Male Infertility

Have you and your male partner tried without success to get pregnant and have a baby? Most people think women are usually responsible for infertility. In reality, infertility is often linked to health problems with men. About 40 percent of conception problems are attributed to male infertility.

Most of the time, men show no outward signs of male infertility. Yet if the cause of male infertility is hormonal, your partner may have some outward signs such as a decrease in sex drive or reduced hair growth on his face or body.

Sperm Quality and Quantity
Most common causes of male infertility are related to sperm health. The following sperm-related issues can affect a man’s fertility, making it harder for a couple to get pregnant.

  • Abnormally shaped sperm
  • Sperm with poor motility
  • Poor sperm quality
  • Sperm that cannot attach the head to egg
  • Sperm that cannot penetrate the egg

How low is too low?
Low sperm count is a common male infertility problem. Usually men have 20 million sperm per milliliter of semen, while a count of 10 million sperm per milliliter or lower is considered low.

Some men suffer from azoospermia, a condition where the ejaculation does not contain sperm. This male infertility problem may be caused by infection, testicles that don’t produce sperm, a congenital absence of the vas deferens, or a previous vasectomy. A semen analysis can tell you more.

Causes of Male Infertility

  • Hormonal disorders
  • Chromosomal defects
  • A deficiency in testosterone production
  • Infection – Infection can cause inflammation of the male testicles, urethra, or prostate, harming sperm production or movement
  • Sexually transmitted diseases (STDs)
  • A male birth defect called hypospadia where the urinary opening is located on the underside of the penis, rather than the tip.
  • Retrograde ejaculation where the sperm enters into the bladder rather than out of the penis after ejaculation.
  • Testicular Cancer

Also, your partner’s testicles must be exposed to the proper temperature in order for sperm production to occur. Two conditions that may not allow this to happen include:

  1. An undescended testicle, which keeps the testicles close to the higher body temperature and does not allow them to be cooled properly
  2. A varicocele, a condition where a swollen vein in the scrotum doesn’t allow for cooling of the testicles, leading to reduced sperm count and motility

Lifestyle Habits Lead to Male Infertility
Certain lifestyle habits can also affect male infertility, including:

In addition, exposure to certain toxins, pesticides or lead can also cause male infertility. If your partner has been exposed to radiation and/or chemotherapy due to cancer treatment or for any reason, there can be a significant risk to his sperm production. Also, having a vasectomy may cause anti-sperm antibodies to form and attack sperm, leading to male infertility, which may cause problems if your partner wants to have a vasectomy reversal.

Diagnosing Male Infertility
If a doctor suspects male infertility, he may run some tests to make a definitive diagnosis. Your partner may first undergo a routine physical exam and semen analysis. The semen analysis will analyze the number of available sperm, the shape of the sperm and its movement. If the semen analysis shows a problem, your doctor may recommend further testing.  Other tests for male infertility may include:

  • A semen culture to look for infection
  • A vital staining test to determine how many sperm are alive in a sample
  • A blood test that checks for abnormal hormone levels or genetic disorders
  • A sonogram of the scrotum to look for blockages
  • A testicular biopsy to see if sperm production is normal
  • A test for anti-sperm antibodies
  • A contrast dye test of the vas deferens to check for a blockage

Lastly, your doctor may run male infertility tests to see how well the sperm attaches to an egg or is able to penetrate it.

Treating Male Infertility

Male infertility treatment is helping many couples get pregnant. Let’s look at some male infertility treatments and how they may help you start your family.

  • Intrauterine Insemination (IUI) is often used as a male infertility treatment, particularly in couples with mild male infertility. For men with retrograde ejaculation that stems from diabetes or other problems, IUI may help you conceive. During the IUI procedure, your partner’s sperm is removed from his semen. The sperm is washed, which activates the sperm for fertilization.  The washed sperm sample is then inserted into your uterus. This procedure improves the number of sperm reaching the site of fertilization, bypassing your cervix, the main site of female sperm antibody production.
  • Intracytoplasmic Sperm Injection (ICSI) is used by most IVF centers across the globe and is the key player in male infertility treatment, particularly for men with low sperm counts or poor motility. ICSI involves directly injecting a sperm into the egg (oocyte). The sperm passes the outer coverings of the egg and barriers to fertilization. Because only a small number of sperm are needed with ICSI, this male infertility treatment may be used for couples who have failed at IVF.
  • Healthy Lifestyle Changes can increase your chances of conceiving. For example:
    • Overweight or obese men have decreased testosterone, less semen, and more sperm abnormalities
    • Smokers have a decline in sperm function and erection problems
    • Heavy use of alcohol affects both sperm count and function
    • Running more than 20 miles a week may reduce fertility

The good news is your partner can boost his fertility by eating a balanced diet, staying at a healthy weight, avoiding alcohol and cigarettes, and exercising moderately.

  • Medications and Male Fertility- Ask your doctor about male fertility drug options. Sometimes hormonal therapies are prescribed, particularly if the infertility results from hypogonadotropic hypogonadism.  Regarding medications, a commonly prescribed blood pressure drug (calcium channel blocker) can affect fertility. Switching to another hypertension drug may be the only male infertility treatment your partner needs. Also, while Viagra does not boost fertility, it can enhance a man’s sexual performance without affecting the sperm. At times, better sex is a male infertility treatment in itself!
  • Surgery for Male Infertility Treatment- Has your RE recommended surgery to correct your partner’s varicocele, a varicose vein of the scrotum? In theory, the dilation of the scrotal veins may increase temperature, which could reduce sperm quality. While sperm counts may increase after varicocele surgery and some believe the surgery may help men with a large varicocele, there’s little conclusive data that varicocele surgery is an effective male infertility treatment.

Most experts believe the couple is a “unit” when it comes to fertility. Diagnosing and treating the couple can further increase the chances that you will get pregnant. Today, there is much hope for male infertility treatment. Using high-tech treatments alongside commonsense lifestyle changes, you and your partner can benefit from the best treatments that let you get pregnant—and start your family.