Male Infertility

Male infertility is any health issue in a man that lowers the chances of his female partner getting pregnant.

About 13 out of 100 couples can't get pregnant with unprotected sex. There are many causes for infertility in men and women. In over a third of infertility cases, the problem is with the man. This is most often due to problems with his sperm production or with sperm delivery.

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Causes

Making mature, healthy sperm that can travel depends on many things. Problems can stop cells from growing into sperm. Problems can keep the sperm from reaching the egg. Even the temperature of the scrotum may affect fertility. These are the main causes of male infertility:

  • Sperm Disorders
  • Varicoceles
  • Retrograde Ejaculation
  • Immunonologic Infertility
  • Obstruction
  • Hormones
  • Medication

Diagnosis

Causes of male fertility can be hard to diagnose. The problems are most often with sperm production or delivery. Diagnosis starts with a full history and physical exam. Your health care provider may also want to do blood work and semen tests.

History and Physical Exam

Your health care provider will take your health and surgical histories. Your provider will want to know about anything that might lower your fertility. These might include defects in your reproductive system, low hormone levels, sickness or accidents.

Your provider will ask about childhood illnesses, current health problems, or medications that might harm sperm production. Such things as mumps, diabetes and steroids may affect fertility. Your provider will also ask about your use of alcohol, tobacco, marijuana and other recreational drugs. He or she will ask if you've been exposed to radiation, heavy metals or pesticides. Heavy metals are an exposure issue (e.g. mercury, lead arsenic). All of these can affect fertility.

Your health care provider will learn how your body works during sex. He or she will want to know about you and your partner's efforts to get pregnant. For example, your healthcare provider may ask if you've had trouble with erections.

The physical exam will look for problems in your penis, epididymis, vas deferens, and testicles. Your doctor will look for varicoceles. They can be found easily with a physical exam.

Treatment

Treatment depends on what's causing infertility. Many problems can be fixed with drugs or surgery. This would allow conception through normal sex. The treatments below are broken into 3 categories:

  1. Non-surgical therapy for Male Infertility
  2. Surgical Therapy for Male Infertility
  3. Treatment for Unknown Causes of Male Infertility

After Treatment

Male infertility can often be fixed with an outpatient procedure. These are done under general anesthesia or IV sedation. While pain after surgery is usually mild, recovery and follow-up vary. After varicocele repair, your health care provider should do a physical exam. This is to see if the vein is completely gone. Often the veins stay enlarged, since they are not removed during surgery but only closed off to prevent abnormal blood flow. Semen should be tested about every 3 months for at least a year, or until pregnancy. If your varicocele returns, or you stay infertile, ask your health care provider about ARTs.

Vasectomy reversals cause only mild pain after surgery. But expect an out-of-work recovery of 4 to 7 days. The chance for pregnancy depends on many things. It mostly depends on the age and fertility of your female partner. The number of years between your vasectomy and reversal also affects success. The longer you wait, the less likely the reversal will be a success.

Frequently Asked Questions

Make an Appointment

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Source: Urology Care Foundation.