Male factor infertility
Approximately one in six couples who are trying to conceive will experience some form of infertility. In about one third of cases, the problem is a form of female factor infertility, while in another third, male infertility is the issue. The remaining couples either have a combination of male- and female-based fertility problems or have infertility that is unexplainable.
Common causes of and treatments for male infertility
Like female infertility, male infertility can be caused by a wide range of factors, including:
Varicocele
A varicocele is a varicose vein in the scrotum. Because the excess blood that pools and backs up in the vein causes overheating, it can diminish the number and quality of sperm cells that are produced. Although we do not treat varicoceles at the Center for Reproductive Medicine, this common cause of male infertility can be easily diagnosed during a physical examination by a urologist and can be corrected surgically.
Physical irregularities
A blocked or missing vas deferens or epididymis is another potential cause of male infertility. This problem is usually indicated by a semen analysis in which the sperm count is very low or there is no sperm at all. However, as long as sperm is still being produced, it can be collected directly from the testicles for use during in vitro fertilization (IVF).
Hormonal imbalances
Gland malfunctions, genetic conditions or unhealthy body weight can all lead to a hormonal imbalance that interferes with sperm production and causes male infertility. Blood tests are used to diagnose hormonal imbalances, and treatment may involve medication or lifestyle changes.
Environmental and lifestyle factors
Because new sperm cells are constantly being produced, the number and quality of sperm are easily affected by environmental exposure and poor health choices. Smoking, heavy alcohol consumption, certain medications, infections, exposure to toxins and anything that causes prolonged overheating of the testicles can cause temporary male infertility. Fortunately, the effects can usually be reversed by eliminating these factors.
Many of these conditions are relatively common and can be easily treated or overcome with assisted reproductive technology.
Diagnosing male infertility
Even if there is a known cause of infertility in the female partner, we recommend that the male partner undergo fertility testing as well to be sure that there are no contributing factors before proceeding with treatment. Screening procedures for male infertility are relatively simple and non-invasive. The initial test is a semen analysis, which will indicate if there are any potential issues that require further testing.
Semen analysis
Once a semen sample has been collected, either in our office or at home, it will be examined for volume and consistency, as well as sperm count, motility and morphology.
Sperm count is the concentration, or number of sperm per milliliter of semen. Normal sperm concentration is considered anything above 20 million sperm per milliliter. Low sperm count can indicate problems with production, caused by physical, hormonal or environmental influences. A complete lack of sperm (azoospermia) is generally caused by a blockage, but it can also be a symptom of certain rare genetic conditions.
The motility and morphology (movement and shape) of the sperm are also major markers of male infertility. If high numbers of sperm are abnormally shaped or do not move properly, it usually indicates a problem with the production of sperm.
Since sperm quantity and quality can fluctuate, we recommend that more than one semen analysis be conducted for greater accuracy. If the results are consistently normal, male infertility can be ruled out. If the results are abnormal, other tests may be conducted to determine the source of the problem.
Physical examination
A basic physical examination involves the inspection of the male reproductive organs by a urologist or male infertility specialist. Your physician will look for irregularities in the shape, size, position or density of your organs. If necessary, an ultrasound may also be performed to evaluate the internal structures as well.
Blood tests
Depending on the results of your semen analysis, blood tests may also be conducted to check for hormonal imbalances or certain genetic conditions. Because these causes of male infertility are less common than others, this testing won't necessarily be performed unless other indications are present.
Frequently asked questions
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Male infertility means there's a problem with a man's sperm or another issue affecting his reproductive system that's making it hard to conceive a child.
Infertility affects around one in six couples when they're trying to conceive. In about 35% of cases, the problem is due to male infertility.
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There are several possible causes of male infertility, including:
- A varicocele: A varicocele is a varicose vein that forms in your scrotum. These veins contain excess blood that can lead to overheating, resulting in a reduction in sperm quantity and quality.
- Physical irregularities: Infertility can be caused by a problem with the structures in your genitals, such as a congenital abnormality or a blockage in the tubes that transport sperm.
- Hormonal imbalances: Malfunctioning glands, a genetic condition, or being overweight or obese can affect the levels of hormones like testosterone, which can compromise sperm production.
- Environmental and lifestyle issues: Exposure to toxins in your environment, some types of medications, poor lifestyle choices (such as smoking or excessive drinking) and anything that results in the overheating of your testicles can cause temporary male infertility.
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The first test your provider performs is a semen analysis, which shows if you have any potential problems. You just need to provide a semen sample, collected either at the Center for Reproductive Medicine or at home.
Our on-site laboratory examines the semen sample for consistency and volume, and determines how many sperm you're producing (sperm count), how well they're moving (motility) and their shape (morphology).