Male Infertility

Infertility isn’t just a woman’s problem.

Infertility is more common than many people realize, and it affects both women and men. One in eight couples has trouble getting pregnant or sustaining a pregnancy, meaning they have trouble conceiving a child after one year if unprotected sex, and about one-third of infertility is attributed to the male partner.

What could be wrong?

Male fertility problems can be caused by many different factors. Men often have pituitary or other hormone problems that can affect both fertility and general life. There are inherited problems like varicose veins in the scrotum, cysts in the prostate or chromosome problems, many of which can be reversed. There also are inherent testis abnormalities that may not be fixable but can be treatable.

How are men tested?

The first test should be a good semen analysis that needs to include information on what the semen looks like, which also provides information on the function of the prostate and accessory glands. It also should include sperm count motility and morphology (shape). If all of these results are normal, you may be fine. However, there is a lot of overlap between normal and not. If you are part of an infertile couple or have problems with fatigue, reduced sexual interest or testis discomfort, consult a reproductive specialist.

What conditions can contribute to abnormal semen analyses?

  • Varicoceles, a condition in which the veins on a man’s testicles become enlarged and cause them to overheat, which can affect the number and shape of sperm. Ten to 15 of every 100 men have a varicocele.
  • Medical conditions or exposures such as diabetes, cystic fibrosis, trauma, infection, testicular failure, or treatment with chemotherapy or radiation.
  • Unhealthy habits such as heavy alcohol use, testosterone supplementation, smoking, anabolic steroid use and illicit drug use.
  • Environmental toxins including exposure to pesticides and lead.

Is it possible to have children after a vasectomy?

Yes, it can be possible with a vasectomy reversal, which reconnects the pathway for the sperm to get into the semen. Most often, the cut ends of the vas are reattached. In some cases, the ends of the vas are joined to the epididymis. When the tubes are joined, sperm can again flow through the urethra.

When should I see a doctor?

  • If you have been trying to conceive for at least one year and you are under 35.
  • If you are over 35 and have been trying for six months.