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.
WHAT CAUSES MALE INFERTILITY?
Infertility can be caused by problems that affect sperm production or how the sperm travels. There are medical tests that can help work out the cause.
About two-thirds of infertile men have a problem where they make low numbers of sperm and/or sperm that don’t work properly.
About one in five infertile men have other physical problems, including those who’ve had a vasectomy but now want to have children. Blockages (often called obstructions) in the tubes leading from the testicles to the penis can stop your ejaculating sperm.
Other less common causes of infertility include:
- Sexual problems that affect whether semen is able to enter the vagina (one in 100 infertile couples)
- Low levels of hormones made in the pituitary gland (a hormone controller in the brain) that affect the testicles (one in 100 infertile men)
- Sperm antibodies (proteins that fight against sperm, which are found in one in 16 infertile men). In most men, sperm antibodies will not affect the chance of a pregnancy, but in some cases it can reduce your fertility.
- Sometimes, male infertility is simply genetic.
HOW IS INFERTILITY DIAGNOSED?
Your doctor will usually ask for your medical history, conduct a physical examination and do a semen analysis. This will check the number, shape, and movement of your sperm. They might also take a blood test to check the levels of hormones that control sperm production or for genetic testing. In some cases, your doctor will test your urine to see if sperm are present, which can occur when there is retrograde ejaculation. Sometimes your doctor will recommend an ultrasound, MRI, or a testicular biopsy, which is a small surgery to remove tissue for testing.
CAN MALE INFERTILITY BE PREVENTED?
There are a number of things that can harm the production of sperm, so it’s best to avoid:
- Smoking cigarettes
- Drinking excess alcohol
- Catching sexually transmitted infections
- Heat stress from tight fitting underwear
- Anabolic steroids taken for body building or sporting purposes.
If you work somewhere that may affect your fertility, it’s important to wear protective clothing and to follow all occupational health and safety guidelines. We also recommended that couples trying to conceive stay away from harmful chemicals.
Because of the possible effects on fertility, it’s important to tell your doctor if you have had hormone treatment, or had surgery as a child to fix undescended testes.
CAN OLD AGE CAUSE MALE INFERTILITY PROBLEMS?
Healthy men in their 70s and beyond can still father children, although if you’re middle-aged or older, it usually takes longer for your partner to become pregnant. This might be because of less sexual activity, lower semen volume, changes to sperm movement, a lower number of properly working sperm, or possibly lower sperm function and DNA quality.
The chance of the child having some genetic or chromosomal problem also gets higher when you get older.
TREATMENT OF MALE INFERTILITY
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:
- Non-surgical therapy for Male Infertility
- Surgical Therapy for Male Infertility
- Treatment for Unknown Causes of Male Infertility
Many male fertility problems can be treated without surgery.
How to cope with infertility
Finding out that you’re infertile is often a shocking and upsetting experience. There’s still a common but incorrect belief that infertility is a woman’s problem. So men are often unprepared when they’re told there is a complication with their sperm.
Fertility problems can affect a man’s sense of masculinity, sexuality, and potency.
It’s normal to have an emotional reaction to infertility. Talking with a medical doctor, a sex therapist or counselor can often help with any negative feelings you might be having, also turning to family, partners, and friends for support can also help.