Male Infertility

Quick Facts

  • The inability of a male to conceive a child

  • Caused by a number of medical and environmental factors

  • Some causes of male infertility may be corrected with medication or surgery

Male Infertility

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What is Male Infertility?

Male infertility is the inability to conceive a child due to a problem with the male’s reproductive system.

A couple is generally considered infertile if they have been having frequent, unprotected sexual intercourse for a year without successfully conceiving a child. About 30 percent of infertility cases are due to male infertility.

Male Infertility Symptoms

Most often, the only symptom of male infertility is the inability to conceive a child, and many men do not know they’re infertile until they’ve failed to conceive. Occasionally, men will experience additional symptoms related to the cause of their infertility. These symptoms may include:

  • Erectile dysfunction
  • Ejaculatory difficulty
  • Testicular pain or swelling
  • Below average sperm count
  • Chronic respiratory infections
  • Reduced hair growth
  • Breast enlargement
  • Diminished sense of smell

Male Infertility Causes

Male infertility can be caused by many different factors. Essentially, it is the inability of healthy sperm to reach and fertilize a woman’s egg. This can be due to low sperm count, malformed sperm, or blockages that prevent the sperm from successfully reaching the female. These problems can be caused by a number of medical and environmental factors:

  • Varicocele, varicose (swollen) veins in the testicle, which may increase body temperature and damage sperm.
  • Infection, which may damage sperm or cause scarring. Some sexually transmitted diseases, such as gonorrhea and AIDS, negatively affect sperm.
  • Ejaculation problems, including reverse ejaculation and ejaculatory inability caused by traumatic injury or surgery.
  • Tubule blockage, damage to the tubes that carry sperm
  • Cancer, of the reproductive organs or pituitary glands
  • Undescended testicles
  • Hormone imbalance
  • Chromosomal abnormalities
  • Premature ejaculation
  • Erectile dysfunction
  • Medications, including steroids
  • Radiation therapy and chemotherapy
  • Severe depression
  • Extreme stress
  • Environmental factors, such as heavy metal poisoning or chemical exposure
  • Lifestyle factors, such as drug use, smoking, and obesity

Male Infertility Risk Factors

A number of environmental and lifestyle factors can reduce or damage sperm, including:

  • Heavy metal poisoning
  • Pollution
  • Chemical exposure
  • Drug use
  • Alcohol use
  • Smoking
  • Hot tub or sauna use
  • Obesity
  • Traumatic injury to the genitals or pelvic area

Male Infertility Diagnosis

If a couple is declared infertile after a year of trying to conceive without success, a physician will order a fertility evaluation. Usually, the woman’s OB-GYN will initiate the fertility evaluation, but it may also be ordered or conducted by an endocrinologist or urologist. For men, the first step of the fertility evaluation  is most often a physical exam, followed by a semen analysis. A semen analysis will assess the number, shape, and movement of sperm within a sample provided by the patient. If the test results indicate abnormalities in the sperm, additional tests may be ordered, including:

  • Scrotal ultrasound, to check for a varicocele (varicose vein) in the testicles.
  • Blood tests, to assess hormone levels.
  • Urinalysis, to see if there are sperm in the urine, which would indicate retrograde ejaculation.
  • Genetic testing, to check for chromosomal abnormalities.
  • Testicular biopsy, to assess the health and number of sperm and determine whether blockage may be a factor.
  • Sperm tests, to assess the movement of sperm.
  • Ultrasound, to search for blockages.

Male Infertility Treatment

Treatment for male infertility varies depending on the cause.

  • Varicoceles may be treated with a minimally invasive surgery called microsurgical varicoelectomy, which is very effective in restoring fertility.
    Infection may be treated by antibiotics.
  • Ejaculation problems and blockages may be corrected by surgery.
  • Hormone imbalances and erectile dysfunction may be treated by medication.
  • Lifestyle changes may reduce stress and improve the health of sperm.
  • In cases where sperm are healthy but unable to travel successfully from the male to the female, sperm retrieval may be used in combination with intrauterine insemination (IUI) or in vitro fertilization (IVF). Intrauterine insemination is an implantation of the sperm directly into the uterus. In vitro fertilization involves the retrieval of both eggs and sperm, which are fertilized in a laboratory, and then placed in the uterus.
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