When a couple tries to conceive without success finding a reason is critical. The focus at that point typically shifts to the woman’s fertility. Is she ovulating? Might she have endometriosis? PCOS? What about her age?
These are all very valid concerns when a couple has trouble conceiving. If a couple is trying to conceive and they haven’t been successful after 12 consecutive months (six months for women over 35) it’s time for some answers. However, the male partner contributes half of the genetic material, so it makes sense to investigate male fertility as well.
In the US solely male factor infertility accounts for 20%-30%. Female factor makes up about 50% and the remaining 20%-30% are a combination or there is no known cause. No matter the root cause of your infertility, the diagnosis is no less heartbreaking. But there are ways to overcome your infertility and grow your family as you intend.
Male infertility has a few different causes. Getting to the root of the cause is the first step in treatment so that you and your partner can grow your family. First, let’s take a look at the process of male reproduction.
In order to conceive, a man must:
- Produce healthy sperm able to fertilize the woman’s egg.
- Maintain an erection and ejaculate so that the sperm reaches the egg.
When a problem with either of these steps occurs, natural pregnancy cannot take place. Here we examine the most common causes of male infertility.
Sperm disorders are among the most common causes of male infertility. Sperm has quite a job. They need to be plentiful enough and strong enough that they reach the egg which awaits fertilization in the fallopian tube. They need to navigate their way through the vagina and cervix and into the uterus into the fallopian tubes. You lose many swimmers along the way so if you don’t ejaculate enough sperm the opportunity for fertilization diminishes. Various conditions cause disorders affecting sperm, such as:
- Hormone or pituitary gland issues
- Chronic conditions and immune disorders which cause your body to make antibodies which attack your own sperm,
- Inflammatory conditions or infections after puberty such as the mumps,
- A prolonged high fever
- Sexually transmitted infections including HIV or gonorrhea,
- Cystic fibrosis or hemochromatosis
- Sickle Cell Disorder
- Lifestyle and environmental factors. These include heavy alcohol or marijuana usage, tobacco use, steroids, recreational drug use and exposure to toxins.
In some cases, a man may not make any sperm at all. This condition, azoospermia happens for several different reasons including:
- Chemotherapy or radiation
- Recreational drug use, especially narcotics
- Absence of the vas deferens on both sides
- Varicoceles, essentially varicose veins within the scrotum
- Genetic condition such as Klinefelter syndrome. This occurs when a baby boy is born with an extra X chromosome which affects testosterone production, muscle mass, and facial and body hair growth.
A testicular or scrotal injury may cause sperm disorders as well.
Some men have a genetic or birth defect that causes a blockage in the genital tract and stops the flow of semen. This is a structural problem. Infection or inflammation from STIs also contribute to structural blockages. Scar tissue from surgeries or swollen or twisted veins in the scrotum may block the flow of semen.
Other Factors That Are Causes of Male Infertility
Certain medications may cause a temporary erectile dysfunction or a dip in sperm production. Premature ejaculation may also inhibit fertility. Liver or kidney disease may cause male infertility as well.
You may be at risk for male factor infertility if you experienced:
- Genital infections
- Prostate inflammation
- Testicular torsion, twisting of the testicles
- Hernia repair
- Undescended testicles
- Early or late puberty
- Exposure of the pelvic region to prolonged high temperatures
Diagnosing the Causes of Male Infertility
Diagnosing the causes of male infertility begins with your health history and a full physical exam by your physician. Additional tests may include:
- Semen analysis: Your physician examines your semen for sperm count, shape, and motility (movement). They also assess the amount of semen, acidity, and uniformity. Your physician uses semen for two samples taken on different days.
- Testicular biopsy: If your semen analysis confirms low or no sperm your doctor takes a small sample of tissue from each testicle to evaluate testicular health.
- Hormone levels: Your doctor uses a blood test to check the levels of your reproductive hormones.
- Ultrasound: an ultrasound of your reproductive system checks for structural issues and blockages as well as blood vessel health.
Treating Male Factor Infertility
Male factor infertility is treatable in most cases. Depending on the causes of your male infertility, treatment includes:
- Hormone therapy: If your hormones are the cause of male infertility, your doctor determines the reason for the imbalance and treats you using hormones such as gonadotropin. In the case of an infection, your doctor includes antibiotics too.
- Surgery: In the case of a physical issue such as a varicocele or structural blockage your doctor may suggest surgery to get your semen flowing as normal.
- Artificial insemination: The doctor identifies healthy sperm and places these sperm directly into your partner’s cervix.
- Intra-uterine insemination (IUI): The doctor inserts a thin catheter through your partner’s cervix, directly into the uterus. Then your physician deposits your healthiest sperm directly into the uterus for a better chance to reach the egg.
- IVF: The doctor mixes your sperm with your partner’s egg in a laboratory setting. When fertilization occurs, the lab observes embryo(s) to ensure healthy growth. Your physician places the healthy embryo into the uterus, so the embryo implants and grows.
If you’re concerned about male infertility, contact LA IVF for more information. Our staff of experts in fertility and reproductive medicine help you find a way to overcome infertility and grow your family. Please reach out to LA IVF today.