Approximately one in six couples who are trying to conceive will experience some form of infertility. In about one third of cases, the problem is a form of female factor infertility, while in another third, male infertility is the issue. The remaining couples either have a combination of male- and female-based fertility problems or have infertility that is unexplainable.

Common causes of and treatments for male infertility

Like female infertility, male infertility can be caused by a wide range of factors, including:

Varicocele

A varicocele is a varicose vein in the scrotum. Because the excess blood that pools and backs up in the vein causes overheating, it can diminish the number and quality of sperm cells that are produced. Although we do not treat varicoceles at the Center for Reproductive Medicine, this common cause of male infertility can be easily diagnosed during a physical examination by a urologist and can be corrected surgically.

Physical irregularities

A blocked or missing vas deferens or epididymis is another potential cause of male infertility. This problem is usually indicated by a semen analysis in which the sperm count is very low or there is no sperm at all. However, as long as sperm is still being produced, it can be collected directly from the testicles for use during in vitro fertilization (IVF).

Hormonal imbalances

Gland malfunctions, genetic conditions or unhealthy body weight can all lead to a hormonal imbalance that interferes with sperm production and causes male infertility. Blood tests are used to diagnose hormonal imbalances, and treatment may involve medication or lifestyle changes.

Environmental and lifestyle factors

Because new sperm cells are constantly being produced, the number and quality of sperm are easily affected by environmental exposure and poor health choices. Smoking, heavy alcohol consumption, certain medications, infections, exposure to toxins and anything that causes prolonged overheating of the testicles can cause temporary male infertility. Fortunately, the effects can usually be reversed by eliminating these factors.

Many of these conditions are relatively common and can be easily treated or overcome with assisted reproductive technology.

Diagnosing male infertility

Even if there is a known cause of infertility in the female partner, we recommend that the male partner undergo fertility testing as well to be sure that there are no contributing factors before proceeding with treatment. Screening procedures for male infertility are relatively simple and non-invasive. The initial test is a semen analysis, which will indicate if there are any potential issues that require further testing.

Semen analysis

Once a semen sample has been collected, either in our office or at home, it will be examined for volume and consistency, as well as sperm count, motility and morphology.

Sperm count is the concentration, or number of sperm per milliliter of semen. Normal sperm concentration is considered anything above 20 million sperm per milliliter. Low sperm count can indicate problems with production, caused by physical, hormonal or environmental influences. A complete lack of sperm (azoospermia) is generally caused by a blockage, but it can also be a symptom of certain rare genetic conditions.

The motility and morphology (movement and shape) of the sperm are also major markers of male infertility. If high numbers of sperm are abnormally shaped or do not move properly, it usually indicates a problem with the production of sperm.

Since sperm quantity and quality can fluctuate, we recommend that more than one semen analysis be conducted for greater accuracy. If the results are consistently normal, male infertility can be ruled out. If the results are abnormal, other tests may be conducted to determine the source of the problem.

Physical examination

A basic physical examination involves the inspection of the male reproductive organs by a urologist or male infertility specialist. Your physician will look for irregularities in the shape, size, position or density of your organs. If necessary, an ultrasound may also be performed to evaluate the internal structures as well.

Blood tests

Depending on the results of your semen analysis, blood tests may also be conducted to check for hormonal imbalances or certain genetic conditions. Because these causes of male infertility are less common than others, this testing won't necessarily be performed unless other indications are present.