An estimated 1 in 8 couples struggle with infertility, but determining the cause can be a bit of an involved process. Of those couples, male infertility is the sole contributing factor 8% of the time and 35% of the time, fertility issues can be attributed to both the male and the female. Since there is often more than one factor in play, examining both partners is important. Let’s start by taking a closer look at male-factor infertility.
Male factor infertility is not often talked about. As with women, age affects male fertility but the loss of fertility happens at a different rate. This is because women are born with a finite number of eggs. After ovulation, an egg is not replaced by a new one. However, men’s bodies produce a large number, between 100 and 200 million in a healthy male, of new sperm each day.
The natural decline in male fertility generally does not start until a man is in his 40s. At this point, the quality and quantity of their sperm can begin to decrease. Though conception may still be possible, the pregnancy may not be viable or the resulting child may have health problems.
Outside of age, there are a number of factors that may contribute to male infertility. These factors generally fit into one of two categories:
- Sperm production problems: In this type of male factor infertility, the quantity and quality of sperm are not ideal for natural conception. Low sperm count and motility are commonly known problems with sperm production. These issues can be caused by trauma, genetic defects, infection, medications, age, and environmental factors.
- Structural problems: These are issues that prevent the movement of semen from the testicles all the way to the urethra for ejaculation. The problem could originate in any of the key locations in the male reproductive process including the epididymis, vas deference, prostate gland, and seminal vesicle. If there is no sperm in the ejaculate, then there is no chance of conception through intercourse.
Conditions that can make regular intercourse difficult or impossible, like erectile dysfunction or premature ejaculation, can also be contributors. Determining the type of male infertility is critical in moving forward with treatment.
Before male factor infertility can be treated, testing must be performed to confirm the diagnosis and determine the source of the problem. Testing for infertility of any type is usually recommended after a couple tries to conceive naturally for 12 months. That timeline drops to 6 months if the woman is over 35.
A medical history and basic screening are completed first. Testing will generally include taking a sample for a semen analysis. In semen analysis, fertility specialists examine the motility, volume, concentration, and morphology (the size and shape) of the sperm. More in-depth examinations might be required such as hormonal blood tests, genetic screenings, or ultrasounds.
When male factor infertility is confirmed, there are a few treatment options to consider depending on the diagnosis:
- Surgical correction of any structural issues that might be preventing the passage of sperm into the ejaculate.
- Treating infections that might be damaging the sperm or preventing passage.
- Lifestyle changes like cessation of medications that can harm sperm production. Talk to your fertility specialist and your prescribing doctor before taking this step.
- Hormone treatments to correct imbalances.
- Treating issues with intercourse such as premature ejaculation or erectile dysfunction. These treatments can include medication and/or counseling.
- Assisted reproductive technology (ART) such as surgical extraction of sperm, IVF, or IUI.
If the above methods do not successfully treat male factor infertility, your fertility specialist may recommend alternative options such as using donor sperm.
Sadri Fertility is a North Carolina-based clinic dedicated to the unique issues of men. Founded by Hooman Sadri, MD, PhD, assistant professor, Sadri Fertility specializes in male reproductive medicine. Call us at 336-716-4131.