It is estimated that approximately 15 percent of couples are not able to conceive a child even though they have had frequent unprotected sex for at least a year (infertile). Male infertility is a factor about half of the time.
Male infertility can be the result of many factors, including: blockages keeping sperm from getting out, low sperm count, immobile or misshapen sperm, genetic abnormalities, hormonal imbalances. Injury, chronic health problems, medication/drug use and illnesses can also play a role in male infertility.
It can be very frustrating and stressful when a couple cannot get pregnant and they want children. Fortunately, there are a number of treatments available when male infertility plays a role.
Symptoms of male infertility can include:
- Unable to cause a pregnancy.
- Erectile dysfunction, ejaculatory dysfunction
- Scrotal pain, swelling, or a lump
- Decreased body and/or facial hair
- Having an abnormal sperm count (lower number, high percentage of irregular sperm)
- You must produce healthy sperm. In order to do that, at least one testicle must be working properly and you must be producing the hormones necessary to trigger and maintain sperm production, including testosterone.
- Sperm has to be transported into the semen that is ejaculated out of the body in sufficient numbers. If sperm count is low, the sperm aren't able to find the egg. A low sperm count is considered less than 15 million sperm per mL, or 39 million per ejaculation.
- The sperm cells also must be able to move and be shaped correctly in order to find and penetrate an egg. This is known as motility (movement) and morphology (shape).
Underlying Issues that Affect Male Fertility:
Celiac Disease: Sensitivity to gluten can affect fertility. After being diagnosed, men can often improve their fertility by adopting a gluten free diet.
Duct Defects: The sperm ducts are tubes that carry sperm can be damaged by injury or illness, causing blockages.
Environment: Exposure to certain chemicals, pesticides, metals, or radiation/X-rays can negatively affect fertility. Heat to the testicles from frequent use of hot tubs or saunas, wearing tight clothing, and even working with a computer in your lap for long periods can overheat the testicles and reduce sperm count. Prolonged bicycle riding can cause testicle overheating as well as erectile dysfunction and prostatitis.
Genetic Factors: Men with cystic fibrosis may be born without sperm ducts. Klinefelter's syndrome (XXY) causes fertility problems as well as those with Kallmann's, Kartangener's and Young's syndromes.
Hormones: Imbalances in hormones can negatively affect fertility. Problems with the adrenals, hypothalamus, pituitary, thyroid or testicles can be an underlying cause of infertility. These can be from tumors or other problems.
Infection: Bacterial and viral infections, including mumps (mumps orchitis), prostatitis (prostate infection), and the sexually transmitted diseases chlamydia and gonorrhea can affect sperm production or cause blockage of sperm.
Drugs/Medications: Chemotherapy, antifungal medications, ulcer drugs, testosterone replacement therapy and steroid use can all decrease fertility. Marijuana, tobacco, cocaine, alcohol and steroids can all reduce sperm quantity and quality.
Physical Factors: Erectile dysfunction, hypospadias, premature ejaculation, painful intercourse, Peyronies' disease. Obesity can decrease fertility.
Psychological Factors: Relationship or psychological problems that interfere with having intercourse and reaching orgasm will negatively affect male fertility. Emotional stress can also reduce sperm quantity.
Retrograde Ejaculation: When semen goes into the bladder instead of out of the penis during an orgasm. Diabetes, medications, surgery of the bladder, prostate or urethra, and spinal injuries can also cause retrograde ejaculation.
Sperm Antibodies: Some men can develop antibodies (immune cells) that attack sperm causing infertility.
Undescended Testicles: Normally, the testicles descend down into the scrotum from the abdomen during infancy. Failure of one or both of the testicles to descend can negatively affect fertility.
Varicoceles: Basically a varicose vein in the veins that drain the testicles. These tend to keep the testicles too warm which reduces sperm count and motility. Dr. Fleming can often surgically correct varicoceles increasing your sperm quality.