Male Infertility
What is it?
Male infertility is the failure of a couple to
become pregnant after six months of regular,
unprotected sexual intercourse due to the male
producing too few sperm or no sperm at all.
Who gets it?
Infertility is a problem for one of every six
couples, with problems in the male partner
responsible for about half of infertility cases.
Sometimes the problem is the natural decline in
fertility that comes with aging, so it is more
common in men over age 40.
What causes it?
Causes for male infertility include exposure to
toxic chemicals or radiation; a genetic disorder
such as Klinefelter’s syndrome; taking frequent,
long hot tub baths; alcohol, tobacco or drug
abuse; a severe mumps infection as an adolescent
or adult; hormone disorders of the pituitary
gland, testicles, thyroid glands, or adrenal
glands; infections of the genital organs causing
blockage of the sperm passages; and wearing jockey
shorts underwear all the time.
Sometimes the cause of male infertility is
malformed sperm that cannot swim properly or have
a short lifespan. Abnormal sperm can result from
inflammation of the testicles (a possible
complication of having mumps as an adult) or
abnormally twisted or swollen veins in the
scrotum, the sac that holds the testicles, and
abnormally developed testicles.
Sometimes the problem is ejaculation, including
early ejaculation, retrograde ejaculation (semen
is forced back into the bladder), inability to
keep an erection (possibly due to side effects of
some blood pressure medications or diseases such
as diabetes or Peyronie's disease), or a
complication of radiation therapy or surgery.
Other causes include hypospadius, when the
urethra opens somewhere besides the end of the
penis, and varicocele, which is varicose veins of
the spermatic cord.
What are the symptoms?
Symptoms of male infertility are six months of
unprotected intercourse with the patient’s partner
unable to get pregnant while other causes have
been ruled out.
How is it diagnosed?
A doctor may diagnose male infertility after a
thorough evaluation of the patient’s medical
history and the completion of various tests. A
doctor may ask about the patient’s sexual history,
including previous pregnancies, history of medical
conditions such as illness and infections, use of
drugs and alcohol, sexual intercourse practices,
such as how often the patient has sex and whether
lubricants are used, genital surgery, circumcision
and genital development.
A doctor may perform a vitro test of cervical
mucus penetration by sperm. This test shows
whether the patient’s sperm can swim through and
survive inside his partner. Another test is
postcoital test of interaction between sperm and
cervical mucus. This test is performed 2 to 12
hours after intercourse to show if the woman's
cervical mucus and the man's sperm are compatible.
It can also show if there are sperm antibodies
present. A sperm agglutination tests determines if
the sperm are clumping together as a result of
antibodies or infection, and a sperm
immobilization test may be done to check how well
sperm swim toward the egg.
What is the treatment?
Treatment for male infertility may include
medication (usually hormones or antibiotics) or
surgery. Possible treatments include taking
hormones for a hormone imbalance, taking drugs to
stimulate sperm production, and taking an
antibiotic to clear up an infection.
Other possible treatment includes avoiding
long, hot showers and frequent use of hot tubs and
saunas and wearing boxer shorts rather than jockey
shorts. Therapy may be needed to treat ejaculation
problems, or surgery may be necessary to correct a
disorder in the testicles or to remove a blockage
of the tubes that carry the sperm.
If the patient’s sperm count is low, artificial
insemination or vitro fertilization may be
options.
Self-care tips
Diagnosis and treatment for male infertility
can be stressful and put an unusual strain on the
patient’s relationship with his partner. A doctor
may recommend counseling to help the couple get
through any difficult times.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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