is defined as the failure of a couple to become pregnant after 1
year of regular, unprotected, sexual intercourse. This period of
time is often shortened to 6 months when the female is over thirty-five
years old. Infertility occurs in approximately 11% of couples at
some time in their reproductive lives. Infertility is not "just
a female problem" as there is a male infertility component
in approximately 50% of couples.
causes male infertility?
Sperm Count, Irregular Motion, Shape
often a man is sub fertile because he produces too few (or no) sperm,
the sperm might be shaped irregularly, swim erratically, or have
a genetic defect. There are many medical and environmental causes
of male sub fertility.
disorders of the pituitary gland, testicles, thyroid glands, or
adrenal glands can cause decreased sperm count (or absent sperm).
Infections of the male reproductive tract cause inflammation and
can damage the vas deferens (tubes that transport the sperm). Severe
mumps as an adolescent can lead to reduced sperm count as an adult.
scrotum performs a temperature regulating function for the testicles.
When the temperature needs to be lowered, the scrotum expands moving
the testicles farther away from the body. Conversely, when the temperature
needs to be increased, the scrotum contracts pulling the testicles
closer to the body.
activities, such as constantly wearing tight jockey shorts or frequent,
long, hot baths may interfere with the scrotum's temperature regulating
function. Occupations, such as a long distance truck driver, where
a man sits for long periods of time can also lower sperm counts.
is another common cause of poor sperm production and motility. A
varicocele is a dilated vein leading to the testicles. When these
veins are dilated, they cannot perform their "heating and cooling"
function in conjunction with the scrotum. A varicocele that is believed
to contribute to a man's infertility is often treated surgically
by a urologist.
to certain toxic chemicals or radiation can also interfere with
sperm production and development. Additionally, it has been shown
that smoking, excessive alcohol use, and "recreational"
drug use can negatively affect sperm count. There are also genetic
disorders that affect sperm production.
must be delivered into the vagina (ejaculation). Ejaculatory problems
include early ejaculation, retrograde ejaculation (semen forced
back into the bladder), or the inability to maintain an erection.
This condition can be a side effect of some medications or can be
caused by Peyronie's disease. It can also be a complication of radiation
therapy or surgery.
is Male Infertility Diagnosed?
couples that are trying to conceive should have a complete infertility
evaluation. In the male, this includes a semen analysis, medical
history, family history, etc. In addition to a semen analysis, the
physician may order blood tests to rule out sexually transmitted
diseases or hormonal imbalances.
is Male Infertility Treated?
fist step is to eliminate all negative environmental factors, such
as long hot baths, smoking, excessive drinking, recreational drug
use, etc. Other treatments might include hormonal therapy, antibiotics
for infections, or surgery to repair a varicocele.
If the sperm count is low but not too critically low, intrauterine
insemination (IUI) may be an option.
on the number of sperm contained in each ejaculate, the sperm can
be collected at several different times and stored as frozen sperm
until there is a sufficient quantity. They are then combined, specially
washed and prepared, and placed directly in the partner's uterus
using a small catheter ("unwashed" or "unprepared"
sperm must never be placed in the uterus as serious allergic reactions
cases of severe sperm abnormalities, a sperm donor may be considered.
There are several sperm banks that allow couples to pick donors
(from photographs) that match the husband's physical characteristics.
vitro fertilization (IVF) is also an option. During an IVF cycle,
the female receives medications to stimulate the development of
multiple eggs. These eggs are retrieved transvaginally and combined
with the male's sperm in a petri dish. After incubation to maturity,
the resultant embryos are transferred to the mother's uterus.
techniques, such as intracytoplasmic sperm injection
(ICSI), allow men with extremely low sperm counts to father
children by artificially injecting a single sperm into the cytoplasm
of the egg. In the TESA procedure, a single sperm is withdrawn from
the reproductive tract and inserted directly into the egg with ICSI.
can be done to help prevent male infertility?
not be possible to prevent infertility resulting from genetic problems
or an illness. However, there are some precautions that can be taken:
The best news is that even severe male infertility is usually treatable
with assisted reproductive technologies such as intracytoplasmic
sperm injection and IVF.
- Prevent sexually transmitted diseases by using latex condoms
and having sex only with your partner.
- Limit alcohol intake.
- Do not use street drugs (such as heroin, cocaine, or marijuana)
or overuse prescription and/or nonprescription drugs.
- Avoid exposure to toxic substances such as industrial chemicals,
herbicides, and pesticides.
- Maintain good personal hygiene and health practices.
- Avoid long, hot tub baths and wearing jockey shorts.