Male Infertility

male-fertility

Overview

Nearly 1 in 7 couples is infertile, which means they haven't been able to conceive a child even though they've had frequent, unprotected sexual intercourse for a year or longer. In up to half of these couples, male infertility plays at least a partial role.

Male infertility can be caused by low sperm production, abnormal sperm function or blockages that prevent the delivery of sperm. Illnesses, injuries, chronic health problems, lifestyle choices and other factors may contribute to male infertility.

The inability to conceive a child can be stressful and frustrating, but a number of treatments are available for male infertility.

Symptoms

The main sign of male infertility is the inability to conceive a child. There may be no other obvious signs or symptoms.

In some cases, however, an underlying problem such as an inherited disorder, hormonal imbalance, dilated veins around the testicle or a condition that blocks the passage of sperm causes signs and symptoms. Signs and symptoms you may notice include:

  1. Problems with sexual function — for example, difficulty with ejaculation or small volumes of fluid ejaculated, reduced sexual desire, or difficulty maintaining an erection (erectile dysfunction)
  2. Pain, swelling or a lump in the testicle area
  3. Recurrent respiratory infections
  4. Inability to smell
  5. Abnormal breast growth (gynecomastia)
  6. Decreased facial or body hair or other signs of a chromosomal or hormonal abnormality
  7. A lower than normal sperm count (fewer than 15 million sperm per milliliter of semen or a total sperm count of less than 39 million per ejaculate)

When to see a doctor

See a doctor if you have been unable to conceive a child after a year of regular, unprotected intercourse or sooner if you have any of the following:

  1. Erection or ejaculation problems, low sex drive, or other problems with sexual function
  2. Pain, discomfort, a lump or swelling in the testicle area
  3. A history of testicle, prostate or sexual problems
  4. A groin, testicle, penis or scrotum surgery
  5. A partner over age 35

Causes

Male fertility is a complex process. To get your partner pregnant, the following must occur:

  1. You must produce healthy sperm. Initially, this involves the growth and formation of the male reproductive organs during puberty. At least one of your testicles must be functioning correctly, and your body must produce testosterone and other hormones to trigger and maintain sperm production.
  2. Sperm have to be carried into the semen. Once sperm are produced in the testicles, delicate tubes transport them until they mix with semen and are ejaculated out of the penis.
  3. There needs to be enough sperm in the semen. If the number of sperm in your semen (sperm count) is low, it decreases the odds that one of your sperm will fertilize your partner's egg. A low sperm count is fewer than 15 million sperm per milliliter of semen or fewer than 39 million per ejaculate.
  4. Sperm must be functional and able to move. If the movement (motility) or function of your sperm is abnormal, the sperm may not be able to reach or penetrate your partner's egg

Risk Factors

A number of risk factors are linked to low sperm count and other problems that can cause low sperm count. They include:

  1. Smoking tobacco
  2. Drinking alcohol
  3. Using certain illicit drugs
  4. Being overweight
  5. Being severely depressed or stressed
  6. Having certain past or present infections
  7. Being exposed to toxins
  8. Overheating the testicles
  9. Having experienced trauma to the testicles
  10. Being born with a fertility disorder or having a blood relative, such as your brother or father, with a fertility disorder
  11. Having certain medical conditions, including tumors and chronic illnesses
  12. Undergoing cancer treatments, such as radiation
  13. Taking certain medications
  14. Having a prior vasectomy or major abdominal or pelvic surgery
  15. Having a history of undescended testicles
  16. Taking certain medications or undergoing medical treatments, such as surgery or radiation used for treating cancer

Prevention

To protect your fertility, avoid known factors that can affect sperm count and quality. For example:

  1. Don't smoke.
  2. Limit or abstain from alcohol.
  3. Steer clear of illicit drugs.
  4. Talk to your doctor about medications that can affect sperm count.
  5. Maintain a healthy weight.
  6. Avoid heat.
  7. Manage stress.
  8. Avoid exposure to pesticides, heavy metals and other toxins.