OVERVIEW
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.
Symptoms
There are typically no symptoms that a man may notice. The diagnosis is typically made after appropriate testing.
Causes
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.
Diagnosis/Evaluation
- What to know before your visit:
- 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.
- 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.
Treatment
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.
SURGICAL TREATMENT
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.
Schedule an appointment with a MidLantic Urology physician near you today!