What is male infertility?
Infertility is a disease of the reproductive system. It makes a person unable to have children. It can affect a man, a woman or both. Male infertility means that a man has a problem with his reproductive system. It means you can't start a pregnancy with your female partner.
What causes male infertility?
Natural male reproduction depends on several things.
You must be able to:
Make healthy sperm that can fertilize the egg
Have an erection and ejaculate so the sperm reaches the egg
Problems with either of these may mean you have infertility. Below are some of the main causes of male infertility.
Problems with making healthy sperm are the most common causes of male infertility. Sperm may be immature, abnormally shaped or unable to swim. In some cases, you may not have enough sperm. Or you may not make any sperm. This problem may be caused by many different conditions, including:
Infections or inflammatory conditions. One example is infection with the mumps virus after puberty.
Hormone or pituitary gland problems
Immune problems in which you make antibodies against your own sperm
Environmental and lifestyle factors. These include tobacco use, heavy alcohol use, marijuana or steroid use or exposure to toxins.
Genetic diseases, such as cystic fibrosis or hemochromatosis
Anything that blocks the genital tract can stop the flow of semen. This could be a genetic or birth defect. Infection or inflammation from a sexually transmitted disease can also block semen. Other causes include scar tissue from surgery or twisted, swollen veins in the scrotum.
Other factors may include erectile dysfunction or premature ejaculation. Liver or kidney disease, or treatment for seizure disorders are examples of problems that can cause infertility.
Who is at risk for male infertility?
You may be more likely to have male infertility if you have had:
Past inflammation of the prostate or past genital infections
Injury to or twisting (torsion) of the testicles
Early or late puberty
Genital exposure to high temperatures
You may also be at risk if you take certain prescription medicines. These include medicines for ulcers, psoriasis, depression and high blood pressure.
What are the symptoms of male infertility?
You may have male infertility if your female partner has not become pregnant after you have tried for 1 year. This means 1 year of regular sex without any birth control.
Your healthcare provider will test both you and your partner to find the cause of infertility.
How is male infertility diagnosed?
Your healthcare provider will review your health history and do a physical exam. Other tests for male infertility may include:
Sperm count (semen analysis). At least 2 semen samples are taken on separate days. Your provider will check the semen and sperm for many things. These include how much semen you make, how uniform it is and how acidic it is. He or she will also look at how many sperm you make, how well they move and what shape they are.
Blood tests. Your provider may use blood tests to check hormone levels and rule out other problems.
Other tests. Your provider does these tests to find the cause of sperm defects or health problems of the male reproductive system. For instance, imaging tests such as an ultrasound may be used to look at your testicles, blood vessels and structures inside the scrotum.
Testicular biopsy. If semen analysis shows that you have only a few sperm or no sperm, your provider may remove a small piece of tissue (biopsy) from each testicle. The sample will be checked under a microscope.
How is male infertility treated?
Treatment depends on what is causing your infertility.
This treatment involves helping your partner get pregnant. This may be through:
Artificial insemination. This method puts many healthy sperm at the entrance of the cervix or right into the partner's uterus. The sperm can then make their way to the fallopian tubes.
IVF, GIFT and other methods. In vitro fertilization (IVF) and gamete intra-fallopian transfer (GIFT) work like artificial insemination. Your provider collects your sperm. Then he or she mixes your partner’s eggs with a lot of high-quality sperm. He or she may mix the eggs and sperm in the lab or in your partner’s fallopian tube.
Intracytoplasmic sperm injection (ICSI). Your provider injects a single sperm into an egg. Fertilization then takes place under a microscope. Your provider puts the fertilized egg in your partner’s uterus.
Hormone treatment may help you if you have a hormone disorder causing your infertility. Hormone imbalances can affect how sperm develop. They may be caused by a problem in how the hypothalamus, pituitary gland and testes interact. Treatment may include gonadotropin therapy or antibiotics.
Your provider may use surgery to fix problems that keep sperm from being made, matured or ejaculated. Surgery to remove swollen veins in the scrotum (varicocele) can sometimes improve the quality of sperm. You may need surgery to reconnect or open blocked tubes that allow sperm to be ejaculated.
Check with your healthcare provider about any questions or concerns you have about your condition.