Infertility

Overview

Conceiving a child is something that most of us take for granted. But almost one in five couples has difficultly conceiving within one year of unprotected sexual intercourse. The issue is due to female infertility about 40 percent of the time and male infertility about 40 percent of the time. The remaining 20 percent of the time, issues with both partners likely contribute to the infertility.   

Education/General Information

The most common cause of male infertility is the inability to produce fully functional sperm. Male infertility may also be caused by abnormalities in the testes or other areas of the male reproductive tract, as well as by immune system defects. Fortunately, many diagnostic tests are available to help determine the causes of male infertility. An initial screening of the male partner should be performed whenever a couple complains of infertility.

Your doctor will examine you for factors that may lead to infertility, including possible structural defects in the reproductive system, hormonal deficiencies, illness or even trauma that might be impairing your fertility. The most common possible causes are:

• Varicocele, a condition in which the veins surrounding the testicles become swollen and dilated, reducing sperm count
• Infection of the prostate or epididymis
• Hormonal problems
• Genetic abnormalities that affect chromosomes and DNA strands
• Blockage of sperm flow
• Medication and treatment side effects

Diagnosis 

Diagnosis for male fertility begins with a medical history and physical exam. Your doctor will check your testicles, scrotum and prostate for obvious problems. Blood tests may also be done to evaluate hormone levels.

A semen analysis is used to evaluate the quality and quantity of your sperm. This helps detect factors that might impair the sperm’s ability to travel to the fallopian tubes or penetrate the egg’s protective covering. The semen analysis reveals sperm motility, sperm count and sperm shape.

Depending on the results of your physical exam and semen analysis, your doctor may perform other tests, including:

• Ultrasound to examine the state of the seminal vesicles
• Antibody testing to determine whether the man or woman produces antibodies to sperm that may destroy or immobilize them

Treatment

 Factors that decrease male fertility may be treatable with medication, hormones or surgery. The treatment depends on what is causing the fertility problem and may include the following:

• Treating infection in any part of the reproductive tract with antibiotics
• Improving sperm concentration through sperm washing
• Treating sperm antibodies
• Correcting hormonal problems through hormone therapy
• Varicoceles surgery
• Reversing vasectomy
• Clearing duct obstructions
• Treating ejaculation problems
• Timing intercourse during the “fertile window”

If these techniques fail, your doctor may recommend assisted reproductive options, such as intrauterine insemination (IUI), in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).

Diet and lifestyle changes may also improve fertility. These changes include:

• Stop smoking
• Reduce alcohol and drug use
• Avoid excessive heat for optimal sperm production
• Improve your diet
• Exercise regularly
• Limit caffeine
• Avoid environmental hazards, such as pesticides or solvents