologies succeed in only half of male infertility cases, new treatments have been actively explored in recent years. Stem cell therapy is one of the most promising directions in this field.
  • Stem cells can be used in several ways to restore male fertility. The most effective of these are described below.

Spermatogonial cell transplantation

  • Spermatogenesis is the process by which mature sperm develop from spermatogonial cells (stem cells). It takes place continuously throughout a man’s reproductive life, and each ejaculation contains millions of sperm. Impaired spermatogenesis is one of the main causes of male infertility.
  • Because spermatogenesis is regarded as a stem-cell-based mechanism, cell therapy is one way of treating male infertility. Stem cells can self-renew, regenerate tissue and differentiate into other cell types. During treatment, the doctor harvests spermatogonial cells by biopsy. These are then cultured and multiplied in the laboratory and injected into the testicles, where the spermatogonial cells subsequently develop into mature sperm. This technique offers hope to men undergoing cancer treatment and to those whose infertility is caused by impaired spermatogenesis.

Mesenchymal stem cell (MSC) transplantation

  • The use of MSCs in treating male infertility is based on their ability to stimulate the regeneration of damaged testicular tissue and improve sperm production. These cells are easily obtained from the patient’s own tissue: they are present in bone marrow, adipose tissue and peripheral blood.
  • MSCs are administered in one of two ways: intravenously or into the testicular area. The treatment promotes the regeneration of damaged cells in the reproductive system, improves microcirculation and restores spermatogenesis. MSCs also have anti-inflammatory and immunomodulatory properties, which help address the underlying causes of impaired male fertility.

Fertility clinics in Switzerland

Switzerland has many clinics specialising in fertility treatment. Among the best known are:

  • ProCrea. One of the largest reproductive medicine centres in Europe, located in Lugano.
  • University Medical Centre Zurich (UZH). One of Switzerland’s leading medical universities, which also offers fertility treatment.
  • Clinique Sainte-Anne. A private clinic in Geneva specialising in the treatment of infertility and other reproductive conditions.

New treatments for azoospermia

Azoospermia is a condition in which the ejaculate contains no sperm at all. There are two types:

  • Obstructive azoospermia. Sperm cannot reach the ejaculate because of a physical blockage in the ductal system. These patients have active spermatogenesis (production of germ cells), and mature sperm are often found in the epididymides or vasa deferentia, yet they do not enter the ejaculate. In such cases, sperm are retrieved surgically for IVF or ICSI.
  • Non-obstructive (secretory) azoospermia. This is characterised by the absence of sperm in the reproductive tract. The genital organs may show no obvious or visible defects, but the production or maturation of sperm may be impaired by a genetic condition, radiation exposure, an accident or surgery.

Non-obstructive azoospermia is considered unresponsive to drug therapy. Men with this diagnosis are unable to father their own biological children; the only options have been donor sperm or adoption.

Assisted reproductive technologies are of very limited effectiveness for men with azoospermia. A viable sperm can be found in only 56% of cases, and the likelihood of successful fertilisation by ICSI is 41%. Overall, the chance of becoming a father with this method is just 23%.

In recent years, new stem cell treatments for azoospermia have emerged. As with other causes of male infertility, the main options for non-obstructive azoospermia are:

  • Spermatogonial cells. Once injected into the testicular area, spermatogonial stem cells (SSCs) migrate to their niche and after a time begin to produce mature male germ cells. Sperm then appear in the ejaculate, creating the conditions for natural conception.
  • Mesenchymal cells. Here the mechanism of action of MSCs is not yet fully understood. Scientists believe, however, that they help restore fertility in men with azoospermia by regenerating the tissues and organs responsible for spermatogenesis. There is also a view that MSCs may interact with very small embryonic-like cells present in the testicles, triggering normal sperm production.

CorSwiss closely follows innovation in medicine and works to make new treatments more accessible to patients. We currently offer a unique opportunity for stem cell treatment of male infertility. The CorSwiss team will answer all your questions and help arrange treatment at one of Switzerland’s leading regenerative medicine clinics.

Preventing male infertility

Some forms of infertility cannot be prevented. There are, however, ways to keep the reproductive system healthy. Men are advised to:

  • stop smoking, drinking excessively and using drugs;
  • avoid baths and saunas, as high temperatures affect sperm production and quality;
  • avoid exposure to industrial or environmental toxins;
  • limit medications that may reduce fertility;
  • eat a healthy diet;
  • lead an active lifestyle.

If a couple has been trying to conceive for a year or more without success, they should see a doctor. It is best to begin diagnosis early, as fertility in both men and women declines with age.

Male infertility treatment in Switzerland is highly effective and safe. The country’s leading specialists work with the most advanced technologies and treatment methods.