Male Infertility

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Upset black couple with negative pregnancy test at home

Solutions if You Can’t Become Pregnant

If you’re unable to conceive after a year of trying, there’s a good chance you’ll still be able to bear a child. Read about the causes of infertility and how your urologist may help.

Overview

What is Male Infertility?

Infertility – the inability to conceive a child after one year of regular, unprotected intercourse – affects about 20% of couples, with 30% to 50% of cases stemming from male-related problems. However, a diagnosis of infertility is not necessarily a verdict of sterility: only 1% to 2 % of infertile couples are actually sterile, and half of those who seek help can eventually bear a child.

Symptoms

What are the symptoms of Male Infertility?

There are typically no symptoms that a man may notice. The diagnosis is typically made after appropriate testing.

Cause

What causes Male Infertility?

There are many causes for male infertility, but a significant number of cases have no defined cause. Possible causes include hormonal problems, blockages, varicocele (dilated veins around the testicle), undescended testicle as a child, tumors (in the testicle or pituitary gland), retrograde ejaculation (sperm going into the bladder rather than exiting the penis), low sperm count, low sperm motility, or genetic causes.

Temporary causes include prolonged exposure to heat or to chemicals or medications. Several diseases also are linked to male infertility, including colitis, diabetes, multiple sclerosis/spinal cord injury, mumps, and cancer.

Diagnosis

How is Male Infertility diagnosed?

Because evaluations of men tend to be noninvasive and easier than those of women, the male partner is usually evaluated first.

What to know before your visit to MidLantic Urology in Philadelphia and surrounding counties:

History and physical examination are very important. The doctor will take a history of both the male and female with regards to previous pregnancies, hormonal problems, menstrual regularity, and overall medical health.
Social habits that may affect male infertility, such as smoking or the use of marijuana, will be discussed.
For the male, physical examination will focus on the size and consistency of the testicles, the vas deferens, the epididymis and the surrounding structures.

Other tests that may be performed during or after your visit:

Testing for male infertility will almost always include a semen analysis – this usually needs to be performed in a specialized laboratory. Due to the variability of semen samples, two specimens are usually required.
Urinalysis to check protein and sugar levels. Abnormal measurements of these substances can indicate diabetes or kidney disease.
Blood work may be ordered to assess the testosterone level and pituitary gland hormones.
If a varicocele is suspected, an ultrasound of the scrotal structures may be obtained.
Biopsy to determine if semen is being trapped in the testicle.

Treatment

How is Male Infertility treated?

NON-SURGICAL TREATMENT

There are no FDA approved medications to improve sperm counts or sperm movement. Patients should focus on a healthy lifestyle – low fat diet and exercise with the avoidance of excessive caffeine and alcohol will be stressed. The elimination of marijuana will be recommended. If specific hormone abnormalities are detected, these may be treated with medications. Antibiotics may be prescribed to treat infections in the reproductive tract.

SURGICAL TREATMENT

Surgical treatments will focus on correcting underlying abnormalities which may include:

Varicocele: These are dilated varicose veins, located above one or both of the testicles, that can impede semen production. The physician can treat this condition through small incisions above the scrotum.
Obstructed vas deferens (the sperm-carrying tubes): This is often the result of a vasectomy, trauma or surgery. The physician removes the scarred segment and reattaches the two ends of the vas deferens with sutures.
Obstructed ejaculatory duct: The physician reopens the passage for sperm.
Cryptorchidism: When one or both of the testicles has not descended, the physician can surgically lower the testicle into the scrotum. Results are best when performed early in life.
Vasectomy reversal: In patients who have undergone a vasectomy, a vasectomy reversal or sperm extraction procedure may be offered in conjunction with IVF (in vitro fertilization). If you have a severe compromise of testicular function with no sperm in the semen sample, your physician may recommend sperm retrieval by a surgical testicular biopsy.