Infertility is a distressing problem for many couples, and while female infertility gets more attention, male infertility is just as common. As an aspiring father, understanding the causes and options for male infertility is important for your reproductive health and planning a family. This comprehensive guide will provide an overview of what male infertility entails, how it arises, and the many treatment paths available so you can take control of your fertility.
From hormonal imbalances to anatomical problems, there are several medical issues that can impact a man’s ability to conceive. The good news is that recent advances in science and medicine have led to a variety of effective options for diagnosing and treating male infertility. By gaining a deeper understanding of how infertility occurs in men and the solutions at your disposal, you’ll be better equipped to work with your doctor to find an approach tailored to your unique situation. Knowledge is power – use this guide to empower yourself on your journey to starting a family.
What Is Male Infertility?
Male infertility refers to a male’s inability to cause pregnancy in a fertile female. Infertility affects approximately 1 in 5 couples in the United States. For about 35% of these couples, infertility is due to the male partner.
There are several potential causes of male infertility:
- Low sperm count (oligospermia): Producing too few sperm to fertilize an egg. A normal sperm count is considered 15 million sperm per milliliter of semen or higher.
- Poor sperm motility (asthenospermia): Sperm that do not move properly or are unable to travel to the egg. At least 40% of a man’s sperm should exhibit normal forward movement.
- Abnormal sperm morphology (teratospermia): Sperm that are misshapen or abnormally formed. At least 4% of a man’s sperm should have normal shape and form.
- Blockages or obstructions: Blockages in the male reproductive tract that prevent the delivery of sperm. Conditions like varicocele or ejaculatory duct obstruction can cause blockages.
- Hormone imbalances: Problems with the hypothalamus, pituitary gland, or testicles that cause low testosterone (low T) or other hormonal imbalances.
- Genetic disorders: Conditions such as Klinefelter syndrome that involve the improper development of the male reproductive organs and/or sex chromosomes.
- Unknown causes: In some men, the underlying cause of their infertility remains unexplained. This is known as idiopathic infertility.
The good news is there are several effective treatment options for male infertility depending on the underlying cause. With the help of reproductive specialists and fertility treatments like ICSI, many men are still able to father children.
Common Causes of Male Infertility
As a male, several factors can contribute to infertility and issues with sperm production or quality. Some of the most common causes of male infertility include:
- Varicocele: A varicocele is an enlargement of the veins in the scrotum. It is a common cause of infertility and can lead to decreased sperm count and quality. Treatment options include surgery to repair the varicocele or assisted reproductive technology (ART) procedures.
- Infection: Infections such as chlamydia, gonorrhea, and herpes can cause sperm abnormalities and blockage of the reproductive tract. Treatment with antibiotics may help improve fertility.
- Ejaculation issues: Problems with ejaculation, such as retrograde ejaculation where semen flows into the bladder, can impact fertility. Treatment may involve medications or surgical correction of any anatomical issues.
- Hormonal imbalance: Improper levels of hormones such as testosterone, follicle stimulating hormone (FSH), and luteinizing hormone (LH) may contribute to infertility. Hormone therapy or medications may be used to restore balance.
- Sperm issues: Low sperm count (oligospermia), poor sperm motility (asthenospermia), or abnormal sperm size and shape (teratospermia) can make conceiving naturally difficult. Options like intrauterine insemination (IUI), in vitro fertilization (IVF), or intracytoplasmic sperm injection (ICSI) may be recommended based on the severity.
- Unknown causes: In some men, the underlying cause of infertility remains unexplained. ART procedures are often the best option for treatment in these cases.
The good news is there are many treatment options and resources available for male infertility. Discussing the potential causes and solutions with a urologist or reproductive endocrinologist is the best first step. With medical intervention, many men are still able to father children.
Symptoms of Male Infertility to Watch Out For
If you and your partner have been trying to conceive for over a year without success, it could indicate male infertility. The most common symptom is difficulty getting a woman pregnant, but there are other signs to watch for.
Low sperm count
A low sperm count, known as oligospermia, is a decrease in the number of sperm present in a man’s semen. A healthy sperm count is typically 15 million sperm per milliliter of semen or more. Under 10 million is considered low and may make conceiving naturally difficult. Sperm count can be tested through a semen analysis.
Abnormal sperm shape and movement
Infertile men may have a high percentage of sperm with abnormal morphology (shape) and motility (movement). Healthy sperm should have an oval head and long, muscular tail that propels energetic movement. Misshapen sperm (teratospermia) and sperm with slow or no movement (asthenospermia) may have trouble reaching and fertilizing an egg. These issues can also be detected in a semen analysis.
Additional symptoms of male infertility to be aware of include:
- Pain or swelling in the testicles
- Recurrent respiratory infections
- Decreased facial or body hair
- Erectile dysfunction or premature ejaculation
If you experience any of these symptoms, especially difficulty conceiving after trying for a year, consult your doctor. They can test your semen and hormone levels to determine if there are any fertility issues and discuss treatment options like medication, surgery, or assisted reproductive technology (ART). While male infertility can be stressful, many causes are treatable, so an early diagnosis and intervention is best.
Diagnosis and treatment
Diagnosing male infertility typically involves a physical exam, medical and sexual history, multiple semen analyzes, and blood tests to measure hormone levels. Treatment options depend on the underlying cause and may include:
- Hormone supplements or medications
- Corrective surgery to repair varicoceles or blockages
- Lifestyle changes like limiting alcohol, smoking cessation, reducing stress
- Intrauterine insemination (IUI) or in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI)
The prognosis is often good, especially when treatment is tailored to the specific cause of infertility. Many infertile men go on to father children with medical intervention. The key is to get tested and explore your options.
Diagnosing Male Infertility: Semen Analysis and Other Tests
To determine the cause of male infertility, a doctor will evaluate a man’s symptoms, medical history, and lifestyle. Diagnostic tests may also be recommended to examine the health and function of the male reproductive system. The most common test is a semen analysis, which analyzes a sample of semen to check for any abnormalities.
A semen analysis measures several factors of semen and sperm health. A man will provide a semen sample, usually through masturbation, that is examined for:
- Sperm count: The number of sperm present in the semen. A normal sperm count is 15 million sperm or more per milliliter of semen. Low sperm count, known as oligospermia, is a common cause of infertility.
- Sperm motility: The ability of sperm to swim in a forward progression. At least 40% of sperm should display normal motility. Poor motility, or asthenospermia, makes it difficult for sperm to reach the egg.
- Sperm morphology: The size and shape of the sperm. At least 4% of sperm should have a normal oval shape with a slender tail. Abnormal sperm morphology, or teratospermia, can inhibit the ability to fertilize an egg.
- Semen volume: The amount of semen produced during ejaculation. A normal volume is 1.5 to 5 milliliters. Low volume may suggest issues with the seminal vesicles or prostate.
- pH level: The acidity or alkalinity of the semen. A normal pH range is 7.2 to 8.0. An abnormal pH can reduce sperm health and activity.
Other tests like blood tests, ultrasound, and genetic testing may also be used to pinpoint the underlying cause of male infertility. Identifying any issues can help determine the appropriate treatment, such as medication, surgery, or assisted reproductive technology like in vitro fertilization (IVF). With treatment and lifestyle changes, many cases of male infertility can be improved or overcome.
Treatment Options for Male Infertility
There are several treatment options available for male infertility depending on the underlying cause. The good news is, many cases of male infertility are treatable.
Medications may be used to treat hormone imbalances or infections that can contribute to infertility. For example, medications such as Clomid may be used to stimulate sperm production. Antibiotics can also be prescribed to treat infections like prostatitis that may impair fertility.
In some cases, surgeries can be performed to correct anatomical problems or blockages that prevent sperm from being ejaculated normally. Options include:
- Varicocele repair: To treat enlarged veins in the scrotum (varicoceles) that can reduce sperm quality.
- Vasectomy reversal: To reconnect the vas deferens after a vasectomy. Success rates depend on how long ago the vasectomy was performed.
- Epididymostomy: To correct blockages in the tubes connecting the testicles to the vas deferens (epididymis).
Assisted Reproductive Technology (ART)
ART includes treatments like intrauterine insemination (IUI) and in vitro fertilization (IVF) where sperm are inserted directly into the female reproductive tract. IUI success rates are typically 10-20% per cycle. IVF offers the highest chances of success but is also the most expensive option. With IVF, sperm and eggs are combined in a lab to create embryos that are then transferred to the uterus. Success rates for IVF depend on factors like the woman’s age but are often 50% or higher per cycle.
Simple lifestyle changes may help improve fertility in some men. These include:
- Reducing stress levels through exercise, meditation, or yoga.
- Quitting smoking and limiting alcohol consumption. Both can damage sperm.
- Avoiding hot tubs, saunas, and sources of radiation which can temporarily reduce sperm count.
- Eating a healthy, balanced diet with plenty of nutrients like vitamin C, zinc, and folate which support sperm health and production.
With the variety of treatment options now available, many cases of male infertility can be overcome. The key is to determine the underlying cause and find an approach that is right for your unique situation. With time and the proper treatment, you have an excellent chance of overcoming infertility.
Lifestyle Changes to Improve Male Fertility
There are several lifestyle changes you can make to improve male fertility and increase your chances of conceiving a child. Making healthy adjustments to your daily habits can have a significant impact on sperm health and viability.
Exercising regularly improves circulation, releases hormones, reduces stress, and leads to better health overall — all of which boost fertility. Aim for 30 to 60 minutes of moderate exercise most days of the week. Activities like walking, jogging, biking, and strength training are excellent options. However, avoid intense exercise that could overheat the testicles.
Eat a Balanced, Nutritious Diet
A balanced diet with plenty of nutrients is essential for sperm health and male fertility. Focus on whole foods like fruits and vegetables, whole grains, lean proteins, and healthy fats. Key nutrients for fertility include:
- Zinc: Oysters, beef, pumpkin seeds, cashews, chickpeas.
- Folate: Spinach, black-eyed peas, brussels sprouts, asparagus.
- Vitamin C: Citrus fruits, broccoli, brussels sprouts, kale, strawberries.
- Antioxidants: Blueberries, sweet potatoes, artichokes, pecans, cranberries.
Limit processed foods, sugar, red meat, and unhealthy fats which can negatively impact sperm health. Stay hydrated by drinking plenty of water to keep your reproductive system in working order.
Chronic or long-term stress can damage sperm and testosterone production, impacting fertility. Try relaxation techniques like yoga, meditation, deep breathing, and journaling. Spend time with loved ones, engage in hobbies, and make sure to schedule downtime for yourself. Seeking counseling or therapy can also help develop coping strategies.
Limit Alcohol and Quit Smoking
Both alcohol and tobacco use have been shown to reduce sperm health and fertility. Limit alcohol to 1 drink per day or avoid completely when trying to conceive. And quit smoking immediately — your fertility may improve in as little as 3 months after quitting.
Making positive lifestyle changes can significantly increase your chances of overcoming male infertility issues and conceiving a child. Commit to living an overall healthy life for the best fertility and beyond.
Facts and Statistics About Male Infertility
Prevalence of Male Infertility
According to various studies, approximately 15% of couples are infertile. Male infertility contributes to around 50% of infertility cases. As such, male infertility affects about 7% of all men. The most common cause of male infertility is low sperm count or abnormalities in sperm quality and production.
A man’s age plays a significant role in fertility and the risk of infertility. Fertility starts declining after age 35 and drops more rapidly after age 40. Men over age 40 have a higher chance of infertility due to decreasing sperm quality and quantity as well as higher risks of health issues like erectile dysfunction or premature ejaculation.
Lifestyle Choices Impact Fertility
Certain lifestyle factors like smoking, heavy alcohol use, drug use, pollution or radiation exposure, overweight or obesity, and anabolic steroid use can negatively impact male fertility. Reducing or eliminating these harmful lifestyle choices can help improve sperm health and fertility. Leading a balanced lifestyle with good nutrition, exercise, limited stress, and avoiding toxic habits is ideal for fertility and reproductive wellness.
Genetic abnormalities account for about 15-30% of male infertility cases. Conditions like Klinefelter’s syndrome where a male is born with an extra X chromosome, Y chromosome abnormalities, or cystic fibrosis can contribute to infertility. In some cases, male infertility may be passed down from mothers or fathers to sons. Genetic testing and counseling may be recommended for some men to determine the cause of infertility and options for treatment.
While these facts and statistics about male infertility may seem disheartening, the good news is that many causes of male infertility are treatable. Lifestyle changes, surgery, medication, assisted reproductive technology, and other options offer hope to many infertile men. By understanding the causes of male infertility and exploring treatment choices with your doctor, you can develop a plan to improve fertility and the chances of conceiving a child.
Common Myths About Male Infertility
Infertility is a “woman’s problem”
This is a damaging myth. According to Resolve, the National Infertility Association, about one-third of infertility cases are due to male infertility alone and another third involve both male and female infertility factors. Infertility is a medical condition that affects both men and women.
Infertility only affects older men
While fertility does decrease with age, infertility can affect men of all ages. In fact, one study found that about 9% of infertile men were under 25 years old. Infertility in younger men is often due to congenital or genetic problems, reproductive tract infections, or other issues.
Infertility is rare
Infertility impacts over 7 million people in the U.S. alone. According to the CDC, about 12% of women and 10% of men of reproductive age experience infertility. Infertility is actually quite common and affects people of all backgrounds.
Lifestyle changes won’t help
Leading a healthy lifestyle that avoids harmful habits can have significant effects on male fertility and sperm health. Things like limiting alcohol, quitting smoking, maintaining a healthy weight, reducing stress, and avoiding recreational drug use have been shown to improve sperm quality and increase fertility rates. While lifestyle changes may not overcome all cases of infertility, they can make a difference and also have overall health benefits.
Infertility is usually unexplained
In about 30-40% of infertility cases, the cause remains unexplained. However, many potential contributing factors have now been identified. Common causes of known male infertility include low sperm count or quality, problems with sperm motility or morphology, hormonal imbalances, genetic issues, reproductive tract obstructions, and medical conditions like diabetes or celiac disease. New tests and procedures can help determine the underlying cause in many previously unexplained cases.
With diagnosis and treatment, many cases of male infertility can be improved or resolved. However, overcoming myths and misconceptions is an important first step. Speaking with a reproductive urologist or infertility specialist is key to getting an accurate diagnosis and exploring options based on your unique situation.
FAQs: Frequently Asked Questions About Male Infertility
What causes male infertility?
Male infertility can be caused by a number of factors, including:
- Genetic issues: Chromosomal or genetic abnormalities can impair sperm production or function.
- Medical conditions: Certain chronic illnesses like diabetes, cystic fibrosis or hypothyroidism can negatively impact sperm health and male fertility.
- Infections: STDs such as chlamydia or gonorrhea can lead to scarring that blocks the passage of sperm. Infections such as mumps may also directly affect the testicles.
- Environmental and lifestyle factors: Exposure to certain chemicals, radiation, medications, tobacco, alcohol, and illicit drugs are linked to lowered sperm count and impaired sperm health. Stress and age are also contributing factors.
How common is male infertility?
According to the National Institutes of Health, male infertility contributes to about 1/3 of all infertility cases. Roughly 15% of couples in the general population experience infertility. So about 5% of couples with infertility struggle due to issues with the male partner.
How is male infertility diagnosed?
If you’ve been trying to conceive for over a year without success, it’s a good idea for you and your partner to get checked out. For men, diagnosis typically begins with a semen analysis to evaluate sperm count, morphology, motility, and other parameters. Blood tests may check hormone levels. A physical exam and health/lifestyle review will also be done. More invasive tests like a testicular biopsy may be needed in some cases.
What treatments are available for male infertility?
Treatment options depend on the underlying cause(s) of infertility and may include:
- Lifestyle changes: Losing excess weight, quitting smoking, limiting alcohol, reducing stress.
- Medications: Hormone treatments, antibiotics for infections, etc.
- Surgery: To repair varicoceles (enlarged veins in the scrotum) or blockages.
- Assisted reproductive technology (ART): Intrauterine insemination (IUI) or in vitro fertilization (IVF) using intracytoplasmic sperm injection (ICSI).
- Donor insemination: Using sperm from a donor to inseminate the female partner.
The good news is that in many cases, male infertility can be treated. The key is to determine the cause(s) through proper diagnosis and testing, then develop an appropriate treatment plan to address the issues, improve sperm health and increase the chances of conception.
In conclusion, male infertility is a complex medical issue that affects many men. While the causes are not always clear, the good news is there are several treatment options to consider with your doctor. Diagnosing the root cause of infertility through testing is the critical first step. From there, lifestyle changes, medication, surgery, or assisted reproductive technology may help overcome infertility. Although it can be difficult to accept, remember that infertility does not define you and there are resources to help you through this challenging time. Staying optimistic and exploring all options with your partner and doctor are the keys to success. With the right treatment and perseverance, many men are able to become fathers.
Anna Haotanto is the Founder of Zora Health and a passionate advocate for women’s empowerment. Anna’s personal experiences with egg-freezing, PCOS and the challenges of fertility have fueled her mission to provide high-quality information, financing, and support to help women and couples navigate their fertility journeys with confidence. She is also recognised for her achievements in finance, entrepreneurship, and women’s empowerment, and has been featured in various media outlets. You can also follow her on Linkedin or Instagram.
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