Infertility affects approximately one out of every six couples. An infertilitydiagnosis is given to a couple who are unable to conceive over the courseof one year. When the problem lies with the male partner it is referredto as male infertility. Male infertility factors contribute to approximately50% of all infertility cases, and male infertility alone accounts for approximatelyone-third of all infertility cases.
What causes male infertility?
Male infertility usually occurs because of sperm that are abnormal, becauseof inadequate numbers of sperm, or problems with ejaculation.
Sperm can be considered abnormal for two possible reasons: unusually shortlife span of the sperm and/or low mobility. Sperm abnormalities may be causedby one or more of the following:
- Inflammation of the testicles
- Swollen veins in the scrotum
- Abnormally developed testicles
Reasons for a low sperm count or lack of sperm include one or more of thefollowing:
- A pre-existing genetic condition
- Use of alcohol, tobacco or other drugs
- Severe mumps infection after puberty
- Hernia repairs
- Hormone disorder
- Exposure to poisonous chemicals
- Exposure to radiation
- Blockage caused from a previous infection
- Wearing restrictive or tight underwear
- Injury to the groin area
Male infertility can also occur when there are problems with ejaculation.Ejaculation problems may include any of the following:
- Premature ejaculation
- Retrograde ejaculation, which occurs when thesemen is forced back into the bladder
- Erection dysfunctions
- Complications from radiation therapy or surgery
Other causes of male infertility can include:
History of STD’s
- Urinary tract infections
- Use of certain types of medications
How is male infertility diagnosed?
Potential male infertility will be assessed as part of a thorough physicalexamination. The examination will include a medical history regarding potentialcontributing factors.
Your healthcare provider may use one or more of the following tests toassess fertility:
- Semen analysis to determine the number and qualityof sperm
- Blood test to check for infections or hormoneproblems. Hormone levels are just as important in male fertility as theyare in female fertility
- Making a culture of fluid from the penis to checkfor infections
- Physical examination of the penis, scrotum and prostate
Semen analysis is the most important part of male fertility testing. Somemen find it more comfortable to do semen analysis testing in the privacyof their own homes. In-home testing kits are available. See ShopMale testing.
What are they looking for in the testing?
When semen analysis is done, your health care provider will be lookingfor some specific markers to access fertility.
Total amount or volume of semen–2 milliliters is considerednormal. A lower amount may indicate an issue with the seminal vesicles,blocked ducts or a prostate gland issue.
- Sperm count- 20 million to 300 million per milliliter is considered in thenormal range for sperm counts. Below 10 million is considered “poor.”
- Morphology–the size and shape of the sperm affect the sperms ability toreach and fertilize an egg. 30% is considered a good amount of sperm thatare shaped “normal.” And “strict” testing shows an evenlower percentage as normal.
- Motility–movement and number of active cells. Movement is rated from 0-4,with score over 3 considered good. The amount of active cells is rated inpercentages from 1-100%, with 50% considered the minimum.
How is male infertility treated?
Male infertility is most often treated by conventional methods that includeone or more of the following:
- Taking medications to help increase sperm production
- Taking antibiotics to heal an infection
- Taking hormones to improve hormone imbalance
- Avoiding taking long hot showers, using hot tubsor saunas
- Wearing looser underwear such as boxer shortsversus jockey shorts
Sperm production may also improve by taking clinically proven supplements.Anything that increases the number of healthy sperm increases the chancesof conception. Many health food stores and vitamin shops offer male fertilitysupplements. See Shopfor male supplements.
Artificial insemination is an option if the man’s sperm count islow. In this procedure, sperm is collected through multiple ejaculations.They are then manually placed in the female’s uterus or fallopiantubes.
In vitro fertilization is another option that canbe used to overcome male infertility factors. In this procedure, the spermand egg are fertilized in a laboratory after which the fertilized egg isplaced in the female’s uterus.
If tests show that there is no sperm production or that other related problemsare present, donor sperm can be usedto help facilitate conception. In this procedure, donor sperm are obtainedfrom a sperm bank and placed inside the female’s uterus or fallopiantubes through artificial insemination.
Can male infertility be prevented?
There is usually nothing that can be done to prevent male infertility causedby genetic problems or illness. However, there are actions that men cantake to decrease the possibility of infertility. These include:
- Avoiding sexually transmitted diseases
- Avoiding illicit drugs
- Avoiding radiation when possible
- Avoiding exposure to toxic substances
- Avoiding heavy or frequent use of alcohol
- Observing good personal hygiene and health practices
- Avoiding long, hot baths, hot tubs or saunas
- Wearing loose-fitting underwear
Compiled using information from the following sources:
RESOLVE: The National Infertility Association, http://www.resolve.org
American Society for Reproductive Medicine (ASRM), http://www.asrm.org
World Health Organization (WHO), http://www.who.int