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Infertility

Infertile is the term used for couples who are unable to become pregnant after at least a year of attempts. A 2007 article by the Mayo Clinic estimates that 10 percent to 15 percent of couples in the United States are infertile.

Pregnancy results from a sequence of events, and infertility can be a complex problem with no single obvious cause. The problem can lie with either partner or may have multiple causes, so it is important that both partners be evaluated in order to develop an effective treatment plan.

For more information visit our infertility expert at Dr.Shep.com.

Causes

In most cases, male infertility is due to low sperm count or abnormal sperm production, which can result from low testosterone, genetic defects or infection. Men with undescended testicles or varicose veins in the scrotum may have sperm production impaired by the resulting higher temperature in the testicles.

Infertility can also result from problems delivering the sperm into the vagina. This may be caused by problems with sexual intercourse or by a physical defect, such as a misplaced urinary opening, blockage in the testicles or sperm-carrying ducts that are missing or blocked. A variety of conditions can cause retrograde ejaculation, in which semen enters the bladder rather than emerging from the penis. Disease or injury to the spinal cord may cause inability to produce semen, and vasectomy occasionally results in production of antibodies that weaken or disable sperm.

Your age, lifestyle and general state of health also affect your fertility. Injury, disease and some surgeries and treatments can impair male fertility. Fertility can also decline due to aging, stress, obesity or nutritional deficiency. Smoking, abuse of drugs and alcohol or exposure to some chemicals can impair your general health and have an adverse effect on fertility. 

Diagnosis

Treating infertility requires evaluation of both partners. You should see a urologist and your partner should consult her gynecologist. Because infertility presents a complex problem, the assessment can require time, a number of tests and a certain amount of trial and error.

Your doctor will probably begin with a thorough physical exam and discussion of your medical history and sexual habits. A blood test will be done to determine the level of testosterone and other male hormones as well as the possibility of genetic causes. One or more semen samples will also be analyzed for quality and quantity of sperm and to detect any presence of blood or infection. Ultrasound may be used to reveal problems, such as obstructions or retrograde ejaculation. 

Treatment

Treatment of male infertility varies, depending on what cause is found. You may be advised to make lifestyle changes, including changing the frequency of intercourse. 
Medication or surgery may be used to correct physical problems, such as low sperm count, that interfere with fertility. If abnormal semen is found, technological methods may be used to bring egg and sperm together. These include artificial insemination and in vitro fertilization.

FAQ

Is male infertility a common problem?
Male infertility and female infertility are equally common. For every five couples dealing with infertility, the primary cause will be male infertility in two cases, female infertility in two cases and a combination of both in one case. That is why both partners must be involved in the attempt to diagnose and treat infertility.

What are some steps I can take to help improve my fertility?
Life style changes that improve your general health can also decreases chances of infertility. These include:

  • Not smoking or using recreational drugs
  • Decreasing consumption of alcohol
  • Getting regular exercise
  • Maintaining a healthy weight
  • Reducing stress
  • Taking a vitamin supplement

In addition, you should avoid overuse of hot tubs and saunas that can raise the temperature inside the scrotum, and avoid lubricants during intercourse.

I had a vasectomy, and now would like to have it reversed. Is this a reasonable option?
Although this procedure is not always successful, vasectomy reversal is often the best option for couples who wish to have a baby after the man has had a vasectomy. When successful, it can allow natural conception, which is the least invasive and least costly way of becoming pregnant.