Infertility is defined as the inability for a couple to conceive a pregnancy after one year of appropriate timed intercourse. When the woman is older than 35 years old, the evaluation of the couple may begin sooner. Approximately 50% of infertility may be attributed to the male.
There are typically no symptoms that a man may notice. The diagnosis is typically made after appropriate testing.
There are many causes for male infertility, but a significant number of cases have no defined cause (idiopathic). 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), or genetic causes.
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.
Surgical treatments will focus on correcting underlying abnormalities. These may include varicocele surgery if a varicocele is detected. In patients who have undergone a vasectomy, a vasectomy reversal or sperm extraction procedure may be offered in conjunction with IVF (in vitro fertilization). Patients who have a severe compromise of testicular function with no sperm in the semen sample may have sperm retrieval by a surgical testicular biopsy.
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